Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study utilized data from the 1981 and 1985 National Ambulatory Medical Care Surveys to study dizziness, a frequently troublesome patient problem in family practice. These data indicate that family physicians and general practitioners see nearly 45% of all outpatients with dizziness. In primary care practices (family physicians, general practitioners, and general internists) the frequency of dizziness as a presenting complaint rises steadily with age, so that nearly 7% of patients aged 85 years and older present with that symptom. Women complain of dizziness more frequently than men, with this relationship being particularly prominent in older age categories. According to primary care physicians who gathered data for the 1981 and 1985 surveys, dizziness was the principal reason for visit (chief complaint) of 2.61% of patients aged 25 years and older (531 recorded encounters). Of these patients, 66.7% were women; 1.5% were hospitalized; 4.4% were referred to specialists; and 89.3% left with a drug prescription. Hypertension was the most frequent diagnosis recorded among these patients who complained of dizziness. Several of the most common diagnoses recorded for these visits (hypertension, diabetes, unspecified dizziness, and coronary arteriosclerosis) differ from common causes of dizziness reported by specialty clinics.
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PMID:Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. 273 48

Over a 14-month period in the outpatient department of a geriatric hospital, 7 female patients over 75 years of age were identified with tardive dyskinesia associated with the use of thiethylperazine. The indication for thiethylperazine treatment had been vertigo or dizziness. 3 of the patients also had symptoms related to cerebral arteriosclerosis and 2 had mild Parkinson's disease without levodopa therapy. None of them were markedly demented nor had chronic psychosis. Tardive dyskinesia appeared after a treatment period of 3 weeks to 6 years. These findings suggest that association of tardive dyskinesia with the use of thiethylperazine is not uncommon in geriatric outpatients.
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PMID:Thiethylperazine and tardive dyskinesia. 650 47

The Aschner and Czermak-Hering tests were carried out in 7 normal young males and 15 elderly patients with cerebral arteriosclerosis. Alterations in the heart rate, blood pressure and blood flow in the internal carotid artery and brachial artery were studied by means of the on-line Doppler ultrasonic apparatus before, during and after the maneuvers, simultaneously and continuously. Aschner Test. Bradycardia, biphasic alteration of blood pressure, increase of blood flow in the internal carotid artery and decrease of blood flow in the brachial artery were observed in the maneuver. The changing rate of the findings was diversified individually. However, no significant difference was observed between the normal young males and the elderly patients. Side effects consisted of slight and transient nausea and dizziness in 6 subjects. Czermak-Hering Test. Bradycardia, hypotension, and decrease of blood flow in the brachial artery were observed in the maneuver. The changing rate of the findings is more conspicuous in the elderly patients than in the normal young males. Alterations in the blood flow in the internal carotid artery were observed. There was a conspicuous increase of the blood flow in the internal carotid artery on the noncompressed side during the maneuver in all the normal young males and in half of the elderly patients. The remainder of the elderly patients showed either no alteration or decrease of the blood flow in the internal carotid artery on the noncompressed side. Slight nausea in 2 subjects, slight dizziness in 5 subjects, and moderate disturbance of consciousness in 1 subject were observed as side effects. The results indicate that the Czermak-Hering test will be more advantageous in investigating the autonomic nervous function (vasovagal reflex) and autoregulation of cerebral circulation in elderly subjects.
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PMID:Circulatory response in Aschner and Czermak-Hering tests, with special reference to cerebral circulation. 721 84

Carotid sinus hypersensitivity (CSH) is recognised in up to 45% of elderly patients with syncope, falls, and dizziness that may not be attributed to specific myocardial sinus node dysfunction, various diseases that affect pacemaker activity, cardiac output and blood supply to the brain. The pathophysiology of CSH is unclear but it is associated with ageing, hypertension, and ischaemic heart disease. CSH is potentially treatable with dual chamber pacing for prolonged sinus arrest (cardio-inhibitory CSH) but therapy for the more prevalent hypotension (vasodepressor CSH) is unsatisfactory. However, hypersensitivity of the carotid sinus is not consistent with the known blunting effects of senescence and hypertension on baroreflex sensitivity. The present hypothesis proposes that CSH in elderly patients results from up-regulation of brainstem postsynaptic alpha-2 adrenoceptors. Reduced carotid sinus compliance in elderly arteriosclerotic hypertensive patients will reduce afferent impulse traffic in the baroreflex pathway. Such relative deafferentation may be expected to cause baroreflex postsynaptic hypersensitivity, mediated by up-regulation of the dominant postsynaptic receptor population in the baroreflex pathway, ie, alpha-2 adrenoceptors. Vigorous carotid sinus stimulation, eg, massage, could thus cause an overshoot baroreflex efferent response, resulting in profound hypotension and bradycardia. Hypotension and bradycardia are compounded by the effects of age, hypertension, ischaemic heart disease and arteriosclerosis on rapid cardiovascular compensation, resulting in cerebral hypoperfusion and syncope. Thus CSH in elderly patients should be considered as a clinical marker of widespread arteriosclerotic disease, rather than as a distinct disease entity. If correct, this hypothesis has potentially important implications for the pharmacotherapy of hypotension-related symptoms in elderly arteriosclerotic patients.
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PMID:Pathophysiology of carotid sinus hypersensitivity in elderly patients. 756 34

Spin-echo magnetic resonance imaging (MRI) was evaluated to 530 cases in order to investigate the clinical, significance of pontine high signals. The subjects comprised 109 cases of pontine infarction with high signal on T2-weighted image and low signal on T1-weighted image (PI group), 145 of pontine high signal with high signal on T2-weighted image but normal signal on T1-weighted image (PH group) and 276 of age-matched control without abnormality either on T1 or T2-weighted images (AC group). Subjective complaints such as vertigo-dizziness were more frequent in the PH group than in the PI group. In both PI and PH groups, periventricular hyperintensity as well as subcortical high signals in the supratentorium were more severe than in the AC group. These degrees were higher in the PI group than in the PH group. In conclusion, PH as well as PI may result from diffuse arteriosclerosis and PH is considered to be an early finding of pontine ischemia.
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PMID:[Clinical significance of pontine high signals identified on magnetic resonance imaging]. 825 23

We report a case with a unilateral sudden sensorineural hearing loss caused by an infarction of brainstem and cerebellum. The patient was a 74-year-old male presented with a sudden onset of hearing loss and tinnitus in the right ear and dizziness. Steroid was administered on suspicion of idiopathic sudden deafness. However, the initial symptoms were deteriorated approximately 2 weeks later. He newly complained of the numbness of the right face and double vision, and he was transferred to our hospital for further evaluation. Neurological examination demonstrated horizontal nystagmus, diminution in the right facial sensation, right peripheral facial palsy, right hearing loss and cerebellar ataxia. Urgent MRI disclosed fresh infarctions of the right middle cerebellar peduncle and cerebellum localized in the territory of anterior inferior cerebellar artery. In general, idiopathic sudden deafness and Meniere's disease are frequent diagnosis in cases of sudden hearing loss with vertigo, but these symptoms may rarely be caused by cerebrovascular disorder. In patients with risk factors for arteriosclerosis, cerebrovascular disorder should be taken into consideration even if idiopathic sudden deafness may be suspected clinically. We emphasize the diagnostic importance of careful observation on neurological findings and early detection of radiological abnormalities on MRI.
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PMID:[Unilateral sudden deafness as a primary symptom of brainstem and cerebellar infarction]. 1705 10

A certain family with a history of familial hypercholesterolemia (FH) in which several members suffered cerebral infarction (CI) for 3 successive generations is reported. The first case is a 54-year-old female who suffered from medial longitudinal fasciculus syndrome caused by a lesion on the pons. The second case is the son of the first case and is a 28-year-old male who suffered from left hemiparesis by a lesion on the corona radiata. The third case is the mother of the first case and is a 77-year-old female who suffered from dizziness as a result of cerebellar lacunae. All 3 patients showed a marked elevation of their serum cholesterol level without any apparent history of coronary heart disease (CHD). Our cases are peculiar and unique because the patients are of 3 successive generations who suffer from CI without any apparent history of CHD. Moreover, the latter generations are having CI at younger ages. The mechanism of CI was thought to be the occlusion of the arteriole by the increased viscosity associated with other risk factors rather than the apparent arteriosclerosis in our cases. Although FH is often associated with a high incidence of CHD, the information about the occurrence of CI has not always been available. The patients may suffer from CI more frequently than was previously thought. We hope to point out the need for such FH patients to be carefully monitored and to be treated as a high-risk group for CI as well as CHD.
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PMID:Familial hypercholesterolemia: a family who suffered cerebral infarction over three successive generations. 1790 64

This study compared the efficacy and long-term survival rate of trimetazidine and cilostazol in the treatment of lower extremity arteriosclerosis obliterans (ASO). A retrospectively analysis on the medical records of 206 patients with ASO who were admitted to The Central Hospital of Wuhan from January 2011 to May 2013 was performed, including 94 patients treated with trimetazidine (group A) and 112 patients treated with cilostazol (group B). On the basis of the same basic treatment, both groups were applied with these two drugs after two courses of treatments. Then the efficacy of clinical treatment, dorsal artery blood flow, anterior femoral artery, posterior tibial artery blood flow, brachial artery index, toe-brachial index, painless walking distance, maximum walking distance, adverse reactions, 5-year survival rates were compared. The total effective rate of clinical efficacy in group B was higher than group A (P<0.05). After the first course of treatment, the above indicators increased in both groups (P<0.05). After the end of the second course of treatment, the above-mentioned index values in both groups were significantly increased (P<0.05). The improvement of the above indicators in group B were better than the trimetazidine group in both the first and second treatment courses (P<0.05). In group A, there were 15 cases of patients with lethargy and hypodynamia and 9 cases of dizziness and headache. There were significant differences between the 7th and 3rd cases of patients when compared to group B (P<0.05). The 5-year survival rate of group A was lower than group B (P<0.05). The clinical efficacy of cliostazol in the treatment of ASO had a good effect, and there was only a few adverse reactions and the long-term survival rate was high. It is worthy of being promoted in clinical practice.
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PMID:Comparison of efficacy between trimetazidine and cilostazol in the treatment of arteriosclerosis obliterans in lower extremity. 3108 77