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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The high incidence of oto-vestibular complaints in patients presenting vertebro-basilar insufficiency (VBI) is emphasized. In some studies up to 90% of the patients are complaining from dizziness, oscillopsia or tinnitus. The indications of the oto-vestibular evaluation and its importance in the diagnosis of VBI is discussed. The authors lay stress on the fact that the Romberg test is not valuable as a vestibular functional screening test, but that only a full oto-vestibular evaluation will contribute to the diagnosis of VBI.
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PMID:[The contribution of oto-vestibular studies in the diagnosis of vertebrobasilar insufficiency--(VBI)]. 269 63

We initiated a prospective study of the dizzy patient to identify key factors on which a directed evaluation could be based. This study used a standardized history, physical examination, and basic laboratory evaluation totalling 66 items to assist collection of relevant clinical information on 125 patients. Diagnosis was based on the emergency physicians' diagnosis. This was modified when necessary based on one month of follow-up using diagnostic criteria adapted from previous studies. The most common disorder was some form of peripheral vestibular disorder, found in 54 patients (43%). These patients were typically vertiginous and were managed successfully as outpatients. Despite correlations with multiple factors, this diagnosis was best predicted by positive Nylen-Barany test with either vertigo, vomiting, or both with 94% specificity and 43% sensitivity. Potentially serious causes were identified, including medication-related, seizure, stroke, transient ischemic attacks, vertebral-basilar insufficiency, hypertension, pericarditis, arrhythmias, and all those requiring hospitalization. The best predictors, either older age, lack of vertigo, or neurologic deficit, could identify 86% of "serious" dizziness with 42% specificity. The following tests were of low yield and may be done in a directed manner based on a brief history: Valsalva, carotid stimulation, Romberg and Quix tests, mental status examination, complete blood count, serum electrolytes, and BUN. Our results do support routine testing of glucose in all patients and monitoring rhythm in patients age 45 and older. Such a directed approach could rapidly classify a significant number of dizzy patients and forego many time- and cost-intensive elements of provocative examination and laboratory testing.
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PMID:A directed approach to the dizzy patient. 272 92

In a follow-up study (performed in 1981) of patients who underwent endarterectomy because of arteriosclerotic carotid artery stenosis or kinking between 1962 and 1980, those cases were analyzed which did not suffer carotid ischemic attacks but were either asymptomatic or had uncharacteristic symptoms (like dizziness or syncopal attacks) or brain stem symptoms indicating vertebro-basilar insufficiency. In all of these patients EEG recordings were performed before operation. From a total group of 324 patients 44 had abnormal EEG findings. In these cases the incidence of surgical complications was somewhat higher as was the incidence of mortality and of strokes. Particularly in hemodynamically effective stenosis, mortality in the later course was higher in cases with pathologic EEG. Although an abnormal EEG cannot be regarded as an absolute contraindication for carotid surgery, these cases should be submitted to a thorough internistic examination and the indication for surgery should be made carefully.
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PMID:[Can the electroencephalogram contribute to the indications for carotid surgery?]. 687 38

To estimate the usefulness of magnetic resonance imaging (MRI) in diagnosing vertebro-basilar insufficiency (VBI), 41 VBI patients with vertigo or dizziness and 26 subjects without vertigo or dizziness (as control) were examined by MRI. Sixty-eight percent of the VBI group and 12% of the control group showed a large difference between the right and the left vertebral artery diameter, the incidence being significantly higher in the VBI group. Thirty-nine percent of the VBI group and 12% of the control group had lacunar infarction in the brain stem, of which the incidence was significantly higher in the VBI group, MRI can be recommended to diagnose VBI providing information on both blood vessel disorder and ischemic changes in the brain.
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PMID:Usefulness of magnetic resonance imaging in diagnosing vertebro-basilar insufficiency. 928 48

Members of the Manipulative Physiotherapists Association of Australia (now Musculoskeletal Physiotherapy Australia) were surveyed to determine their use of cervical manipulation, compliance with and attitudes to the Australian Physiotherapy Association's (APA) Protocol for Pre-manipulative Testing of the Cervical Spine, and the incidence of adverse effects from cervical manipulation. The questionnaire was mailed to 740 members and returned by 480 members (65%). Cervical manipulation (84.5%) and passive mobilization (99.8%) were used by a high percentage of respondents. Most were familiar with the protocol with 63% supporting its continued endorsement. Adverse effects were reported at a rate of one per 1000 years of practice (or 0.003/week). The most common effects were symptoms potentially related to VBI (94.4% responses), with no reported major complications. Only 37.1% of respondents always informed the patient about potential dangers of cervical manipulation and consent was sought on every occasion by 33% of respondents. The results suggest that the use and interpretation of the protocol are variable among members of MPA. The risk of adverse effects from manipulative (musculoskeletal) physiotherapy practice, including cervical manipulation, appears to be very low. Recommendations for revision of the protocol were made on the basis of results of the survey and treatment diary, in addition to a review of the literature related to testing for vertebro-basilar insufficiency, adverse incidents related to cervical mobilizing and manipulative technique, differentiating features of VBI related dizziness and vertigo related to benign paroxysmal positional vertigo (BPPV) and current issues surrounding informed consent. Finally, a summary of the content of the new Clinical Guidelines for Pre-Manipulative Testing of the Cervical Spine (APA, 2000) is provided.
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PMID:Pre-manipulative testing of the cervical spine review, revision and new clinical guidelines. 1504 Sep 69

Dizziness and vertigo are symptoms caused by several etiological factors, they are result of general diseases, within anemia. They are associated with several diseases of the organ of hearing and balance, which are under laryngological care, and one of most important tests to distinguish vertigo of central and peripheral origin is videonystagmography. Several diseases of the central nervous system cause instability of posture and gait. Psychogenic feeling of being insecure and unsafe makes the diagnostics more complicated. Vertigo of central origin in children can be a first symptom of severe conditions, such as tumor of CNS, therefore the neuroradiological evaluation is necessary for early diagnosis, before the occurrence of increase of intracranial pressure symptoms. Vascular diseases, such as vertebro-basilar insufficiency or stroke are diagnosed more common in adults, still they are not excluded in children, and therefore vascular evaluation is necessary. The cerebrovascular ultrasound is a method significant in the diagnostics as well as in the monitoring of therapy of cerebral vascular diseases. The elecrophysiological evaluation, EEG or videoEEG is useful in the evaluation of paroxysmal conditions. Evoked potentials are helpful in diagnostics of demyelination of CNC. The serological tests (within to detect boreliosis) are infrequently performed; they may lead to correct diagnosis and causal treatment. The paper presents examples of diagnostic methods valid in children with dizziness of central origin.
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PMID:[Causes and diagnostics of dizziness of central origin in children]. 2029 43