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)

Dantrolene sodium or dantrolene1 is 1([5-(nitrophenyl)furfurylidend] amino) hydantoin sodium hydrate. It is indicated for use in chronic disorders characterised by skeletal muscle spasticity, such as spinal cord injury, stroke, cerebral palsy and multiple sclerosis. Dantrolene is believed to act directly on the contractile mechanism of skeletal muscle to decrease the force of contraction in the absence of any demonstrated effects on neural pathways, on the neuromuscular junction, or on the excitable properties of the muscle fibre membranes. Controlled trials have demonstrated that dantrolene is superior to placebo in adults or children with spasticity from various causes, as evidenced by clinical assessments of disability and daily activities, and by muscle and reflex responses to mechanical and electrical stimulation. It is somewhat less effective in patients with multiple sclerosis than in those with spasticity from other causes. There has been a general clinical impression in controlled trials that dantrolene caused less sedation than would have been expected from therapeutically comparable doses of diazepam. In 2 controlled trials, there was no significant difference between dantrolene and diazepam in terms of reductions in spasticity, clonus, and hyperreflexia, but side-effects such as drowsiness and inco-ordination occurred significantly more frequently on diazepam. Long-term studies have indicated continuing benefit for patients taking dantrolene, though the incidence of side-effects has often been high and there has been a suggestion of exacerbation of seizures in children with cerebral palsy. Dantrolene may be of value in the medical treatment of spasm of the external urethral sphincter due to neurological and non-neurological disease, and animal studies suggest a potential use in the management of malignant hyperpyrexia. Chemical evidence of liver dysfunction may occur in 0.7 to 1% of patients on long-term treatment with dantrolene, with symptomatic hepatitis in 0.35 to 0.5% and fatal hepatitis in 0.1 to 0.2%. The drug commonly causes transient drowsiness, dizziness, weakness, general malaise, fatigue and diarrhoea at the start of therapy. Muscle weakness may be the principal limiting side-effect in ambulant patients, particularly in those with multiple sclerosis, and therapy could be hazardous in patients with pre-existing bulbar or respiratory weakness. The dosage of dantrolene has been fixed in most controlled trials, though long-term studies have indicated the need for individualisation of dosage. The initial dose is usually 25mg once daily, increasing to 25mg two, three or four times daily, and then by increments of 25mg up to as high as 100mg two, three or four times daily. The lowest dose compatible with optimal response is recommended.
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PMID:Dantrolene sodium: a review of its pharmacological properties and therapeutic efficacy in spasticity. 31 89

Synthetic human and ovine corticotropin-releasing hormone (hCRH, oCRH) are commonly used as a diagnostic tool of the hypothalamo-pituitary-adrenal axis. In this paper reports about side effects after various modes of CRH-application are analyzed and compared to our corresponding data of human studies with hCRH and oCRH. Generally, CRH is well tolerated after single administration and interval-application of standard doses, although minor side effects appear sometimes after higher doses (greater than 200 micrograms hCRH, oCRH) of CRH-bolus-injections. Predominantly the cardiovascular system (e.g. tachycardia, hypotension, flushing) is affected; neuropsychological symptoms are only seen sporadically (e.g. dizziness). Long term continuous infusion (several hours) of low CRH-doses (hCRH, oCRH) are well tolerated but side effects appear (see above) when cumulated doses of 200 micrograms-300 micrograms/h are given. Standard doses of hCRH and oCRH are also well tolerated in severely ill patients; it has to be considered that higher doses may provoke marked side effects in persons with neurologic disorders, in subjects with coronary heart disease and in patients with endocrinological disorders of the pituitary-adrenal axis, especially in those subjects in whom the blood-brain-barrier may have been damaged (e.g. head injury, intracranial operation). Single hCRH- and oCRH-bolus-injections in standard doses have a very low rate of complications, "non-standard" doses should provisionally be used only in clinical studies with well designed safety-precautions.
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PMID:Safety and side effects of human and ovine corticotropin-releasing hormone administration in man. 203 13

Among 4470 consecutive neurological inpatients presenting "with typical neurological symptoms" 405 (9%) were found to have psychogenic rather than neurological dysfunction of the nervous system as the primary cause of admission. This probably represents a conservative figure, since secondary and minor pseudoneurological symptoms were not included. Retrospective analysis of these cases showed that pain was the most common psychogenic symptom, followed by motor symptoms (in particular stance and gait disturbances), dizziness, psychogenic seizures, sensory symptoms, and visual dysfunction. Unilateral motor and sensory symptoms were equally distributed to the left and right side of the body. Psychiatric abnormalities in these patients were heterogenous. Depressive syndromes were most common (38%), whereas hysterical features were less frequent than expected (9%). On discharge, improvement was significantly better for patients with recent onset of symptoms (2 weeks or less) than for those with longstanding disturbances. Short-term outcome was best for motor symptoms and worst for pain. Improvement was independent of psychiatric findings, coexistence of a neurological disease, age, and sex.
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PMID:Psychogenic disorders in neurology: frequency and clinical spectrum. 228 51

The profile and prognosis of symptoms of 87 patients (mean age 38.6 years) in whom a chronic organic solvent intoxication due to tri- or perchloroethylene or mixtures of solvents had been diagnosed 3-9 years earlier were examined by means of an interview. Both at the time of diagnosis and upon reexamination, the most common symptoms were abnormal fatigue, memory disturbances and headache. Also dizziness, sleep disturbances, sensory symptoms in the extremities, mental depression, concentration difficulties, psychic irritability, emotional lability, tremor and nausea were present in over 60% of patients at the time of diagnosis. Upon reexamination, 52% of the intoxication patients with no other contributing neurological disease felt that their overall subjective condition was better than at the time of diagnosis, 21% felt that it was worse, and 27% reported no change. Most of the individual symptoms had more often changed for the better than for the worse; the differences were statistically significant with regard to abnormal fatigue, headache, dizziness, sleep disturbances, nausea, and emotional lability, whereas memory disturbances had changed in the opposite direction. Younger persons, who had had a longer follow-up period and without regular check-ups at the Institute of Occupational Health seemed to have better prognosis at the group level. Due to the great variation between the individuals, the prognosis was, however, impossible to predict in individual cases.
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PMID:Prognosis of symptoms in patients with diagnosed chronic organic solvent intoxication. 715 5

Panic disorder is a chronic illness that affects at least 3 percent of the population. Panic disorder is associated with significant morbidity and an increased risk of suicide. Patients generally present with multiple somatic and psychologic complaints, including heart palpitations, chest pain, tremor, shortness of breath, choking, nausea or abdominal distress, dizziness, derealization, fear of losing control or going crazy, fear of dying, paresthesias, chills or hot flushes, headache, diarrhea, insomnia, chronic fatigue, anxiety and depression. To make the correct diagnosis, these symptoms must be evaluated carefully since they also occur with serious cardiovascular, pulmonary, endocrinologic and neurologic disorders. Many effective treatments are available, including tricyclic antidepressants, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, benzodiazepines such as alprazolam and clonazepam, and psychotherapy.
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PMID:Panic disorder. 748 99

EMGs were recorded from the gastrocnemius and anterior tibialis muscles of 77 adult subjects in response to perturbation of stance by upward toe tilts. Subjects aged 22-88 y were initially grouped in seven decades (20s-80s). Each presented a history free of ear disease, eye disease not correctable by lenses, neurological disease, and persistent difficulty with balance or dizziness. All demonstrated functionally normal balance for their age on routine dynamic posturography. EMG recordings yielded onset and offset latencies, durations, and integrated amplitudes of the short and medium latency responses of the gastrocnemius and the long latency responses of the anterior tibialis. Analysis of the data revealed statistically significant left-right differences in amplitude of response and statistically significant height, gender, and age effects. Procedural issues were discussed; data were summarized for normative purposes; and suggestions were made for dealing with statistically significant differences in a clinical environment.
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PMID:Electromyographic responses of lower leg muscles to upward toe tilts as a function of age. 792 38

The prevalence of all neurological disorders in a Japanese town was calculated, with a result of 91.1 per 1,000 population. The prevalence of cerebrovascular disease was 28.8; myelopathy and/or radiculopathy caused by deformity of the spine or disc herniation, 23.9; neuralgia, 11.5; dementia, 10.4; peripheral nerve disturbance, 5.5; epilepsy, 4.4; Parkinson's disease, 2.0; mental retardation, 2.9; brain/spinal tumor, 1.4; headache, 10.8, and vertigo/dizziness, 4.4. The prevalence of headache and vertigo/dizziness was also calculated from the results of the questionnaires sent to inhabitants: headache, 79.6, and vertigo/dizziness, 60.8. Neurological disorders are common in Japan and likely to continue to increase.
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PMID:Prevalence of neurological disorders in a Japanese town. 881 3

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).
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PMID:[Diagnosis of common causes of vertigo using a structured clinical history]. 1079 28

This study evaluates sociodemographic and clinical characteristics of patients reporting discrepant levels of tinnitus loudness and annoyance. 4958 subjects recruited from a national tinnitus association completed a comprehensive screening questionnaire including Klockhoff and Lindblom's loudness grading system and the psychometric Mini-TQ (Tinnitus Questionnaire). There was a moderate correlation of 0.45 between loudness and annoyance. Of the subjects reporting very loud tinnitus, about one third had only mild or moderate annoyance scores. They were not different from those with high annoyance regarding age, gender and tinnitus duration, but annoyance was increased when subjects had additional hearing loss (OR = 1.71), vertigo/dizziness (OR = 1.94) or hyperacusis (OR = 4.96). Another significant predictor was history of neurological disease (OR = 3.16). Subjects reported low annoyance despite high loudness more often if not feeling low/depressed and not considering themselves as victims of their noises. A specific psychological profile was found to characterize annoyed tinnitus sufferers. Permanent awareness of the noises, decreased ability to ignore them and concentration difficulties were reported frequently even when overall annoyance scores were comparatively low. It is concluded that the coexistence of tinnitus with hearing loss, vertigo/dizziness and hyperacusis as complicating otological conditions seems to be of clinical relevance for the prediction of high annoyance levels. Tinnitus loudness and annoyance are not necessarily congruent and should be assessed separately.
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PMID:When tinnitus loudness and annoyance are discrepant: audiological characteristics and psychological profile. 1766 70

Orthostatic tremor (OT) is a neurological disease of unknown aetiology. It is defined by the presence of a 10-20 Hz tremor in the legs while standing still. Symptoms described are dizziness and instability that diminish if the patient sits down or leans on something; drinking small amounts of alcohol significantly reduces OT. Due to the dizziness and/or unsteadiness, these patients are usually referred to the neuro-otology department. We report 4 cases diagnosed with OT. The diagnosis of OT should be considered for patients with instability. The clinical history is a key factor to suspect this entity, and the diagnosis is given by the register of 10-20 Hz contractions on limb electromyography. Treatment for this disease consists of medical treatment; the first option is clonazepam.
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PMID:[Orthostatic tremor inducing instability]. 2215 51


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