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

Motor vehicle accidents with a whiplash mechanism of injury are one of the most common causes of neck injuries, with an incidence of perhaps 1 million per year in the United States. Proper adjustment of head restraints can reduce the incidence of neck pain in rear-end collisions by 24%. Persistent neck pain is more common in women by a ratio of 70:30. Whiplash injuries usually result in neck pain owing to myofascial trauma, which has been documented in both animal and human studies. Headaches, reported in 82% of patients acutely, are usually of the muscle contraction type, often associated with greater occipital neuralgia and less often temporomandibular joint syndrome. Occasionally migraine headaches can be precipitated. Dizziness often occurs and can result from vestibular, central, and cervical injury. More than one third of patients acutely complain of paresthesias, which frequently are caused by trigger points and thoracic outlet syndrome and less commonly by cervical radiculopathy. Some studies have indicated that a postconcussion syndrome can develop from a whiplash injury. Interscapular and low back pain are other frequent complaints. Although most patients recover within 3 months after the accident, persistent neck pain and headaches after 2 years are reported by more than 30% and 10% of patients. Risk factors for a less favorable recovery include older age, the presence of interscapular or upper back pain, occipital headache, multiple symptoms or paresthesias at presentation, reduced range of movement of the cervical spine, the presence of an objective neurologic deficit, preexisting degenerative osteoarthritic changes; and the upper middle occupational category. There is only a minimal association of a poor prognosis with the speed or severity of the collision and the extent of vehicle damage. Whiplash injuries result in long-term disability with upward of 6% of patients not returning to work after 1 year. Although litigation is very common and always raises questions of secondary gain in patients with persistent symptoms, most patients are not cured by a verdict. Acute treatment of neck pain consists of ice for 24 hours followed by heat applications, pain pills, NSAIDs, and muscle relaxants. Trigger point injections can be beneficial in both the acute and the persistent phases. Use of cervical collars should probably be kept to a minimum during the first 2 to 3 weeks after the injury and then avoided. Early passive mobilization and range of motion exercises may accelerate recovery. Physical therapy and transcutaneous nerve stimulators may be helpful in reducing pain and improving movement.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Some observations on whiplash injuries. 143 66

All clinicians responsible for diagnosing and treating diseases of the head and neck should be familiar with the possible clinical manifestations of a mineralized stylohyoid or stylomandibular ligament. Many patients with Eagle's syndrome have been misdiagnosed as having neuralgias, TMJ problems, psychosomatic disorders, or other vague, ill-defined diseases of the head and neck. Unfortunately , patients have been treated for these conditions with negative results. Extraction of teeth, especially third molars, has been performed unnecessarily in an attempt to alleviate the symptoms caused by a mineralized stylohyoid or stylomandibular ligament. Patients complaining of vague facial pain (especially when swallowing, turning the head or opening the mouth), dysphagia, otalgia, and headache with dizziness and with radiographic evidence of mineralization in the stylohyoid-stylomandibular ligament complex may have Eagle's syndrome. If digital palpation of the tonsillar fossa on the affected side causes the typical pain that the patient has been experiencing and if the mineralized abnormality can be felt in the fossa, the patient is considered to have the syndrome, and surgical resection of the abnormality should be considered.
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PMID:Eagle's syndrome diagnosed after history of headache, dysphagia, otalgia, and limited neck movement. 695 Sep 78

Temporomandibular disorders (TMD) afflict millions of men, women and children. Although the management of these disorders has traditionally been the pervue of dentistry, the most common symptoms are otolaryngologic. The involvement of an otolaryngologist was important and necessary in the role of primary diagnostician and as a secondary diagnostician to rule out primary otolaryngologic disease in many of the 2,760 patients evaluated over the past 13 years. In 996 patients referred to the Center for Myofacial Pain/TMJ Therapy from the Otolaryngology Clinic of the New York Eye and Ear Infirmary, 85% complained of ear symptoms, including otalgia (64%), dizziness (42%), and muffling (30%). Sixty percent complained of throat symptoms, while headaches were reported by 81%. In 1,764 private patients evaluated for TMD, 53% were seen and/or referred by an otolaryngologist. The dentist and otolaryngologist must act as a team in recognizing and diagnosing TMD. As many of the symptoms of TMD fall within the pervue of the otolaryngologist, he or she must be cognizant of the clinical presentation of TMD. Likewise, dental practitioners must utilize the services of their medical colleagues to rule out primary otolaryngologic disorders in all patients with suspected TMD.
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PMID:Recognizing otolaryngologic symptoms in patients with temporomandibular disorders. 811 96

Psychologic factors were studied in 10 patients with symptoms presumed to be caused by electricity (EG) and in 10 patients with symptoms presumed to be caused by visual display units (VG) and compared with a sex- and age-matched control group (CG). Psychologic differences between the EG and VG were also measured. The symptoms presumed to be caused by electricity or visual display units were registered, and the personality, psychologic functioning, and quality of life were determined by using the Karolinska Scales of Personality (KSP), an additional Personality Scale (PS), a Psychological Functioning Scale (PFS), and a quality of Life Scale (QLS). The results showed that the commonest general symptoms in the EG/VG were skin complaints, fatigue, pain, and dizziness, and the commonest oral symptoms were gustatory disturbance, burning mouth, and temporomandibular joint dysfunction. The patients in the EG described more different types of both general and oral symptoms than those in the VG. The result showed that the VG scored significantly higher only in the KSP Somatic Anxiety and Muscular Tension scales, and the EG scored significantly lower in the KSP Socialization scale and significantly higher in the Somatic Anxiety, Muscular Tension, and Psychasthenia scales. In addition, only the EG differed significantly on the PS, PFS, and QLS. The EG differed significantly in such psychologic aspects as being more fatigued in the PS, in having more difficulty in concentrating, in taking the initiative, and in getting on with people in the PFS and experiencing inactivity and visiting other people rarely in the QLS. The conclusion was that patients with symptoms presumed to be caused by electricity and visual display units differed from each other psychologically and, therefore, should be handled clinically in different ways. The need for an interdisciplinary approach to these patients is emphasized.
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PMID:Psychologic aspects of patients with symptoms presumed to be caused by electricity or visual display units. 855 7

Although James Costen was not the first to ascribe ear pain, tinnitus, impaired hearing, and even dizziness to temporomandibular joint dysfunction, he developed an integrated and systematic approach ascribing the symptoms to dental malocclusion. He wrote extensively on it, and a few years after his original article, the term Costen's syndrome came into general use. Recently, the use of the eponym has decreased, as dental malocclusion has assumed a lesser role in explaining many of the symptoms formerly ascribed to it.
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PMID:Jaws revisited: Costen's syndrome. 934 77

Criteria used to establish ideal skeletal position of the maxilla and mandible relative to the cranial base is exacting. It must first enhance facial esthetics and facial profile. Secondly, it must improve TMJ health; and finally, it must improve physiologic harmony. Physiologic harmony include alleviation of many medical symptoms such as migraine headaches, neck-shoulder-back pain, myalgia, mouth breathing, otitis media, ringing in the ear, dizziness, vertigo, etc. The Skeletal Archial Analysis is a powerful diagnostic aid. Once the skeletal landmarks are learned, it takes clinicians less than 5 minutes to trace and diagnose. This is because it uses visual references rather than columns of angles and linear measurements. How powerful and accurate is this analysis? If done correctly, patients treated to their anterior arc and correct vertical arc will often times achieve significant facial esthetics, TMJ health, and physiologic harmony. Both the Skeletal Archial Analysis and the Skeletal Classification System indicate whether the disharmony is in the maxilla, mandible, or both. They clearly show in which direction these skeletal structures must be moved to enhance facial appearance and health. In all cases, the direction is to move these structures as close to skeletal Type I, Normal, as physiologically possible. Figure 8 shows a 21-year-old female individual with this skeletal classification. She has ideal maxillary and mandibular A-P position and ideal lower facial height. As can be seen, she has an attractive facial profile and she has no clinical symptoms of temporomandibular disorder or other medical problems. Conversely, patients with facial disharmony often seem to have various medical problems, including premenstrual syndrome and infertility. Once clinicians become adept at using the Skeletal Archial Analysis, they will begin to see many more types of facial disharmonies than previously thought. It then becomes a verbal challenge to accurately describe the multitude of different types of skeletal malpositions. In light of this, it is important that a universal Skeletal Classification System be established to promote better understanding in the diagnosis and treatment of facial-skeletal problems.
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PMID:Skeletal classification of maxillary and mandibular malpositions. 956 80

The term Costen's syndrome has been used in the dentomedical literature to describe a constellation of craniofacial symptoms. Since some of the same complaints have been reported in patients with "generalized" psychological distress, symptoms associated with the syndrome may not be useful in differential diagnosis of temporomandibular disorders. The present study investigated whether some somatic complaints, particularly tinnitus and dizziness, were pathognomonic in patients with chronic temporomandibular pain. Illness behavior and personality factors were studied for possible interrelationships with these symptoms. Factor analysis revealed that tinnitus and dizziness loaded on separate factors. Tinnitus loaded with nasal stuffiness, tearing, and itching of the eyelids and nose, while dizziness loaded with complaints of altered taste and smell and blurred vision. Neither was consistently related to measures of pain or to indices of illness behavior or somatic focus.
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PMID:Otalgia and aversive symptoms in temporomandibular disorders. 1052 81

Middle ear muscles have a common embryological and functional origin with masticatory and facial muscles. Therefore, symptoms referred to the ear may originate from the stomatognathic area. When a primary otological cause is discarded in the diagnostic work up for tinnitus, vertigo, hypoacousia, hyperacousia, ear pain or sensation of occluded ear, a temporomandibular joint dysfunction may be the cause of these symptoms. Temporomandibular joint dysfunction is twice more common among women and has environmental, physiological and behavioral causes. Among patients with this dysfunction, the prevalence of ear pain, tinnitus and dizziness varies between 33 and 76%
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PMID:[Otological symptoms among patients with temporomandibular joint disorders]. 1835 61