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

The authors report the case of an AIDS patient with rare neurologic manifestations: primary vasculitis of the central nervous system and VIII cranial nerve dysfunction. The authors make a review on the subject, and call special attention for the differential diagnosis. In fact, the patient, a 36 year old woman, with promiscuous life, presented with dizziness, gait ataxia, nausea, headache and hypoacusia. Seven days after the admission, she noted blurred vision in both eyes and soon she became blind. The physical examination showed bilateral optic neuritis and vestibulocochlear dysfunction, stiff neck and fever. No abnormalities were detected on CT scan. CSF showed 40 mononuclear cells/mm3, 79 mg/dl of proteins and normal glucose content. Microbiological research was negative. Serum anti-HIV test was positive. The hypothesis of primary CNS vasculitis was made, and pulse methylprednisolone therapy was introduced with good recovery of neurological syndrome except for persistent amaurosis.
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PMID:[Isolated vasculitis of the central nervous system and involvement of the 8th cranial nerve: rare manifestations of acquired immunodeficiency syndrome]. 130 67

Since 1987, the authors have observed the therapeutic effect of Xin Bao on 87 patients with sick sinus syndrome. Electrophysiological stimulation examination: SNRT greater than 1900 ms and CSNRT greater than 600 ms in all patients. Routine ECG and Holter monitoring ECG: (1) Persistent sinus bradycardia or/and atrio-ventricular junction escape rhythms or/and premature beat, heart rate less than 48 +/- 6 beats/min in 40 patients; (2) sinus standstill (arrest) or secondary degree sinoatrial block in 10 patients; (3) bradycardia-tachycardia syndrome in 30 patients; (4) the heart rate greater than 60 beats/min in 7 patients. The major symptoms were dizziness, palpitation, chest press, malaise, remission in memory, nocturia, amaurosis and Adams-Stokes syndrome, etc. Self-comparison was taken, Xin Bao was given 2-10 tablets 2 or 3 times a day by oral administration for 2 months. The major symptoms of sick sinus syndrome was greatly improved after treatment. The total effective rate attaining to 85%. The improvement in heart function was also significant, the total effective rate being 80%. After treatment SNRT and CSNRT were shortened (P less than 0.01), the total heart beats for 24 hours and the average heart beats/min greatly increased (P less than 0.01). CO and EF increased too (P less than 0.05). No serious adverse reactions were found during the treatment. It was believed that Xin Bao could stimulate sino-atrial node and increase it's excitability. The basic heart rate was increased and the heart function improved with no adverse reactions. It may be administrated in long term. Therefore, Xin Bao may be recommended as appropriate drug for treating sick sinus syndrome.
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PMID:[Use of xin bao in the treatment of 87 patients with sick sinus syndrome]. 226 39

Symptomatic common carotid artery occlusion (CCAO) is rare. We studied 17 patients with ischemic cerebrovascular symptoms and unilateral CCAO on angiography to help clarify clinical and radiologic features. Mean age was 62 years; 65% were women. Predominant symptoms and signs included visual-ipsilateral monocular or retrochiasmal symptoms (88%), motor weakness (88%), sensory disturbance (59%), dizziness/lightheadedness (53%), and syncope (24%). Dysarthria, headache, or involuntary limb shaking occurred less frequently. Positionally related symptoms occurred in approximately two-thirds of the patients. TIAs were often multiple and preceded a stroke or occurred without subsequent stroke in 82%. Hemispheric TIAs contralateral to the CCAO occurred in 41%. Ten patients (59%) suffered stroke, seven (70%) of which were ipsilateral to the CCAO. Vascular risk factors included cigarette use (76%), hypertension (71%), diabetes mellitus (41%), and hyperlipidemia (41%); 82% had two or more risk factors. Known cardiac disease was present in 59%. CCAO was present at the origin of the vessel in most patients. Most had atherosclerotic narrowing of multiple extracranial large vessels. During follow-up, none of the patients had a spontaneous second infarct; five had TIAs, including two with amaurosis fugax, all in the CCAO territory. More restricted external carotid collaterals may, in part, explain the higher frequency of ipsilateral stroke and contralateral TIAs than reported for internal carotid occlusion.
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PMID:Common carotid artery occlusion. 279 68

Noninvasive carotid artery testing was performed in 73 patients with nonvalvular atrial fibrillation who were referred because of symptoms or signs of cerebrovascular disease. Thromboembolism related to atrial fibrillation without valvular heart disease was the probable source of cerebral ischemia in 25 (80%) of 31 patients with stroke and coexisting atherosclerotic disease at the carotid artery bifurcation in six (20%). Nonvalvular atrial fibrillation was the probable source of symptoms in nine (70%) of 13 of patients with transient cerebral ischemia, while coexisting carotid artery disease was present in four (30%). Nonvalvular atrial fibrillation accounted for the symptoms in four of five patients with amaurosis fugax, with atherosclerotic carotid artery disease present in one. The remaining 24 patients had nonhemispheric symptoms of cerebrovascular disease, including vertebrobasilar insufficiency, dizziness, and syncope, and only one had a carotid lesion. A significantly higher proportion of patients with focal hemispheric symptoms had coexisting carotid disease than patients with nonfocal symptoms had, suggesting that atherosclerotic cerebrovascular disease contributes to stroke in patients with nonvalvular atrial fibrillation. Noninvasive carotid artery testing may be helpful in identifying atherosclerotic lesions at the carotid artery bifurcation in patients with atrial fibrillation and cerebrovascular disease, because different therapeutic modalities may be appropriate when two potential sources of cerebral ischemia are present.
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PMID:Noninvasive evaluation of the extracranial carotid arteries in patients with cerebrovascular events and atrial fibrillations. 230 22

A variety of neurological disturbances may occur in patients receiving ocular administration of timolol. Possible mechanisms include direct effects on neurons of the central nervous system, effects on peripheral vasculature, and cardiac arrhythmias. Interestingly, transient ischemic attacks have not been documented to occur synchronously with timolol-related arrhythmias. We report a case of recurrent dizziness and staggering gait occurring synchronously with timolol related arrhythmias. An attack of amaurosis fugax also occurred. Discontinuing timolol abolished all the symptoms. Pre-existing autonomic dysfunction in our patient may have been an important contributing factor in his symptomatology.
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PMID:Transient ischemic attacks and amaurosis fugax from timolol. 397 21

Neurological symptoms of transient unsteadiness, dysarthria, dysphasia, dysbasia, transient monoor hemiparesis, hemiparesis, scintillating scotomas, amaurosis fugax, vertigo, dizziness, migraine accompaniments, syncope and seizures were the presenting manifestations of thrombocythemia in various myeloproliferative disorders. Erythromelalgia preceded or followed the neurologic ischemic attacks. The neurologic and ocular attacks usually had a sudden onset, lasted for a few seconds to several minutes and occurred independently or sequentially rather than simultaneously. This clinical syndrome is caused by platelet-mediated ischemic and thrombotic processes in the end-arterial microvasculature and reflects the existence of a platelet dependent and aspirin responsive arterial thrombophilia in thrombocythemia as novel disease entity, which confirms and elucidates Mitchell's hypothesis.
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PMID:Atypical transient ischemic attacks in thrombocythemia of various myeloproliferative disorders. 895 74

Three patients, two women and one man, aged 56-70 year (mean 59 years) with modest neurological deficits and bilateral occlusion of the common carotid arteries initially identified by duplex scanning and angiography were followed by repeated clinical and transcranial Doppler examination (TCD) over 6.5 years. Vasomotor reactivity (VMR) was tested by combined examination of TCD and xenon-133 cerebral blood flow (CBF) before and after intravenous administration of 1 g acetazolamide. At follow-up CBF was measured using single photon emission computerised tomography (SPECT). In two patients mean velocities in the middle cerebral artery (MCA) were within the normal range at repetitive examinations with good VMR ranging 30-111%, whereas CBF was reduced in MCA territories ranging 29-36 ml 100 g(-1) min(-1), but increasing 44-69% after acetazolamide, indicating good VMR. These 2 cases had anterograde flow in the ophthalmic artery and siphon. The third patient had very low MCA mean velocities of 21-27 cm sec(-1), increasing 26-33% after acetazolamide. This patient had retrograde flow in the ophthalmic artery and siphon connected with bilateral prolonged episodes of amaurosis fugax and transient ischemic attacks. In all three patients the posterior cerebral arteries were major supplying collaterals having high mean velocities of about 100 cm sec(-1) and high velocities in the basilar arteries of 85 cm sec(-1) as well. During follow up no patient had a new stroke, but all experienced orthostatic dizziness and chronic fatigue.
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PMID:Bilateral common carotid artery occlusion with minimal neurological deficit: long term follow up in 3 patients. 916 64

The development of the duplex scanner has made the diagnosis of carotid arterial disease easy to those trained in its interpretation. The difficulty lies in the ability to define the patient population most likely to benefit from early diagnosis and treatment. All patients referred to the vascular laboratories at two major hospitals for evaluation of neurologic symptoms were entered into the study. The indications for the study, comorbid conditions, and medications were tabulated and compared with the results of the carotid duplex scan. The purpose was to see whether there was a relationship between the severity of carotid arterial disease and symptoms. A total of 5,807 carotid duplex scans were performed on 5,001 patients. There were 525 patients (11%) with an internal carotid artery stenosis of >70 per cent and 252 patients (5%) with an occlusion of the internal carotid artery. In addition, there were a group of 139 patients with severe bilateral carotid disease. Bruit and a history of known carotid disease were the only indications that were statistically related to severe carotid arterial disease. Smoking, diabetes, peripheral vascular disease, cardiac conditions, and hyperlipidemia were also statistically related to patients with significant carotid disease. This study indicates that the classic indications for carotid duplex scans such as transient ischemic attack, amaurosis fugax, and dizziness have no correlation with the severity of the disease.
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PMID:Severe carotid arterial disease: a diagnostic enigma. 1091 77

The significance of the risk factors and the rapid diagnosis of encephalic vascular disease (EVD) is the reason for this research, where the authors decided to register and analyze the non-medical people knowledge about these risk factors and the symptoms of this group of disease. For this purpose a questionnaire with questions about these facts was applied to 500 voluntaries without pre-selection, 72.6% of them with ages between 16-35 years old, and the answers analyzed by statistical methods. The authors recognized that the risk factors has a good level of knowledge by this population (87.8 % for hypertension, 76.8 % for smoking, 70.8 % for obesity, 68.7 % for sedentary persons, 66.7 % to stress, 66.3 % to alcohol ingest, 60.7 % for fat diet, 59 % to illicit drugs) while the signs and symptoms of EVD has a minor level of knowing and correction: lost sensitivity 70.3 %, headache 64.2 %, twisted mouth 59.5 %, lost or altered speech 57.5 %, dizziness 56 %, syncope 51.7 %, amaurosis 50.3 %, disequilibrium 45 %, deafness 31.2 %, weakness 41.1 %, nervousness 20.7%, chest pain 20.2 %, fatigue 15.3 % and tinnitus 18.9 %. According this data, the authors suggest that the correction or prevention of risk factors as well the precocious medical attention by the recognition of symptoms of EVD must be the object of public health programs.
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PMID:[Lay knowledge about stroke]. 1459 81

Moyamoya disease is characterized by idiopathic steno-occlusion at the terminal portion of the internal carotid artery with concomitant abnormal vascular networks that can lead to transient ischemic attacks and hemorrhagic stroke with symptoms of headache, confusion, dizziness, ataxia, seizure, and cognitive and personality changes. Because these symptoms also occur in patients with type 1 diabetes mellitus(T1DM), patients with both diseases might go unnoticed and without the less common diagnosis of akin moyamoya disease, accurate diagnosis and treatment could be delayed. Here, we report the case of a 32-year-old woman with past history of T1DM for 26 years presenting with right amaurosis, which was diagnosed as akin moyamoya disease even though she had suffered right incomplete hemiparesis 2 years ago. She underwent superficial temporal artery-middle cerebral artery anastomosis with pial synangiosis in the left hemisphere without complication. She had no cerebrovascular events postoperatively. Although akin moyamoya disease associated with T1DM is rare in Japan, we recommend that clinicians consider the coexistence of both diseases when evaluating patients with T1DM who have neurologic signs or symptoms and not overlook the possibility of cerebrovascular diseases, such as akin moyamoya disease.
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PMID:[A case of akin moyamoya disease associated with type-I diabetes mellitus managed by extracranial-intracranial bypass]. 2574 8


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