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

The clinical and pathological features of 28 fatal cases of acute uncomplicated massive cerebellar infarction are reviewed. Although infarcts may involve any portion of the cerebellum, they predominantly involve the posteroinferior half of one cerebellar hemisphere. The frequency of acute uncomplicated fatal cerebellar infarction is much greater than previously appreciated, approximating that of acute fatal cerebellar hemorrhage. All patients were past middle age. Atherosclerosis and acute vertebral artery occlusion were the most common etiological factors. The onset was sudden in most cases, with vomiting, dizziness, vertigo, and cerebellar dysfunction. All patients died with progressive brain stem dysfunction and medullary respiratory failure secondary to compression by a swollen cerebellum. Death usually occurred between the third and sixth days following the onset of symptoms, but only six to 30 hours after the onset of obtundation; therefore, decompressive therapy must be instituted promptly.
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PMID:Cerebellar infarction. A clinicopathological study. 113 Oct 69

Clinical features are described for 35 cases of endemic food-borne botulism managed at a single medical center over 14 years. Important diagnostic findings included dryness of mucous membranes (90%), weakness (84%), and abnormal pupillary reaction (79%). Sensory examination was normal. Dizziness, dyspnea, and weakness of the extremities were significantly more common in patients requiring assisted ventilation. Transitory neurological deterioration occurred in 38% of patients despite the early administration of trivalent (ABE) equine antitoxin. The short course of respiratory failure suggests that toxin effect is unusually ephemeral with a mean intubation interval of only 8.6 days. Rapid recovery of strength without relapsing respiratory failure followed extubation. Tracheostomy was associated with a high complication rate and was abandoned. Extremely thick, tenacious sputum probably contributed to the high nosocomial pneumonia rate. Empirical antibiotic use to eliminate persistent C. botulinum was associated with unacceptably high nosocomial infection rates (p less than .01). Unexpected significant elevations of blood leukocyte and neutrophil band forms were noted.
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PMID:Endemic food-borne botulism: clinical experience, 1973-1986 at Alaska Native Medical Center. 195 79

Clinicopathological and immunohistochemical studies were performed in a patient with paraneoplastic limbic encephalitis, myelitis, sensory neuropathy and cerebellar degeneration secondary to small cell lung cancer. A 67-year-old male smoker developed orthostatic dizziness 6 months prior to admission. Over the following months, his wife noticed that he became forgetful and confused. Over the next three weeks, he became unable to sit or stand unaided and admitted to our service. On admission, he was lethargic and disoriented in time and place. Neurological examination revealed marked limb weakness with distal dominant muscle atrophy. A chest radiograph demonstrated a mass in the right middle lobe and a bronchial biopsy revealed a small cell carcinoma. CT scan and MRI of the brain revealed abnormalities in the bilateral medial temporal lobes and putamen. He was treated with anti-cancer chemotherapy, but died of respiratory failure after 13 months illness. Postmortem examination showed a mass in the right middle lobe of the lung. No tumor metastases were noted in the nervous tissue. Microscopical examinations of the nervous system revealed neuronal loss, astrogliosis and perivascular and parenchymatous lymphocytic infiltration in the hippocampus, subiculum, amygdala, putamen, medulla oblongata, spinal cord and dorsal root ganglia. Loss of Purkinje cells was also seen in the cerebellum without lymphocytic infiltration. Immunohistochemical analysis of the patient's serum and CSF by the use of adult rat brain revealed immunoreactivity at the hippocampal pyramidal neurons CA3 and CA4. At the higher dilution, neuronal nuclei were specifically stained.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A clinicopathological study of a patient with paraneoplastic limbic encephalitis, myelitis, sensory neuropathy and cerebellar degeneration, associated with a unique antineuronal antibody]. 839 16

Ibuprofen overdose is usually characterized by GI upset, dizziness, and mild sedation. On rare occasions, severe complications such as respiratory failure, metabolic acidosis, renal failure, coma, and death have been reported in both adults and children. Presently, treatment of acute ibuprofen intoxication with complications requires supportive therapy until the symptoms resolve over 24 to 48 hours. We report the case of an 11-month-old female infant with a depressed level of consciousness after ingestion of ibuprofen whose mental status markedly improved with administration of naloxone.
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PMID:Central nervous system manifestations of an ibuprofen overdose reversed by naloxone. 1069 43

Between 1989 and 1999, 25 cases of puffer fish poisoning (PFP) were admitted to the medical service of Chon Buri Hospital. The severity of the poisoning was classified into four stages based on clinical signs and symptoms of PFP. Of the 25 patients, 23 were males and 2 were females. Three patients were in stage 1, four were in stage 2 and eighteen were in stage 4. Paresthesia was the early presenting complaint of all patients. Paresthesia consisting of either numbness or tingling of lips, tongue, around the mouth, hands, and feet. Muscle weakness, dizziness, vertigo, nausea and vomiting were common complaints. Eighteen patients developed acute flaccid paralysis and respiratory failure requiring ventilatory support. All patients received symptomatic and supportive treatment and general supportive care, including gastric lavage and intravenous fluid. Intubation and mechanical ventilation was considered especially when paralysis was progressing rapidly. Most were taken off the respirator 12-48 hours later. All patients completely recovered without any sequelae. Clinical features of PFP, toxicity of puffer fish and management were discussed.
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PMID:Puffer fish poisoning: clinical features and management experience in 25 cases. 1146 Sep 40

A 64-year-old woman presented with a rare anaplastic ganglioglioma in the right cerebellopontine angle manifesting as dizziness persisting for 2 weeks. Preoperative magnetic resonance (MR) imaging revealed a partially enhanced cystic lesion of the right cerebellopontine angle. The tumor was subtotally removed through a right lateral suboccipital craniectomy. The tumor was thought to originate from the brain stem with exophytic growth into the right cerebellopontine angle. Histological examination showed neoplastic ganglional and glial cells with anaplastic features such as mitosis, pleomorphism, and endothelial proliferation. The MIB-1 labeling index of the glial components was 40% to 60%. The diagnosis was anaplastic ganglioglioma (World Health Organization grade IV). She received postoperative radiotherapy but died of respiratory failure with tumor recurrence 11 months after the operation. Gangliogliomas usually have a good prognosis. Histological features of anaplasia and a high MIB-1 labeling index may be predictive of a poor clinical outcome.
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PMID:Anaplastic ganglioglioma of the cerebellopontine angle. Case report. 1630 20

Assessing the requirements for in-flight oxygen in passengers with pulmonary limitations can be a challenging task for clinicians. Aeromedical guidelines are available to help identify passengers that may require oxygen in flight. However, little is known about the actual in-flight response to passengers on oxygen. We measured the oxygen response (pulse oximetry) of a 67-yr-old female patient with chronic respiratory failure during a trans-Tasman flight (duration 170 min). This patient was assessed at the respiratory clinic before her journey and resting PaO2 (57 mmHg) indicated the requirement for in-flight oxygen. Bottled oxygen delivered at 2 L x min(-1) via nasal cannula was prescribed for her journey. Preflight SpO2 without supplemental oxygen was 92%. Mean in-flight SpO2 was well maintained at 93% while on oxygen at rest. There were four significant hypoxic events, which included light physical activity while on oxygen (three events; SpO2 to 84%) and a visit to the lavatory (off oxygen; SpO2 to 70%). Dyspnea and dizziness were reported during the lavatory visit. This case illustrates the importance of a preflight medical screening for passengers considered at risk during air travel and provides insight into the response of oxygen supplementation during flight.
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PMID:Episodic hypoxemia in an airline passenger with chronic respiratory failure on supplemental oxygen. 1767 71

Ingestion of immature, environmentally stressed, or cultivar-specific Solanum species (particularly the potato) has been previously associated with gastrointestinal and neurological symptoms caused by solanaceous steroidal glycoalkaloids (SGAs). We report on two geographically, temporally disparate outbreaks of poisoning by susumber berries (Solanum torvum- Solanaceae) and on detection of alkaloids not present in non-toxic berries. Five family members in New York City participated in a traditional evening meal containing Jamaican susumber berries. All those consuming berries were symptomatic the following morning with varying degrees of gastrointestinal distress, dizziness, slurred speech, cranial nerve deficits, and ataxia. The most seriously afflicted patient developed hypertension, confusion, proximal upper extremity weakness, and hypercapnic respiratory failure requiring prolonged mechanical ventilation. A separate cohort of six patients in Toronto ate unripe Jamaican susumber berries. They presented 14h post-ingestion with varying degrees of diarrhea, weakness, facial paralysis, slurred speech, ataxia, early hypertension, and proximal weakness. Two patients had ventilatory decompensation; one required intubation. Poisonous berries appeared indistinguishable from non-toxic varieties. We isolated solasonine, larger amounts of solamargine, and other steroidal glycoalkaloids in the toxic berry strains. S. torvum poisoning can produce significant neurological and gastrointestinal effects which appear to be mediated by SGAs present in the berries.
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PMID:Solanaceous steroidal glycoalkaloids and poisoning by Solanum torvum, the normally edible susumber berry. 1872 44

The gelsemium plants are highly poisonous but toxicological evaluation of suspected poisoning cases has been hampered by the chemical complexity of the gelsemium toxins involved. A novel liquid chromatography-tandem mass spectrometry protocol was optimized for the collective detection of gelsemine and related alkaloids from Gelsemium elegans. The screening protocol was applied to the clinical investigation of unexplained intoxications following the ingestion of seemingly nontoxic herbs. In three clusters of toxicological emergencies ranging from severe dizziness to respiratory failure, Gelsemium elegans mistaken for various look-alike therapeutic herbs was suspected to be the hidden cause of poisoning. Nine cases of gelsemium poisonings were thus ascertained by the diagnostic urine alkaloid profiles. Gelsemine was sustained as the main urinary marker of Gelsemium exposure.
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PMID:Confirmation of gelsemium poisoning by targeted analysis of toxic gelsemium alkaloids in urine. 1916 70

Lepidoptera is a large order of insects, with more than 180,000 species word-wide, showing larval stages of butterflies and moths known as wormlike caterpillars. Almost 12 families of butterflies around the world are capable of causing severe human injuries, varying from dermatitis, renal failure, hemostatic alterations, respiratory failure and neurotoxic symptoms. These caterpillars are coated in long, hair-like setae containing venom to protect themselves against aggressive predators. The setae cause a painful reaction, upon contact, due to presence of neurotoxins. These caterpillars are extensively dispersed all through North America and often, during the dry and wet seasons in tropical regions, being able to sustain two annual larval generations. There exist several species of Megalopyge caterpillars; however, Megalopyge opercularis is the most widely distributed species in Latin America and the United States. This work reports, to our knowledge, the first case of envenomation by the "gusano-pollo" (Megalopyge opercularis), a stinging caterpillar, described in Venezuela. The patient in this report presented severe symptoms, including systemic reactions such as intense hand pain irradiated to the upper arm, restricted swelling, headache, dizziness, serious chest distress and shock-like symptoms that required hospitalization. Symptoms improved upon treatment with opiaceous analgesic drugs.
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PMID:Description of envenomation by the "gusano-pollo" caterpillar (Megalopyge opercularis) in Venezuela. 2081 62


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