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)

Since 1964 we have performed 136 vertebral artery reconstructions representing 4% of all operations on extracranial cerebral arteries by our staff. Fifteen of our patients were under age 55 years and had symptoms of dizziness, bilateral visual disturbances, ataxia, presyncopal episodes, and occasionally localized extremity weakness. Dizziness, often severe and incapacitating, has been the most common and consistent symptom. The diagnosis of vertebral artery lesions was made using aortic arch four-vessel cerebral arteriography. Operations were performed for severely obstructing bilateral vertebral artery lesions and included only unilateral vertebral vein patch angioplasty with or without suture plication of the artery in 13 patients. Unilateral carotid vertebral bypass was performed in one patient and unilateral vertebral reimplantation to the carotid in another. Follow-up averaged 8.9 years, ranging from ten months to 20 years. Eleven of 15 patients have remained asymptomatic and without strokes. Recurrent dizziness was present in three, two of whom had vertebral arteriography showing patent vertebral reconstructions. Another had a stroke related to the anterior circulation in follow-up at nine years. Atherosclerotic obstruction of vertebral arteries does occur in patients in the preatherosclerotic age group. Even atypical symptoms suggestive of vertebrobasilar insufficiency may be associated with isolated correctable bilateral flow-impeding vertebral lesions. These symptoms warrant evaluation with cardiac neurological and cerebrovascular studies. Vertebral angioplasty relieves symptoms and the incidence of stroke during follow-up is low.
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PMID:Vertebral artery angioplasty in patients younger than 55 years: long-term follow-up. 201 81

We compared the efficacy and tolerability of controlled-release carbamazepine (CBZ-CR) with conventional carbamazepine (CBZ) in 131 epileptic patients (both men and women, ages 6-65 years) in an open, multicentre, cross-over trial. Patients entered into the trial were previously on CBZ monotherapy or polytherapy. During the first 4 weeks, patients were treated with equivalent daily doses of CBZ and then switched to CBZ-CR for the subsequent 4 weeks. The majority of patients were switched to the more convenient b.i.d. dosing schedule of the controlled-release (CR) preparation without a detrimental effect on seizure frequency or adverse effects. In 44/131 (34%) of patients, the switch to CBZ-CR was accompanied by an improvement in tolerability, primarily due to a reduction in peak-dependent CNS side-effects such as tiredness, double or blurred vision, dizziness and ataxia. At the end of the study, investigators preferred CBZ-CR for 76% of their patients and 70% of the patients preferred CBZ-CR.
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PMID:A comparison of the efficacy and tolerability of controlled-release carbamazepine with conventional carbamazepine. 203 18

Computerized tomography of the head was done in 5021 patients aged 21 to 81 years from various neurological, neurosurgical and neurotraumatological indications. Brain atrophy as an only finding (primary) was noted in 11.5%- and in 5.4% of cases it was associated with other changes. The neurological-radiological correlations were established in 200 cases of primary strophy. History data included: headaches in 54.5%, dizziness in 15.0%, epilepsy in 24.5%. Objective examination showed: slight hemiparesis in 37.5%, spastic-atactic gait disturbances in 31.5%, isolated damage to the corticospinal tracts with signs limited to one side of the body was more frequent in cortical atrophy, and these signs associated with ataxia were more frequent in subcortional atrophy. The authors explain this as a loss of cortical cells or damage to the paraventricularly coursing nerve fibres. A probable aetiology of "primary" atrophy was established in 405% of cases (hypertension, atherosclerosis, minor craniocerebral trauma). No signs or neurological syndromes were observed which could be regarded as more or less characteristic of brain atrophy.
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PMID:[Brain atrophy: radiological-neurological correlations]. 213 53

Aminoglutethimide (AG) was administered as palliative therapy in 112 patients with metastatic breast cancer. In 36 patients, the dose level was 1000 mg/day; 76 patients received a dose level of 500 mg/day. Patients with brain or liver metastasis were excluded, as were patients with tumors determined to be negative for estrogen receptors. Objective regression was observed in 35 (31%) patients, with the duration of response ranging from 4 to 36 + months (mean, 12 months; median, 10 months). Response was observed in 11 of 31 (35%) patients with soft tissue metastasis; 16/59 (27%) patients with osseous metastasis; and 8 of 22 (36%) having visceral metastasis. In 93 patients with positive estrogen receptor (ER), 33 responded (35%), whereas in 19 patients with unknown ER status, two responded (11%). Response to previous treatment with tamoxifen (TAM) had occurred in 31 patients; of these, response to AG was noted in 11 (35%). Of 24 patients failing to respond to prior treatment with tamoxifen, four (17%) responded to subsequent therapy with AG. Thirteen patients had previously received combination chemotherapy, and response to AG was noted in two (15%). The side effects observed in this study included skin rash in ten patients, fever in eight, somnolence in three, weakness and dizziness in one, headache in one, insomnia in one, dyspnea in one, and ataxia in one. Treatment had to be discontinued in eight patients, due to the severity of the side effects. As expected, patients receiving AG at the lower dose level of 500 mg/day experienced fewer and less severe side effects than those treated with the higher dose. The response rate in the 1000 mg/day group was 10/36 (28%) and in the 500 mg/day group, it was 25/76 (33%). The lower dosage was better tolerated without apparent compromise in therapeutic efficacy.
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PMID:Aminoglutethimide in patients with metastatic breast cancer. 246 35

D-Lactate-associated encephalopathy is a rare clinical syndrome characterized by dizziness, ataxia, confusion, headaches, memory loss, lethargy, and aggressiveness which may progress to frank but reversible coma. It occurs in patients with profound dysfunction of the short-bowel syndrome and is believed to result from massive carbohydrate malabsorption with resultant over-production of D-lactate and other organic anions by the colonic flora. Extremely elevated serum levels of D-lactate (but not L-lactate) confirm the diagnosis, but currently D-lactate is not clearly established as the putative neurotoxin. We describe a patient who repeatedly developed D-lactate encephalopathy after surgical removal of nearly the entire jejunum and ileum. Markedly elevated D-lactate serum levels were documented during an encephalopathic episode. Potential pathophysiologic mechanisms and the treatment rationale are discussed.
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PMID:D-lactate-associated encephalopathy after massive small-bowel resection. 276 Apr 34

The inside of an epidermoid is formed by masses of epithelial debris, desquamative keratin and cells derived from the epithelial capsule which accumulate very slowly within the capsule. As a result, the growth of the tumor is very slow, and the clinical signs are very diverse and bizarre because of the situation and extension of the epidermoids throughout the basal cisterns. A 52-year-old housewife was admitted to our clinic with complaints of dizziness and gait disturbance. The abnormal neurological findings were truncal ataxia, lt-trigeminal disturbance, lt-facial palsy, lt-hearing disturbance, lt-cerebellar signs (dysmetria, dysdiadochokinesia) and nystagmus. CT scan revealed low density area in the prepontine cistern and lt-cerebello-pontine angle, which was not enhanced following intravenous injection of the contrast medium. Metrizamide CT cisternography showed staining of the tumor heterogeneously revealing a honeycomb appearance. MRI showed the tumor clearly as well as the severe atrophy of the lt-cerebellar hemisphere and the pontine basal area. In this case atrophy of the cerebellar hemisphere and pons may have resulted from being compressed by the tumor. Because of this, we think it necessary to stress that early diagnosis and operation of the epidermoid are very important.
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PMID:[Cerebello-pontine angle epidermoid with cerebellar atrophy; report of a case]. 281 70

Nabilone is a new orally active cannabinoid for the treatment of severe gastrointestinal toxicity associated with cancer chemotherapy. The pharmacological profile of nabilone suggests that it acts primarily by preventing emesis controlled by the medulla oblongata, although its secondary mild anxiolytic activity may contribute to the overall efficacy. Nabilone 2mg twice daily starting 12 hours prior to, and continued for the duration of, chemotherapy produces significant reduction in the severity and duration of nausea and the frequency of vomiting in about 50 to 70% of patients with severe symptoms refractory to conventional therapy. Nabilone has proven to be more effective in controlling symptoms and preferred by more patients than prochlorperazine 10mg 2 to 4 times daily in a limited number of studies, despite a higher incidence of side effects. Comparative trials against other new antiemetic agents, such as high dose metoclopramide, and use of nabilone in combination with other antiemetics remain to be undertaken. The incidence of side effects is high with nabilone; drowsiness, dizziness and/or vertigo occur in 60 to 70% of patients, but rarely lead to drug withdrawal, although more troublesome effects, such as postural hypotension, ataxia, vision disturbance and toxic psychoses, may cause discontinuation of therapy. Thus, nabilone offers an effective alternative to the treatment options available in a difficult therapeutic area - those patients with severe gastrointestinal side effects from cancer chemotherapy who are refractory to conventional therapy.
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PMID:Nabilone. A preliminary review of its pharmacological properties and therapeutic use. 286 27

Forty-two patients with malignant melanoma were treated with doxifluridine, 4000 mg/m2 daily X 5, repeated every 3 weeks. The daily dose was reduced to 3000 mg/m2 in patients who had experienced severe myelosuppression with prior chemotherapy. A total of 35 patients were evaluable for response, and 25 of these received two or more courses. Two responses were observed. Toxicity mainly took the form of nausea, vomiting, stomatitis, dizziness, ataxia, and fatigue. Mild leukopenia was frequent (43%). Nadir counts less than 1.5 X 10(9)/l leukocytes or 50 X 10(9)/l platelets were seen in 7% and 2% of the courses respectively. Doxifluridine has no useful activity against malignant melanoma.
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PMID:Phase II study of 5'-deoxy-5-fluorouridine (doxifluridine) in advanced malignant melanoma. 293 77

A double-blind placebo-controlled trial of 7 days administration of lamotrigine as add-on therapy was performed in 10 patients with frequent therapy-resistant, chiefly partial, seizures. Dosage was adjusted on the basis of estimated half-life. Six patients showed a 50% seizure reduction on lamotrigine and two an increase. Side effects (ataxia, dizziness and apathy) occurred in 3 patients, but only at blood levels above 3 micrograms/ml, and were rapidly relieved when the dose was reduced in two. EEG spike counts were significantly reduced on lamotrigine. There was no evidence of interactions with co-medication.
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PMID:Seven day administration of lamotrigine in epilepsy: placebo-controlled add-on trial. 333 66

The rehabilitative course for patients who have suffered vertebral-basilar vascular lesions is often interrupted by intermittent episodes of increasing dizziness, nausea, vomiting, and ataxia. Since CT studies of the brain do not always visualize these lesions reliably, the rehabilitation specialist has been without a diagnostic tool to distinguish between progressive and stable vertebral-basilar system infarctions. Magnetic resonance imaging (MRI) offers a safe, noninvasive, sensitive means of monitoring vascular lesions in the posterior fossa. The purpose of this study was to use MRI to evaluate patients with suspected vertebral-basilar vascular lesions. In three patients studied, MRI was superior to CT scan. Advantages of MRI included lack of artifact due to bone scattering from ionizing radiation, ability to image directly in the sagittal plane, visualization and localization of pathologically smaller lesions, and potential for performing serial studies without exposing patients to large doses of radiation. In each case, MRI data yielded valuable adjunctive information that aided further rehabilitation evaluation and management. We conclude that MRI may be a useful diagnostic and prognostic tool in evaluating and managing rehabilitation patients with vascular lesions involving the vertebral-basilar system.
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PMID:Magnetic resonance imaging for vertebral-basilar system infarction. 333 41


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