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

The clinical manifestations, surgical treatment and postoperative results of three patients with gangliocytomas of the cerebellum (Lhermitte-Duclos disease) are presented. Particular attention is placed in one of the cases, that of a young woman with a short clinical history of episodic symptoms of intracranial hypertension, dizziness and ataxia, with a concomitant frontal meningioma and in the general context of a multiple hamartoma syndrome (Cowden disease). The possible relationship between both diseases is contemplated, since they can be the extremes of a wide spectrum of a peculiar form of phakomatosis.
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PMID:Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease) and its relation to the multiple hamartoma syndrome (Cowden disease). 796 80

Clinical trials of lamotrigine (LTG) began in 1984. By November 1992 about 5,800 patient-years' experience of adverse effects had been compiled. In general, LTG has an acceptable safety profile. Mild central nervous system adverse effects such as ataxia, dizziness, and headache occur significantly more frequently with LTG than with placebo but seldom demand discontinuation of LTG therapy. Dosage-related allergic skin rash occurs in about 5% of patients. The rash rarely is severe enough to require hospitalization. The adverse-reaction profile of LTG compares favorably with that of traditional antiepileptic drugs.
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PMID:Safety of lamotrigine. 803 69

1. Signs and symptoms of pseudotumor cerebri include papilledema with imaging studies that reveal a normal brain; elevated intracranial pressure with normal cerebrospinal fluid contents; and abducens palsies with diplopia. 2. The most common presenting symptom is headache. Preverbal children may be irritable. Infants often are sleepy or apathetic. Other symptoms include dizziness and ataxia. 3. Loss of acuity or visual field is the only serious permanent complication of pseudotumor cerebri; children often complain of "blurred vision."
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PMID:Pediatric pseudotumor cerebri. 806 80

A few days after a judo session, an 11-year-old boy presented with an ischemic stroke with dizziness, aphasia and ataxia. CCT scan revealed a left thalamic infarct. Angiography showed a fibromuscular dysplasia (FMD) of the left vertebral artery probably complicated by dissection. Subsequent evolution was favorable. This observation points out the fact that the association of a cervical pain with neurological signs of vertebrobasilar stroke, especially occurring after a cervical trauma or rotatory motion, should alert to the possibility of vertebral-artery dissection. The diagnosis is mainly based on angiographic criteria. Accurate diagnosis has implications for prognosis and probably for acute medical treatment.
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PMID:Vertebral-artery dissection following a judo session: a case report. 807 74

Twenty-two cases of cerebellar infarction were diagnosed by clinical findings, computerized tomography (CT), magnetic resonance image (MRI) and autopsy. Most of the infarctions occurred in the territory of the posterior inferior cerebellar artery (18/22). The most common and earliest symptoms were dizziness or vertigo (19/22), which occurred repeatedly and were accompanied by nausea and vomiting. The symptoms and signs of cerebellar lesion such as unsteady gait, limb and/or trunk ataxia, dysarthria were also the main clinical manifestations. However, in a number of patients there were no cerebellar symptoms or signs (9/22). Rapid deterioration of consciousness suggested acute compression of the brainstem, where the prognosis would be poor. CT scan made it possible to diagnose cerebellar infarction in the patients. But CT is not a satisfactory instrument in identifying this disease. MRI without bony artifacts from the posterior fossa has much higher resolution and renders the infarction to be visualized earlier. It may be regarded as the most ideal instrument in diagnosing this disease.
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PMID:Cerebellar infarction. Analysis of 22 cases. 808 78

This is the 2-year interim report of results from a multicenter, open-label study evaluating the long-term efficacy and safety of gabapentin (Neurontin) as add-on therapy in patients with refractory partial seizures who had had a therapeutic response to gabapentin in a preceding 12-week double-blind trial or 12-week open-label extension. A total of 240 patients continued to receive gabapentin as add-on therapy at dosages of 600-2400 mg/day for an average of 342 days (range 10-784 days). Efficacy analyses compared seizure frequency during consecutive 12-week treatment periods with seizure frequency during the 12-week baseline. During the nine treatment periods evaluated, the percent of patients with a 50% or greater reduction in seizure frequency ranged from 35% to 71%, and the median percent change in seizure frequency ranged from -33% to -60%. At the time of data cutoff, 30% of patients had withdrawn from the study due to lack of efficacy, and 4% due to adverse events. In 225 patient-years of gabapentin treatment in this study, CNS adverse events reported by more than 10% of patients were nystagmus, somnolence, diplopia, tremor, ataxia, and dizziness. No consistent changes in clinical laboratory values were associated with gabapentin. Gabapentin as add-on therapy at dosages up to 2400 mg/day is safe during long-term treatment in patients with refractory partial seizures. Subgroup analyses of patients who remained in the study over the long term confirmed that gabapentin maintained efficacy for up to 2 years.
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PMID:The long-term safety and efficacy of gabapentin (Neurontin) as add-on therapy in drug-resistant partial epilepsy. The US Gabapentin Study Group. 808 58

The efficacy and safety of lamotrigine (LTG), a new antiepileptic drug (AED), were evaluated in a multicenter, randomized, double-blind, placebo-controlled, cross-over study of 98 patients with refractory partial seizures. Each treatment period lasted 14 weeks. Most patients were titrated to a LTG maintenance dose of 400 mg/day. Seizure frequency with LTG decreased by > or = 50%, as compared with placebo, in one fifth of patients. Overall median seizure frequency decreased by 25% with LTG as compared with placebo (p < 0.001). With LTG, the number of seizure days decreased by 18% as compared with placebo (p < 0.01), and investigator global evaluation of overall patient clinical status favored LTG by 2:1 (p = 0.013). Plasma LTG concentrations appeared to be linearly related to dosage. LTG had no clinically important effects on the plasma concentrations of concomitant AEDs. Adverse experiences were generally minor and most frequently were CNS-related (e.g., ataxia, dizziness, diplopia, headache). Most were transient and resolved without discontinuing treatment. Five patients withdrew as a result of adverse experiences while receiving LTG, including 3 patients with rash. One placebo patient was also withdrawn because of rash. The addition of twice-daily LTG to an existing AED regimen was safe, effective, and well tolerated in these medically refractory partial seizure patients.
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PMID:Lamotrigine therapy for partial seizures: a multicenter, placebo-controlled, double-blind, cross-over trial. 811 32

Side effects play a significant role in the selection of drugs to be used in panic disorder/agoraphobia whose polyphobic symptomatology often includes a suspiciousness about taking drugs and a fear of undesired side effects which may lead to the refusal of treatment. The safety, side effects and patients' acceptance of alprazolam and imipramine versus placebo were evaluated in 1168 subjects with panic disorder/agoraphobia who had been enrolled in the second phase of the Upjohn World Wide Panic Study. Side effects that worsened over baseline to a greater extent with alprazolam than with imipramine and placebo were sedation, fatigue/weakness, memory problems, ataxia and slurred speech. In the imipramine group blurred vision, tachycardia/palpitations, insomnia, sleep disturbance, excitement/nervousness, malaise, dizziness/faintness, headache, nausea/vomiting and decrease in appetite were worse than in the other groups. In the placebo group the anxious symptoms were most prominent. The highest level of compliance was shown in the alprazolam-treated group and the lowest in the placebo-treated group. Strong predictors of side effects were not observed. If a side effect profile is known, it will be easier for a clinician to choose the right drug and the appropriate management by taking into account compliance, safety and efficacy in each patient under treatment. Further information about side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.
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PMID:Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo. 820 96

Infarction of the cerebellum comprises about 1.5 percent of all strokes. The symptoms are initially very similar to those of benign labyrinthitis, and the diagnosis is easy to miss. There are three major causes of clinical deterioration and death: Expansion of the infarct to the brainstem, swelling of the infarcted cerebellum with compression of the brainstem, and hydrocephalus. Surgical intervention may be lifesaving if hydrocephalus develops. Five patients admitted to our department are described. All described sudden vertigo or dizziness, which in three of them was accompanied by headache. All had ataxia. In four this was ipsilateral to the infarction and in one bilateral. Two had slight hemiparesis and plantar inversion. Two patients developed hydrocephalus. One was operated with external drainage. It is important to have this diagnosis in mind in all patients with acute labyrinthine symptoms. Acute CT scanning should be carried out if the patient becomes less conscious.
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PMID:[Cerebellar infarctions]. 823 75

The frequency of cerebellar infarctions over two and a half years was 2.7% of the 1300 hospitalized patients over that period. Sixteen patients with cerebellar infarctions were studied by using clinical manifestations and magnetic resonance imaging (MRI). Ages ranged from 41-87 (mean 63.5) years; 13 were men and 3, women. Risk factors included: hypertension (50%), diabetes (44%), prior stroke (44%), cardiac disease (38%), and hyperlipidemia (19%). Common symptoms and signs were dizziness/vertigo (75%), unsteadiness (69%), dysarthria (69%), and nausea/vomiting (50%). Infarcts mainly involved the posterior inferior cerebellar artery (PICA) territory and tended to be associated with brainstem infarcts in 14 of the 16 patients. Most cerebellar infarctions had a benign course, especially the small ones. No mortality was noted in this series. The short-term outcome of the cerebellar infarctions seemed to depend on the size of the infarcts and the sites of the artery occlusion. It was concluded that diagnosis of cerebellar infarctions requires a high index of clinical suspicion, especially when patients present with a sudden onset of ataxia, dizziness/vertigo, nausea/vomiting and dysarthria; and that MRI is a useful tool for the detailed study of cerebellar infarctions and can elucidate associated brainstem infarcts.
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PMID:A clinical and MRI study of cerebellar infarctions. 829 26


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