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

A self-administered questionnaire designed to identify people with transient cerebral ischemia (TIA) in large population groups was distributed to approximately 10,000 elderly persons living in public and private retirement facilities in the United States. The population resided in eight cities, and 74% completed the survey. Transient focal neurological symptoms compatible with a diagnosis of TIA within the previous year were reported by 6.4% of the respondents. Uncertain manifestations of TIA, i.e., dizziness, light-headedness, or loss of balance, were noted by an additional 15.4%; the remaining 78.2% had no manifestations of this disorder. A clinical history for TIA was taken by a neurologist in a sample of 1,712 respondents to determine the validity of the questionnaire responses. Thirty (7.1%) of 423 persons presumed by the questionnaire to have TIA met the standard clinical criteria for the diagnosis. An additional 8 cases of TIA were found by the neurologist among the 1,289 interviewed persons presumed by the questionnaire to have uncertain TIA or no evidence of the disorder. The twelve-month period prevalence of TIA was estimated to be 8.2 per 1,000 in the total respondent population and 5.8 per 1,000 among those without a history of prior completed stroke. Despite the high proportion of false-positive neurological symptoms of TIA elicited by the questionnaire, this survey instrument nevertheless screened out for further study the 6% of the population in whom 55% of the TIAs occurred.
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PMID:Use of a self-administered questionnaire for detection of transient cerebral ischemic attacks: I. Survey of elderly persons living in retirement facilities. 50 55

The aim of the study was to investigate the relationship between medical and behavioural aspects of dizziness, and the subjective experiences before, during and after an 'attack'. Clinical and self-report data were collected on 60 patients who attended a neuro-otology clinic and whose main complaint was dizziness. The results indicated little direct correlation between subjective experience and organic severity, though there was some correlation between types of movement provocation and both subjective and organic factors. Correspondence analysis of self-reported dizzy sensations revealed four principal clusters. There was a clear distinction between attacks characterized by sensations of actual loss of balance and those preceded by autonomic sensations. Two types of mainly psychologically generated dizziness were proposed: one characterized by inhibition of sensory-motor processes and breathing problems; the other by a range of sympathetic signs. It is suggested that the reporting of sensations should be considered as an independent part of dizziness behaviour and not as a by-product of the physiological disturbance.
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PMID:Dizziness: behavioural, subjective and organic aspects. 326 96

The results of various forms of treatment of patients with minor head injuries have been examined. The number and frequency of post-concussional sequelae was markedly reduced by treatment which included information, explanation and encouragement. Dizziness, loss of hearing and loss of balance were related to external lesions to the vestibular system caused by injuries to the parieto-temporal region of the skull. PTA proved to be a reliable indicator of the severity of cerebral concussion and correlated with post-concussional sequelae and periods of disability. Other factors which increased the number and frequency of post-traumatic sequelae, especially those related to stress before the accident, could be counteracted by better treatment of the patient. The results bear out the hypothesis that post-concussional sequelae start off on an organic basis (PTA) and that persistent sequelae after minor head injuries are also caused by psychogenic, and especially by iatrogenic factors.
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PMID:Treatment of minor head injuries. 625 11

We investigated motion sickness evoked by walking while wearing horizontally reversing goggles. The subjects were 36 healthy adults and 90 children aged 4 to 15 years. Most adults soon displayed not only severe sickness, but also dizziness and instability. Instability was certified by Graybiel's ataxia tests in 10 adults. Young children aged 4 to 5 years rarely became sick; however, they showed marked ataxia manifested as drunken gait, falling, or failure to stand up. In older children, autonomic nervous symptoms became manifest and more severe, but ataxia became less severe since locomotion was stopped by uncomfortable symptoms. The present study strongly suggests that motion sickness makes animals learn loss of spatial orientation, which inevitably produces loss of balance.
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PMID:Teleology of motion sickness. 761 Jul 87

Two female patients with an adenocarcinoma of the colon (Duke stages B and C) underwent colectomy followed by adjuvant chemotherapy combining 5 fluorouracil (5 FU) and levamisole. Secondary neurological manifestations occurred in both patients including vertigo, nausea and vomiting, dizziness with loss of balance, slow ideation, impaired memory, headache and, on one case, central origin facial paralysis. Symptoms appeared between the 11th and 34th week of treatment. The patients had received 9 to 30 g 5 FU and 2.7 to 7.6 g levamisole. CT scan and/or MRI first suggested cerebral metastases then demyelinisation. The clinical signs disappeared spontaneously in less than one month. The brain images were unchanged. The 5 FU/levamisole combination was undoubtedly responsible for the neurological manifestations. Levamisole may have potentialized the effect of 5 FU leading to demyelinisation. Whether chemotherapy should be stopped or not is debated.
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PMID:[Multifocal inflammatory leukoencephalopathy: a complication of chemotherapy by fluorouracil and levamisole]. 774 17

Drop attacks are sudden, unexpected, nonsyncopal falls, which are not preceded or accompanied by loss of consciousness, dizziness, lightheadedness, or loss of balance. They can be a manifestation of epilepsy, brain stem tumors, and a variety of other conditions. In the elderly, they have been associated with vertebrobasilar insufficiency, cervical spondylosis, or both. However, the specificity and etiology of drop attacks have come under some scrutiny in recent years. The patient described in this case report experienced frequent drop attacks that were effectively prevented with nifedipine. Possible pathophysiologic mechanisms are discussed and the relevant literature is reviewed.
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PMID:Treatment of drop attacks with nifedipine: a case report. 779 70

Transient ischemic attack (TIA) is the most powerful predictor of stroke. Estimates of its prevalence in various regions of the world differ depending upon the instruments and exclusion criteria used and the population surveyed. For example, if the questioner uses technical language, or if he or she excludes events lasting but a few seconds and symptoms such as dizziness (without accompanying phenomena), numbness and tingling, and transitory amnesia (euphemistically called forgetfulness), an entirely different prevalence results than if these events and symptoms are included. In a survey of people aged 45 to 64, cross-sectional data were ascertained by means of a standardized TIA/stroke questionnaire and an algorithm. For women the prevalence of TIA-like events was 5% and fr men, 3%, increasing with age for both sexes. These events were more prevalent in African-Americans than Caucasians. The most frequent symptoms were change in speech, followed by dizziness and loss of balance.
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PMID:Transient ischemic attack: awareness and prevalence in the community. 791 66

As part of the Atherosclerosis Risk in Communities (ARIC) Study assessment of the etiology and sequelae of atherosclerosis, a standardized questionnaire on transient ischemic attack (TIA) and nonfatal stroke and a computerized diagnostic algorithm simulating clinical reasoning were developed and tested at the four ARIC field centers: Forsyth County, North Carolina; Minneapolis, Minnesota; Jackson, Mississippi; and Washington County, Maryland. The diagnostic algorithm used participant responses to a series of questions about six neurologic trigger symptoms to identify symptoms of TIA or stroke and their vascular distribution. Among 12,205 ARIO participants reporting their lifetime occurrence of one or more symptoms probably due to cerebrovascular causes, nearly half (47%) reported the sudden onset of at least one symptom sometime prior to their ARIC examination. Of those with at least one symptom, only 12.9% were classified by the computer algorithm as having symptoms of TIA or stroke. Dizziness/loss of balance was the most frequently reported symptom (36%); 1.2% of these persons were classified by the algorithm as having a TIA/stroke event. Positive symptoms of speech dysfunction were classified most often (77.%) as being symptoms of TIA or stroke. Symptoms suggesting TIA were reported more frequently than symptoms suggesting stroke by both sexes. TIA or stroke-like phenomena were more frequent (p < 0.001) in females (7%) than in males (5%) and increased with age in both sexes (p = 0.13 for females; p = 0.02 for males). In Forsyth County, TIA and stroke symptoms were greater in African Americans than in Caucasians (p = 0.05, controlling for sex). The association of algorithmically defined symptoms of TIA or stroke with traditional cerebrovascular risk factors is the subject of a companion paper.
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PMID:Self-reported transient ischemic attack and stroke symptoms: methods and baseline prevalence. The ARIC Study, 1987-1989. 889 Jun 63

Complaints of dizziness and disequilibrium increase with age. Sixty-five percent of individuals older than 60 years of age experience dizziness or loss of balance, often on a daily basis. Some degree of imbalance is present in all individuals older than 60. This is the result of a generalized functional degradation. Initially, the imbalance is situational and manifests when the righting reflexes cannot meet the demands of a challenging environment, such as a slippery surface. As the functional degradation progresses, the imbalance occurs during everyday activities, independent ambulation becomes difficult, and the likelihood of falls increases. When instability is constant, the individual resorts to the use of a cane, a walker, or a wheelchair.
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PMID:Equilibrium and balance in the elderly. 1048 48

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).
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PMID:[Diagnosis of common causes of vertigo using a structured clinical history]. 1079 28


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