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

Different causes of dizziness or vertigo can only be recognized by thorough anamnestic explorations. Following a classification in vestibular and nonvestibular causes for vertigo, a further differentiation is possible by defining different characteristic qualities of the symptoms involved. In addition to the classical vestibular forms of vertigo seen, dizziness currently results from drug overdosages, hypertension, polyneuropathy and--less commonly, but equally important--brief epileptic seizures. Psychosomatic and neurotic symptoms may also lead to unsteady gait, dizziness or vertigo, all of which are distinguished only with difficulty by the patient.
HNO 1978 May
PMID:[Diagnostic problems in dizziness or vertigo (author's transl)]. 35 Aug 16

Dizziness and provoked or even spontaneous nystagmus are common findings in multiple sclerosis. Disturbances of hearing are thought to be rare, and there are few case reports in the literature. The importance of characterizing the audiometric abnormalities of disseminated encephalomyelitic disease of uncertain neurological aetiology is stressed. They may be defined as follows: 1. The pure tone threshold level may be normal or may be seen as a flat loss. 2. Pulse tones are better heard that continuous tones (Bekesy, tone decay tests). 3. Recruitment or its equivalents demonstrate hearing impairment at neural or neuronal levels. 4. The acoustico-facial reflex (impedance audiometry) cannot be elicited or is obviously reduced on the affected side. 5. Intelligibility of numbers in speech audiometry is not altered or may be better than that expected on the pure tone threshold findings. The intelligibility of monosyllabic words is obviously bad. 6 Dichotic discrimination of speech may be completely absent on one side even though the pure tone threshold is near normal. Multiple sclerosis primarly involves the central nerve fibres. The presence of remissions distinguishes the disease from vascular lesions and from acoustic neuromas. An audiological approach offers a new application of otology in neurological practice.
HNO 1975 Apr
PMID:[Hearing disturbances in multiple sclerosis (author's transl)]. 121 8

There are many drugs marketed for the purpose of altering vascular blood flow in various regions, especially of the central nervous system and in peripheral arterial insufficiency. More than 50 different methods are described for the treatment of sudden deafness. Considerations of the therapy of sudden deafness are influenced by the fact that the cause of the disease is unknown. The dysfunction of the hair-cells of the organ of CORTI is thought to be caused by a deficit of oxygen due to disorders of micro-circulation in the inner ear. The infusion of vaso-active drugs in the early state of disease can lead to a remarkable improvement of hearing whereas the prospect of improvement without treatment remains uncertain. Nevertheless it may be difficult to distinguish the beneficial effects of vasodilator agents from spontaneous improvement. Naftidrofuryl oxalate (dusodril) has been in use for many years and proved its therapeutic value in many studies. It is regarded as non-toxic and is used extensively in Europe. Side effects are only reported rarely, and include decrease of cerebral blood flow, abdominal distension, diarrhoea, oesophageal ulceration, epileptic seizures, aphasia, disturbances of consciousness, hypotension, hypertensive crisis, vertigo and dizziness, depression of cardiac conduction, thrombophlebitis, and allergy. This case report of allergic reaction in a young female patient demonstrates that the intravenous application of this drug may lead to severe complications.
HNO 1987 May
PMID:[Allergic reaction in therapy with naftidrofuryl (Dusodril). A case report]. 361 Jun 82

The contribution of cervical spine disorders to cochleovestibular symptoms was based on the evaluation of patients complaining of dizziness and/or inner ear hearing loss, treated in the ENT Department of Tubingen University between 1977 and 1982. Cervicogenic vertigo was provoked by movements of the cervical spine, but the latter rarely caused tinnitus and never induced hearing loss. The diagnosis between a vascular or proprioceptive nystagmus may be made on the presence of lesions of the cervical spine. These are disorders of the cranio-cervical or the thoraco-cervical region especially and much less often due to osteochondrosis of the vertebrae. The findings of a cervical osteochondrosis has no diagnostic value unless vertigo is provoked by head movements. In cervical vertigo the thoraco-cervical region should be examined to prove a thoracic outlet syndrome. In selected cases operative treatment is possible, eg. transoral resection of the dental process of the axis, resection of the posterior arch of the atlas, myotomy of the anterior scalenus muscle or decompression of the vertebral artery.
HNO 1984 Dec
PMID:[Cervical vertebra-induced hearing and equilibrium disorders. Recent clinical aspects]. 653 Mar 73

A vacuum operated suction appliance can be invaluable for all areas of surgery. The suction process carries a greater risk (e.g. dizziness, deafness), especially in microsurgery of the ear. A newly developed vacuum valve for microsurgery that is mechanically adjustable is presented. The surgeon operates the valve with his foot outside the aseptic area of surgery. The valve enables him to regulate the vacuum or to quickly interrupt the suction process. This allows for swifter, safer surgery. Examples of use of the device in microsurgery of the ear are described in detail.
HNO 1996 Mar
PMID:[Newly developed vacuum suction valve for microsurgery]. 864 3

Sildenafil citrate, an oral therapy for erectile dysfunction, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), the predominant isozyme metabolizing cGMP in the corpus cavernosum. Chemically, it is a compound of the pyrazolo-pyrimidinyl-methylpiperazine class. Sildenafil has no direct relaxant effect on human corpus cavernosum but enhances the relaxant effect of nitric oxide (NO) on the corpus cavernosum by inhibiting PDE5, which is responsible for degradation of cGMP in this tissue. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil increases concentrations of cGMP in the corpus cavernosum, causing smooth muscle relaxation and blood flow into the penis, resulting in an erection. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. The drug is rapidly absorbed after oral administration, with absolute bioavailability of 40%. Its pharmacokinetics are dose proportional over the recommended dosage range. Maximum plasma concentrations are reached within 30 to 120 minutes after oral dosing in the fasting state. Sildenafil is cleared predominantly by the hepatic microsomal isoenzymes CYP3A4 (major route) and CYP2C9 (minor route). Clinical studies assessed the effect of sildenafil on the ability of men with erectile dysfunction to engage in sexual activity and, specifically, to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil was evaluated at doses of 25, 50, and 100 mg in randomized, double-masked, placebo-controlled clinical trials of up to 6 months' duration. The drug was administered to hundreds of patients aged 19 to 87 years having erectile dysfunction of various etiologies for a mean duration of 5 years. Sildenafil was associated with statistically significant improvement in erectile function compared with placebo. Adverse effects reported at a rate of >2% were headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness, and rash. No cases of priapism were reported. The use of sildenafil is contraindicated in men who are taking organic nitrates, because of the potential for a precipitous decrease in blood pressure. Postmarketing reports and surveillance have revealed at least 39 deaths with sildenafil use in men having a history of heart disease, men taking nitrate medications, and men in poor physical health due to lack of exercise. Many of the men who experienced serious adverse effects or death had a variety of concomitant diseases and were taking multiple medications.
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PMID:Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. 991 1

Nebivolol is a new selective beta 1-adrenergic blocking agent, that possesses a peculiar pharmacodynamic profile and an original chemical structure, by which it differs from traditional beta 1-blockers. Nebivolol is a racemic mixture of two enantiomers in equal ratios. It is endowed with a highly selective beta 1-blocking activity, and does not show an intrinsic sympathomimetic activity. Nebivolol is endowed with peripheral vasodilating properties mediated by the modulation of the endogenous production of nitric oxide. It does not significantly decrease airway conductance compared with atenolol and propranolol. Nebivolol does not compromise the left ventricular function, but it may increase stroke volume, and does not reduce heart inotropism during exertion. Nebivolol is quite safe and is well tolerated, also when compared to traditional beta-blockers. The most common adverse effects are dizziness, headache and fatigue. Owing to its combined dual mechanism of action, nebivolol leads to a unique haemodynamic and therapeutic profile by which it may be advantageous in essential hypertension, ischaemic heart disease and congestive heart failure.
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PMID:Pharmacology of nebivolol. 999 Jun 50

Sildenafil, a selective inhibitor of phosphodiesterase type 5 (PDE5), is the first in a new class of orally effective treatments for erectile dysfunction. During sexual stimulation, the cavernous nerves release nitric oxide (NO), which induces cyclic guanosine monophosphate (cGMP) formation and smooth muscle relaxation in the corpus cavernosum. Sildenafil facilitates the erectile process during sexual stimulation by inhibiting PDE5 and thus blocking the breakdown of cGMP. Sildenafil alone can cause mean peak reductions in systolic/diastolic blood pressure of 10/7 mm Hg that are not dose related, whereas the heart rate is unchanged. Sildenafil and nitrates both increase cGMP levels in the systemic circulation but at different points along the NO-cGMP pathway. The combination is contraindicated because they synergistically potentiate vasodilation and may cause excessive reductions in blood pressure. Erectile dysfunction is a significant medical condition that shares numerous risk factors with ischemic heart disease, and hence a substantial overlap exists between these patient groups. From extensive clinical trials, the most commonly reported cardiovascular adverse events in patients treated with sildenafil were headache (16%), flushing (10%), and dizziness (2%). The incidences of hypotension, orthostatic hypotension, and syncope and the rate of discontinuation of treatment due to adverse events were <2% and were the same in patients taking sildenafil and those taking placebo. Retrospective analysis of the concomitant use of antihypertensive medications (beta blockers, alpha blockers, diuretics, angiotensin-converting enzyme inhibitors, and calcium antagonists) in patients taking sildenafil did not indicate an increase in the reports of adverse events or significant episodes of hypotension compared with patients treated with sildenafil alone. In clinical trials, the incidence of serious cardiovascular adverse events, including stroke and myocardial infarction, was the same for patients treated with sildenafil or placebo. Concurrent disease states, such as renal or hepatic impairment, or concomitant use of inhibitors of the cytochrome P450 isozyme CYP3A4 could increase systemic exposure to sildenafil. Since the US market launch in April 1998, monitoring of spontaneous adverse event reports in association with sildenafil has demonstrated a pattern that is generally consistent with the experience observed during clinical development, with the exception of infrequent reports of priapism. In conclusion, extensive clinical testing has shown that overall treatment with sildenafil for up to 1 year is well tolerated and is associated with a low incidence of adverse events that result in discontinuation of treatment in <3% of patients.
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PMID:Overall cardiovascular profile of sildenafil citrate. 1007 41

An absolute requirement for acquiring a driving license according to German law consists in the suitability for driving a motor vehicle. The "driving license decree" defines these requirements; in case of doubt the administrative authority may demand a medical certificate. According to law (enactment: 1.1.99) these medical certificates must be refunded by either appropriate medical specialists, company doctors or public health officers. The criterions for appraisal are set down in the guidelines for driving ability which are edited by the advisory board for traffic medicine; a new edition will be published soon. Concerning otorhinolaryngology hearing impairment and dizziness are the most relevant diseases. Bilateral deafness is no general exception for conferring a driving license for the classes A and B; for classes C and DE hearing loss, established from the pure tone audiogram must not exceed 60%; an exceptional case is a three year demonstration of reliability in class B. Permanent dizziness or vertigo attacks are in most cases incompatible with conferring driving licenses. The most important issue for medical appraisal is to determine the amount of compensation of the impaired sense organ. Therefore in cases of multiple disabilities more stringent criterions must be established.
HNO 1999 Nov
PMID:[Expert-assessment of suitability for a driving license in otorhinolaryngology]. 1060 83

Adenomas of the middle ear are rare benign glandular neoplasms arising from the middle ear mucosa. After previous operations 25 and 15 years before, a 67-year-old female complained about dizziness, tinnitus, and unilateral hearing loss on the left side. A tumor in the tympanum that was revealed by otoscopy could be removed completely. Histological examinations showed an adenoma of the middle ear with cholesteatoma. This was inconsistent with the histological result of the operation in 1983, which had described a hidradenoma. An exact analysis of the preparations confirmed that a middle ear adenoma had already been present in 1983. Hidradenoma is one of the most important differential diagnoses. The characteristic histological sign of middle ear adenomas in contrast to hidradenomas is the lack of myoepithelial cells. In addition, it is very difficult to differentiate middle ear adenoma and adenocarcinoma using histopathological and clinical methods. Therefore, thorough follow-up is mandatory for patients after surgical treatment of middle ear adenomas.
HNO 2001 Feb
PMID:[Middle ear adenoma. Long-term course of a rare neoplasm]. 1127 Jan 95


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