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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A careful history is the most important part of a medical examination for vertigo, especially to establish whether it is acute, chronic or recurrent. If the patient spontaneously volunteers ear complaints, such as fullness, tinnitus, or hearing loss, the cause is probably otologic and deserves immediate referral. If no otologic complaints are volunteered, the whole body becomes a source of investigation. All nonvital drugs should be withheld while the vertigo study is progressing. A complete physical examination and blood profile should be carried out. Roentgenograms of the skull and chest should be obtained. Accurate diagnosis and proper management are possible only with prolonged follow-up. Unnecessary expense, inconvenience, and discomfort for the patient can be avoided by a screening audiogram to identify unilateral hearing loss. All unilateral hearing loss should be investigated thoroughly in order to diagnose serious retrocochlear disease early.
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PMID:A practical approach to the patient with vertigo: an outline of diagnosis and management for the nonspecialist. 111 59

The female climacteric is attributed to physiological ovarian failure with the consequent decrease in the secretions of oestrogen, progestones and androgens. Numerous metabolic, psychological and physical changes have been associated with this event. Oral discomfort, including the burning mouth syndrome and the dry mouth syndrome, has been described as a menopausal symptom. However, the relationship between the hormonal changes related to climacteric and the onset of oral discomfort is still controversial. The purpose of the present study was to evaluate the prevalence of oral symptoms, with particular regard to burning sensation, xerostomia, altered taste and recurrent oral ulcerations. The relationship between oral and climacteric symptoms and psychological status of the patients was also evaluated. A questionnaire was administered to 136 women (mean age: 51.2 years, range 40-62) being consecutively referred to the University Hospital Menopause Clinic from October 1991 to March 1992. The questionnaire included informations regarding menopausal state, oral symptoms, drug assumption, wearing of partial or total dentures, parafunctions (lip and cheek biting, bruxism, tongue thrusting). Climacteric symptoms including flushes/sweats, palpitations, headache, arthralgia/myalgia, vaginal dryness, decreased concentration, tiredness, decreased libido, insomnia, vertigo were evaluated. Visual analogue scale (VAS) was used where appropriate. Information regarding the alteration of the psychological status was collected by means of the Hospital Anxiety and Depression Scale Statistical analysis was performed by chi 2 test or Fisher's Exact Probability Test and Mann-Whitney U-test. The level of significance accepted was 5%. The subjects in this study were divided into two groups on the basis of their answers to the questionnaire: group I (no. 39), premenopausal women; group II (no. 97), menopausal women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Oral symptoms in the climacteric. A prevalence study]. 129 73

We described two cases of the lateral medullary syndrome (Wallenberg's syndrome) due to vertebral artery dissection following minimal neck injuries. The first case was a 45-year-old man, who hit his head and often rotated his head because of posterior neck discomfort. Two years after the injury, he suffered from sudden sharp neck pain, nausea, and vertigo, which was followed by left hand numbness and difficulty in walking due to the right lateral medullary syndrome. Angiography showed right vertebral artery dissection at the fourth segment. The second case, a 48-year-old man, suffered from neck pain immediately after he hyperextended his neck for painting a wall. Within several hours, he experienced left hand numbness and difficulty in walking due to the lateral medullary syndrome. Angiography showed a saccular aneurysm and dissection of the right vertebral artery at the fourth segment. In both cases, minor traumas were thought to be the causes of vertebral artery dissection. We surveyed previously reported 84 cases (men: 50, women: 34) of the vertebral artery dissection due to minor traumas. Seventy per cent of patients were in their third or fourth decade of life. The main causes of trauma preceding the dissection were neck manipulation especially chiropractics (52%). The third segment was most vulnerable. Delay in onset following neck trauma could be more than a week, but in most cases the delay was less than 24 hours. Cervical rotation and extension were thought to precipitate dissection.
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PMID:[Wallenberg's syndrome due to vertebral artery dissection following minimal neck injury--report of two cases]. 139 31

Fifty pregnant women with a hemoglobin between > 10 and < or = 12 g/100 ml during the second three months of pregnancy participated in a non-comparative clinical trial intended to evaluate, during a one month treatment period, the acceptability and effectiveness of an iron supplement (Bio-fer), combined with a high iron diet. Gastric discomfort regressed (present in 11 and 3 women before and after treatment) (p < 0.05), the same applying to constipation (p < 0.05) (present in 17 and 8 women before and after treatment). Reasons for abandoning treatment were nausea (n = 2) and vertigo (n = 1). Anemia or deficiency, evaluated on the basis of hemoglobin and iron-binding capacity levels, improved or stabilised in 34 patients out of 47 (72.3%). Hemoglobin increased (p < 0.0001) on average from 11.4 +/- 0.6 to 11.7 +/- 0.8 g/100 ml.
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PMID:[Efficacy and tolerance of a dietary iron supplement (Bio-fer) in pregnancy anemia]. 148 77

This study was conducted to evaluate the relationship between the prevalence of subjective symptoms in workers using vibrating tools and the duration of chain saw operation and to examine whether the symptoms were relevant to factors other than the usage of vibrating tools. The statistical model of multivariate analysis was adapted to analyze individual data on the subjective symptoms of 317 chain saw operators. The obtained results were as follows: 1. In analysis of covariance, age-adjusted operating year in workers with peripheral circulatory, peripheral neurological and musculoskeletal disturbances was significantly longer than that without such disturbances. For these disturbances, partial regression coefficients of operating year were significantly high in multiple regression analysis. These results show that these disturbances and age-adjusted operating year are mutually closely related. 2. Multiple regression analysis showed that the partial regression coefficients of both operating year and age were low for nine symptoms, i.e. dulling sense of touch, joint pain, headache, dizziness and/or tinnitus, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, hearing disturbance and lumbago. These results suggest that such symptoms were not related to either age or chain saw operation. 3. The results of principal component analysis were visualized in three-dimensional space in order to evaluate the relationships among the symptoms. The analysis showed that peripheral circulatory and neurological disturbances appeared independently and that general symptoms such as easy fatigability, headache, forgetfulness, vertigo and/or tinnitus, easy irritability, sleep disorder, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, shoulder stiffness, hearing disturbance and lumbago consisted of four independent groups. Each group has no relationship with duration of chain saw operation. This suggests other harmful factors of the groups play a role in the prevalence of the symptoms.
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PMID:[Multivariate analysis on subjective symptoms in forestry workers using chain saw]. 175 44

In order to assess the efficacy of trimetazidine in the treatment of ischemia-related cochleovestibular disorders, we carried out a double-blind placebo-controlled study with crossover. Each treatment period spanned 2 months, during which the patients were given either trimetazidine (20 mg tid) or placebo, following a two-week washout period. Enrolled in the study were 45 patients (aged 32 to 69 years) presenting cochleovestibular symptoms (tinnitus, vertigo, hearing loss). Tinnitus occurred in 99.7% of cases, deafness in 88.8%, and vertigo in 68.8% of cases. Pure-tone and speech audiometric data were not modified. Improvement was felt primarily with respect to subjective symptoms. The intensity of vertigo events and the duration of the spells improved much more substantially by trimetazidine and placebo, although the limited number of patients studied did not allow to reach the threshold of significance. The activity of trimetazidine was particularly apparent in relation to tinnitus. The intensity of the latter symptom as well as the degree of discomfort occasioned by it diminished more significantly with trimetazidine than placebo following a 2-month treatment period (p less than 0.05 and p less than 0.02, respectively). These results underscore the therapeutical efficacy of trimetazidine in the treatment of cochleovestibular syndromes, as assessed by a rigorously controlled double-blind trial with crossover versus placebo using a reliable methodology.
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PMID:[The efficacy of trimetazidine in cochleovestibular disorders of ischemic origin. A crossover control versus placebo trial]. 224 Oct 7

The efficacy and acceptability of the adrenoceptive-blocking agent, Prazosin, as a male contraceptive pill were investigated in 10 healthy men who had been referred for sexual sterilization. Prazosin was administered by mouth twice a day at a dosage that was increased from 0.5 mg to a maximum of 5.0 mg for an average of 40 days (range 5-110 days). No significant differences were recorded in pretreatment and post-treatment values for semen volume or sperm concentration. Nor were there any significant changes in sperm penetration or motility as a result of treatment with Prazosin. No changes were noted in either blood chemistry or blood pressure. Postejaculation urine collected to detect possible signs of retrograde ejaculation contained no spermatozoa. 5 (50%) of volunteers complained of side effects, including minor vertigo, palpitation, and generalized discomfort. Overall these findings failed to confirm either the efficacy or the acceptability of Prazosin as a male contraceptive drug. Another adrenoceptive antagonist, phenoxybenzamine, has been shown to be an effective antifertility agent without significant side effects at doses as high as 30 mg/day. However, it should be noted that this agent is not chemically identical to Prazosin.
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PMID:Prazosin, an adrenergic blocking agent inadequate as male contraceptive pill. 289 90

The experience at the Mayo Clinic with 18 patients who had Cogan's syndrome is reviewed. Typically, the illness began with systemic symptoms. The ocular and audiovestibular symptoms included ocular discomfort and redness, photophobia, and fluctuating sensorineural deafness with imbalance. Each patient had interstitial keratitis; the ocular symptoms periodically recurred but responded to therapy. Thirteen patients who had fluctuating bilateral sensorineural deafness subsequently suffered total bilateral deafness. Two patients who are unilaterally deaf have good residual hearing. Two other patients regained hearing within normal limits after treatment with corticosteroids. No hearing symptoms were observed in one patient who had severe vertigo and whose condition is stable. Seventeen patients had vertigo: 11 have no labyrinthine function, 1 had absent responses on vestibular testing initially but currently demonstrates good responses, and the 5 others have remained stable with diminished vestibular function. If Cogan's syndrome is diagnosed early and treatment with corticosteroids is initiated promptly, hearing can be stabilized; otherwise, the prognosis for auditory function is poor.
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PMID:Cogan's syndrome: audiovestibular involvement and prognosis in 18 patients. 387 92

In the etiology of premature labor prostaglandins fulfill a significant role. It is known that indomethacin is a strong inhibitor of prostaglandin synthesis. The effect of indomethacin on premature labor was studied in a prospective randomized double-blind study in 36 patients. Eighteen patients received indomethacin and eighteen received placebo. 200-300 mg of indomethacin was the total dosage in a 24 hours period. The activity of the uterus was monitored with a cardiotocograph. The mean duration of pregnancy and the mean birth weight in indomethacin group (36.4 weeks, 2833 g) were both significantly greater (p less than 0.001) than that in placebo group (31.2 weeks, 2028 g). In the indomethacin group 3 children weighted less than 2500 g compared with 14 in placebo group. In 15 of 18 indomethacin treated patients (83.3%) premature labor was arrested after indomethacin treatment compared with 4 of 18 in the placebo group (22.2%). The indomethacin group had a mean 1 minute APGAR score of 9.3 +/- 0.2 whereas the placebo group showed a score of 7.8 +/- 0.5 (p less than 0.01). Three infants died from respiratory distress syndrome; one in the indomethacin group (1810 g) and two in the placebo group (600 and 1450 g). Autopsies in the infants demonstrated a typical picture of pulmonary atelectasis and hyaline membranes. There was no evidence of premature closure of the ductus arteriosus or pulmonary hypertension. 2 mothers in the indomethacin group suffered minor discomfort i.e. nausea, vomiting and vertigo.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Further study of the inhibition of premature labor by indomethacin. Part II double-blind study. 637 98

A prospective neuro-otological study concerning 30 cases of fibrositis syndrome (psychogenic rheumatism, PR) and 30 age-matched normal controls was made and a retrospective study concerning 33 cases of Meniere's disease (MD) diagnosed and followed-up, examined between 1965 and 1982. Results showed: sensorineural hearing loss at low frequencies in all early stages of MD and in 10/30 of PR; hyperacusis (pain threshold below 100 dBHL bilaterally for all frequencies) without other sign of recruitment in 73.3% of PR and in 3/4 cases of MD where it was measured (discomfort or vertigo due to noise was noted retrospectively in 16/33 of early stages of MD); hyperreactivity of per-rotatory nystagmus in 53.3% of PR without neurological or peripheral vestibular lesions and, with or without vestibular unilateral lesions, in 39.9% of MD. None of the controls showed hyperacusis, hyperreactivity of per-rotatory nystagmus or deafness at low frequencies.
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PMID:Meniere's disease and fibrositis syndrome (psychogenic rheumatism). Relationship in audiometric and nystagmographic results. 659 16


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