• Title/Summary/Keyword: Benign paroxysmal vertigo

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The Effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo: A Systematic Review Using the CNKI Database (양성 돌발성 두위 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과 : 체계적 문헌고찰 - CNKI 검색을 중심으로)

  • Gwon, Gi-hyeon;Oh, Seo-hye;Park, Eun-soo;Kim, Mi-hyeon;Hong, Seung-hyo;Song, Geum-ju;Park, Eun-young
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.572-589
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    • 2021
  • Objectives: This study examines the effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo (BPPV) through a systematic review of randomized controlled trials (RCTs) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: RCTs were included that tested the effect of Banhabaekchulcheonma-tang on BPPV. A study of the literature in the CNKI was performed for papers published from January 1, 2011 to June 30, 2021. Results: A total of eight RCTs met the inclusion criteria. All studies identified the effect of Banhabaekchulcheonma-tang in the treatment of BPPV. The effectiveness of treatment was higher in the intervention group than in the control group, as shown through evaluation indicators, including the total effective rate, dizziness handicap inventory (DHI), and blood lipids. Conclusion: Treatment with Banhabaakchulcheonma-tang was found to be effective in treating BPPV. However, due to the low quality of available studies, the significance of this conclusion is somewhat limited. Further clinical studies are needed on the development of diagnosis and treatment methods for BPPV based on Korean medicine.

Banhabaeckchulchunma-tang for Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis (양성 발작성 자세변환성 현훈에 대한 반하백출천마탕(半夏白朮天麻湯)의 효과: 체계적 문헌고찰과 메타분석)

  • Kim, Geun-Lip;Hong, Chul-Hee;Lee, Kyou-Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.71-89
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    • 2021
  • Objectives : The purpose of this study is to evaluate the effect of Banhabaeckchulchunm a-tang(BBCT) for Benign Paroxysmal Positional Vertigo(BPPV) Methods : We searched randomized controlled trials(RCTs) which assess the effect of BB CT for BPPV through 8 electronic databases from their inception to July 2021. RevMan 5.4 was used to evaluate the risk of bias. Results : 12 RCTs with 901 subjects were included. The BBCT treatment group had significantly higher total effetive rate(TER) than the western medicine treatment group(P=0.0001), and the Dizziness Handicap Inventory(DHI) score(P=0.003), traditional chinese medicine syndrome(TCM syn.) score(P<0.00001), and Visual analog scale(VAS)(P=0.0006) were significantly lower than the western medicine treatment group. The combined treatment of BBCT and canalith repositioning procedure(CRP) group had significantly higher TER than only CRP treatment group(P=0.02), and there was no significant difference in DHI score(P=0.12). TG(P=0.006) and TC(P=0.04) were significantly lower, and ApoA1 was significantly higher(P=0.0001). There was no significant difference in LDL(P=0.24). Conclusions : These results demonstrate that BBCT could be effective for BPPV especially after CRP. However, because of limits of included studies such as high heterogeneity between the literatures, unclear risk of bias, insufficient reports of adverse events(AEs), a well-designed RCTs with a low risk of bias in more diverse countries are needed in the future.

Pitfalls in the Diagnosis of Vertigo (현훈 진단에 있어 함정)

  • Kim, Hyun Ah;Lee, Hyung
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.280-288
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    • 2018
  • Vertigo/dizziness is a common complaint in patients who are seeking a primary health clinic. Vertigo is traditionally attributed to damage of the vestibular system. Many peripheral and central vestibular disorders are usually presented with vertigo. However, patients with benign paroxysmal positional vertigo (BPPV), a leading cause of vertigo, may present with postural lightheadedness, near faint, imbalance rather than true vertigo. On the contrary, patients with orthostatic hypotension may present with true spinning vertigo, not dizziness. Persistent postural perceptual dizziness, a second most common cause of dizziness (after BPPV), is mainly occurred after organic vestibular disorders such as BPPV or vestibular neuritis, and classified as a chronic functional vestibular disorder. This article describes non-vestibular disorders presenting dizziness and/or vertigos, which conditions may be misdiagnosed as structural vestibular disorders.

Posttraumatic Peripheral Vertigo (외상 후 말초성현훈)

  • Yoon, Soyeon;Kim, Mi Joo;Kim, Minbum
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.125-129
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    • 2018
  • Posttraumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral, and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of posttraumatic vertigo; benign paroxysmal positional vertigo, temporal bone fracture, perilymphatic fistula, labyrinthine concussion, posttraumatic hydrops, and cervical vertigo. Since the differential diagnosis of the posttraumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of posttraumatic vertigo were described according to the current literature.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Journal of Audiology & Otology
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    • v.25 no.2
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    • pp.89-97
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    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • Journal of Audiology & Otology
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    • v.25 no.1
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • Korean Journal of Audiology
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    • v.25 no.1
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Korean Journal of Audiology
    • /
    • v.25 no.2
    • /
    • pp.89-97
    • /
    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.