Saturday, 30 November 2013

Vertigo - Diagnosis and Diseases associated with Vertigo

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Diagnosis and Diseases Associated to
Diagnosis and Diseases associated with Vertigo
Dr. Della-Morte D, Rundek T. at the University of Miami, indicated that differential diagnosis between vascular vertigo and other causes of vertigo can result in misclassification due to the overlapping of symptoms. Careful medical history, physical examination, neuroimaging and ear, nose, and throat studies may help to distinguish vascular vertigo from other causes.(1)
1. Positive Dix-Hallpike test.
In the study of Twelve patients from the derivation set and six patients from the validation set had DHT + BPPV. Binomial logistic regression analysis selected a "duration of dizziness ≤15 seconds" and "onset when turning over in bed" as independent predictors of DHT + BPPV with an odds ratio (95% confidence interval) of 4.36 (1.18-16.19) and 10.17 (2.49-41.63), respectively. Affirmative answers to both questions yielded a likelihood ratio of 6.81 (5.11-9.10) for diagnosis of DHT + BPPV, while negative answers to both had a likelihood ratio of 0.19 (0.08-0.47).(15)

2. Electronystagmography versus videonystagmography
In the study to assess the value of electronystagmography (ENG) and videonystagmography (VNG) for diagnosing vertigo of various origin, scientists at the Medical University of Łódź, showed that In all patients with vertigo due to vestibular neuritis, barotrauma and kinetosis, significant CP, the important sign of peripheral site of vestibular lesion was identified both in ENG and VNG. None of the patients with central origin disorders showed CP in VNG; in the majority of cases DP was observed. However, in ENG we found CP in 5 patients with central origin disorders. There were no essential differences between ENG and VNG in measurements of FRQ and SPV except for higher values in VNG in controls and patients with mixed vertigo(16)

3. CT scan
CT scan  if a brain injury is suspected to be the cause of vertigo or your doctor would like to rule out the tumors or cancer causes of vertigo.

4. Etc.

In the study to the DISCUSSION ON VERTIGO, the team wrote that Vertigo associated with
1. acute, non-perforative otitis media
2. chronic otitis media
3. labyrinthine fistula
4. otosclerosis,
5. post-suppurative adhesions
6. peripheral nerve deafness,
7. gun deafness;
8. with rhinitis,  
9. ethmoiditis, 
10. sinusitis, 
11. nasal polypi, 
12. postnasal catarrh and 
13. dental infections.-Influence of general health on recurrent vertigo and vice versa (3)

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