The clinical utility of vestibular autorotation test in patients with vestibular migraine

Objective: To investigate the characteristics and clinical utility of vestibular autorotation test (VAT) in patients with vestibular migraine.

Methods: This study included two groups, an experimental group (441 patients) and a control group (65 healthy subjects). Both groups undertook VAT; the parameters evaluated were horizontal gain/phase, vertical gain/phase and asymmetry. The differences in VAT results between the two groups were investigated.

Results: There were no statistical differences between the VAT data of the control group when compared to the reference value from the manufacturer (p?>?.05). There were statistically significant differences in VAT results between the experimental and control group, namely elevated horizontal gain at frequency 2, 3, 4 and 5?Hz, horizontal phase delay at frequency 2, 4, 5 and 6?Hz, elevated vertical gain at frequency 2?6Hz and vertical phase delay at frequency 4?6Hz.

Conclusion: The results of this study using VAT in VM patients demonstrate elevated horizontal gain, vertical gain and delay in horizontal phase, vertical phase. We suggest the application of VAT as a diagnostic tool which may provide objective evidence that can contribute to the diagnosis of VM and also in differential diagnosis.     

Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) may compromise the balance of elderly subjects.ObjectiveTo observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance.MethodThis is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test) were submitted to the Timed Up & Go (TUG) test, the Clinical Test of Sensory Interaction and Balance (CTSIB), and lower limb testing before and after they were repositioned using the modified Epley maneuver.Resultsmost subjects were females, and the group's mean age was 70.10 years (SD = 7.00). All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006), nausea and vomiting (p = 0.021), and tinnitus (p = 0.003). Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001). Patients performed better on the CTSIB after the Epley maneuver on condition 2 (p < 0.003), condition 3 (p < 0.001), condition 4 (p < 0.001), condition 5 (p < 0.001), and condition 6 (p < 0.001).ConclusionClinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver.     

整脊手法治疗131例颈性眩晕疗效分析及对眩晕性疾病的再认识

目的：探讨整脊手法治疗颈源性眩晕的治疗机理,重新认识颈源性眩晕及眩晕性疾病的病因病理。方法：对131例颈源性眩晕患者进行整脊手法治疗,恢复其颈胸椎曲度,术前术后即刻TCD检查以比较椎动脉血流变化,再予拔罐和红外线治疗3天,之后间隔性调整治疗。结果：治愈121例,占92．37％,好转8例,占6．11％,无效2例,1．53％。即时缓解129例,占98．47％。结论：整脊手法治疗颈源性眩晕疗效明确,但椎动脉血流并未单纯增加或减少,故反思眩晕性疾病的中西医病因病理,提出眩晕性疾病结构异常和急慢损伤两大病因;病理和解剖方面的多机制变化,尤其颈部的结构变化在眩晕性疾病中的重要作用;治疗上凡眩晕者,必正其骨。     

Medication-related dizziness in the older adult

With increased medication use among the older adult population, adverse drug events and polypharmacy can be significant causes of dizziness in the elderly. The evidence evaluated in this review is helpful in clinical practice but requires an additional detailed investigation into the agents discussed to understand the risk/benefit ratio associated with medications. Examples of medications highly associated with dizziness in older adults and discussed in this review include cardiovascular and central nervous system agents. Several other medication classes associated with dizziness are among the medications most commonly used by older patients.     

良性阵发性位置性眩晕治疗前后生活质量研究

目的:探讨管石复位法(CRP)治疗前后良性阵发性位置性眩晕(BPPV)患者健康相关生活质量(QOL)的变化。方法:采用中文版SF-36健康调查量表(SF-36)和汉化英文版眩晕障碍量表(DHI),分别对86例施行CRP的BPPV患者(治疗组)和120名健康体检者(对照组)进行QOL的调查与评估,并将2组的结果进行对比。结果:通过SF-36和DHI评估显示,BPPV患者治疗前SF-36的维度计分均低于对照组,DHI各条目计分均高于对照组,差异均有统计学意义(均P<0.05)。BPPV患者治疗后3个月SF-36和DHI量表得分与对照组差异均无统计学意义(均P>0.05)。结论:CRP可明显改善BPPV患者的QOL;SF-36和汉化DHI量表能有效评估BPPV患者的QOL。