• Title/Summary/Keyword: central vertigo

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Spontaneous Vertigo (자발현훈)

  • Choi, Kwang-Dong;Kim, Ji Soo
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.1-4
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    • 2007
  • Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. This review focuses on two common presentations of spontaneous vertigo: acute prolonged spontaneous vertigo and recurrent spontaneous vertigo. Common causes of acute prolonged spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. The history and detailed neurological/neurotological examinations usually provide the key information for distinguishing between peripheral and central causes of vertigo. Brain MRI is indicated in any patient with acute vertigo accompanied by abnormal neurological signs, profound imbalance, severe headache, and central patterns of nystagmus. Recurrent spontaneous vertigo occurs when there is a sudden, temporary, and largely reversible impairment of resting neural activity of one labyrinth or its central connections, with subsequent recovery to normal or near-normal function. Meniere's disease, migrainous vertigo, and vertebrobasilar insufficiency (VBI) are common causes. The duration of the vertigo attack is a key piece of information in recurrent spontaneous vertigo. Vertigo of vascular origin, such as VBI, typically lasts for several minutes, whereas recurrent vertigo due to peripheral inner-ear abnormalities lasts for hours. Screening neurotological evaluations, and blood tests for autoimmune and otosyphilis are useful in assessment of recurrent spontaneous vertigo that are likely to be peripheral in origin.

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Differential diagnosis of vertigo (어지럼증의 감별진단)

  • Kang, Ji-Hoon;Shin, Ji-Yong;Kim, Min-Ju;Ma, Hyeo-Il
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.64-75
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    • 2019
  • Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.

Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography (안진검사에서 단속운동검사, 시추적검사, 시운동성 안진검사의 임상적 의의)

  • Choi, Yoon Seok;Na, Hyung Gyun;Song, Si-Youn;Kim, Yong-Dae;Bae, Chang Hoon
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.29-36
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    • 2017
  • Background: Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. Methods: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. Results: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. Conclusion: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

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.

Case Studies of Central Vertigo Patients Diagnosed as Cerebellar infarction (중추성 현훈과 운동실조를 주소로 한 소뇌경색 환자 치험 1례)

  • Choi, Ki-Suk;Lee, Hyung-Ho;Shin, Yong-Soo;Kim, Jin-Sung;Kim, Young-Suk;Han, Yang-Hee;Im, Mi-Kyung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.6
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    • pp.1589-1593
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    • 2008
  • Vertigo is a frequent clinical finding in cerebellar infarction patients. In this report, one case suffered from central vertigo diagnosed as cerebellar infarction and could not walk without any help. After the Oriental medicine therapy, the severity of his vertigo reduced and he could walk without any help in hospital. We suggest Oriental medicine therapy is significantly effective on the treatment of cerebellar infarction.

A Case of Vertigo with Heterophoria and Nystagmus (안구편위와 진탕을 동반한 현훈 환자 1례)

  • Sim Sung-yong;Kim Kyung-tae;Um Yu-sik;Nam Hae-jeong;Kim Kyung-jun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.2
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    • pp.106-111
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    • 2004
  • Vertigo is a symptom, not a disease. The tenn vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in balance. It's sometimes referred to as a hallucination of motion. The cause of vertigo is very various and generally divided into peripheral and central. A patient presented with severe vertigo, nystagmus and heteophoria. She has taken the BanHaBaekChulChunMa-tang and treated by acupuncture. After 2 days, her symptoms become disappeared and about 1 week, all symptoms except heterophoria were disapperaed. And after 2 weeks, heterophoria was disappeared. In conclusion, we diagnosed her case as vestbular neuronitis by her clinical course, but we also considered her illness as vertebrobasilar insufficiency, TIA etc.

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Pathogensis of Benign Paroxysmal Positional Vertigo (BPPV) (양성돌발성 두위현훈의 역학)

  • Kim, Chul-Seung;Park, Sang-Muk
    • Korean Journal of Clinical Laboratory Science
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    • v.40 no.1
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    • pp.62-70
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    • 2008
  • Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities encountered in a dizzness clinic. Retrosepective review was performed for the patient's diagnosed as BPPV at Sunchon "S" hospital dizzness center. Variables for statistical analysis included age, sex, involved canal presence of recent head tramua, presence of chronic otitis media, history of middle ear surgery, underlying disease such as hypertension or diabetics, headache, central lesion. From July 2004 to May 2005, we sampled the 600 dizzness patient's who visited the dizzness center. Dizzness could be classified into BPPV, vestibulopathy. Among these patients, 256 patients had BPPV, 222 patients had vesibulopathy and 97 patients had Normal. Among these BPPV patients, 80 patients had lateral canalolithiasis BPPV (31.3%), 28 patients had lateral cupulolithiasis BPPV (10.9%), 90 patients had posterior canalolithiasis BPPV (35.2%), 7 patients had multicanalolithiasis BPPV (2.3%), 52 patients simultaneously had BPPV, other vestibular disease, and central lesion (20.3%).

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Effect Analysis of Virtual-reality Vestibular Rehabilitation based on Eye-tracking

  • Lee, Sungjin;Hong, Min;Kim, Sungyeup;Choi, Seong Jun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.14 no.2
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    • pp.826-840
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    • 2020
  • Vertigo is one of the most common complaints encountered by physicians and the patients are steadily increasing. These patients are exposed to the risk of secondary accidents such as falls due to vertigo. There are two ways to improve this symptom: medication and rehabilitation. Although temporary symptomatic improvement may be expected in patients treated with medication, vertigo may recur and medication can delay central compensation. In contrast vestibular rehabilitation exploits central mechanisms of neuroplasticity to increase postural stability and enhance visual-vestibular interactions in situations that generate conflicting sensory information. However, vestibular rehabilitation may be compromised by incorrect performance of exercises, and there is a need for active effort and interest from the patient during rehabilitation. To solve these problems, we decided to apply FOVE HMD for eye-tracking and Unity3D to create virtual reality. The proposed eye-tracking based algorithm calculates the concentration of users with eye tracking data and calculates the motion width of the patient with nystagmus, thus the severity of the patient according to the score can be determined. According to our experimental test against healty group and patients group, this result showed the meaningful data to use define the contents result.

Case Study of Cerebellar Infarction Base on Oriental Medical Diagnosis of Dongeuibogam (동의보감 현훈, 운동실조의 내용을 중심으로 살펴본 소뇌경색 환자 치료경과 3례)

  • Lee, Jae-Wang;Hong, Sang-Hoon;Kim, Jung-Eun;Son, Ho-Young;Kim, Do-Gyoung;Sin, Cheol-Kyung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1497-1502
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    • 2009
  • The cerebellum processes input from other areas of the brain, spinal cord and sensory receptors to provide precise timing for coordinated, smooth movements of the skeletal muscular system. A stroke affecting the cerebellum may cause vertigo, nausea, balance and coordination problems. The papers on central vertigo caused by cerebellar infarction were reported by Kim, Ku, Ko, Choi, and Han. Their cases were classed as Heo hoon, Dam hoon, and Sangchopungyeul yeul dam, and they treated with Jaeumkunbi-tang, Taeksa-tang, Cheonghunwhadam-tang gami, Cheonginwhadam-tang, Hachulbosim-tang. In this paper, three patients who suffered from vertigo were diagnosed as cerebellar infarction. They felt too giddy to walk without any help. After Oriental medical treatment based on Dongeuibogam, their sequelae of cerebellar infarction - vertigo, nausea, ataxia - had improved dramatically. So we report these cases, and suggest Oriental medical treatment based on Dongeuibogam have effect on cerebellar infarction. But more clinical case reports should be further examined.