Journal of Vestibular Research-Equilibrium & Orientation最新文献

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Head and vestibular kinematics during vertical semicircular canal impulses. 垂直半规管脉冲时的头部和前庭运动学。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-230010
Michelle J Karabin, Regan G Harrell, Patrick J Sparto, Joseph M Furman, Mark S Redfern
{"title":"Head and vestibular kinematics during vertical semicircular canal impulses.","authors":"Michelle J Karabin, Regan G Harrell, Patrick J Sparto, Joseph M Furman, Mark S Redfern","doi":"10.3233/VES-230010","DOIUrl":"10.3233/VES-230010","url":null,"abstract":"<p><strong>Background: </strong>The video head impulse test (vHIT) is a common assessment of semicircular canal function during high-speed impulses. Reliability of the vHIT for assessing vertical semicircular canals is uncertain. Vertical head impulses require a complex head movement, making it difficult to isolate a single semicircular canal and interpret resulting eye rotations.</p><p><strong>Objective: </strong>The purpose of this study was to provide descriptive head kinematics and vestibular stimuli during vertical plane impulses to ultimately improve impulse delivery and interpretation of vHIT results for vertical semicircular canals.</p><p><strong>Methods: </strong>Six participants received right anterior (RA) and left posterior (LP) semicircular canal impulses. Linear displacements, rotational displacements, and rotational velocities of the head were measured. Peak velocities in semicircular canal planes and peak-to-peak gravitoinertial accelerations at the otolith organs were derived from head kinematics.</p><p><strong>Results: </strong>The largest rotational velocities occurred in the target semicircular canal plane, with non-negligible velocities occurring in non-target planes. Larger vertical displacements and accelerations occurred on the right side of the head compared to the left for RA and LP impulses.</p><p><strong>Conclusions: </strong>These results provide a foundation for designing protocols to optimize stimulation applied to a singular vertical semicircular canal and for interpreting results from the vHIT for vertical semicircular canals.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"367-376"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inter-day and intra-day variations in effective intensity of noisy galvanic vestibular stimulation to improve postural stability in bilateral vestibulopathy. 噪声前庭电流刺激有效强度的日间和日间变化,以改善双侧前庭病变的姿势稳定性。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-230060
Chisato Fujimoto, Takuya Kawahara, Makoto Kinoshita, Teru Kamogashira, Mineko Oka, Kentaro Ichijo, Kento Koda, Tatsuya Yamasoba, Shinichi Iwasaki
{"title":"Inter-day and intra-day variations in effective intensity of noisy galvanic vestibular stimulation to improve postural stability in bilateral vestibulopathy.","authors":"Chisato Fujimoto, Takuya Kawahara, Makoto Kinoshita, Teru Kamogashira, Mineko Oka, Kentaro Ichijo, Kento Koda, Tatsuya Yamasoba, Shinichi Iwasaki","doi":"10.3233/VES-230060","DOIUrl":"10.3233/VES-230060","url":null,"abstract":"<p><strong>Background: </strong>The reproducibility of the effective intensity of noisy galvanic vestibular stimulation (nGVS) to improve postural stability is not well known.</p><p><strong>Objective: </strong>We aimed to investigate inter-day and intra-day variations in effective intensity in patients with bilateral vestibulopathy (BVP).</p><p><strong>Methods: </strong>Thirteen BVP patients were measured for center-of-pressure movements in the standing posture at five time points: morning of the first test day, morning and evening of the second test day, and morning and evening of the third test day. The mean velocity, the envelopment area, and the root mean square were measured in the eyes-closed condition for 30 s during nGVS application ranging from 0 to 1000μA. The effective intensity was defined as the intensity at which all the three parameters measured during the stimulation were simultaneously smaller than the values at baseline (0μA).</p><p><strong>Results: </strong>Seven of the 13 patients had a common effective intensity throughout the three test days. Six patients on the second test day and five patients on the third test day had no common effective intensity between morning and evening.</p><p><strong>Conclusions: </strong>The effective intensity of nGVS changes depending on the time during the day as well as between the days.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"423-429"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation between nystagmus intensity and vestibular-ocular reflex gain in benign paroxysmal positional vertigo: A prospective, clinical study. 良性阵发性位置性眩晕中眼球震颤强度与前庭-眼反射增益的相关性:一项前瞻性临床研究。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220106
Merih Onal, Ahmet Aygun, Bahar Colpan, Harun Karakayaoglu, Ozkan Onal
{"title":"Correlation between nystagmus intensity and vestibular-ocular reflex gain in benign paroxysmal positional vertigo: A prospective, clinical study.","authors":"Merih Onal,&nbsp;Ahmet Aygun,&nbsp;Bahar Colpan,&nbsp;Harun Karakayaoglu,&nbsp;Ozkan Onal","doi":"10.3233/VES-220106","DOIUrl":"https://doi.org/10.3233/VES-220106","url":null,"abstract":"<p><strong>Background: </strong>Video head impulse test (vHIT) and videonystagmography (VNG) provide significant benefits in evaluating benign paroxysmal positional vertigo (BPPV) and determining the semicircular canal localization of the otoconia.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between vestibular-ocular reflex (VOR) gains measured via vHIT and the slow-phase velocity (SPV) of nystagmus in patients with the posterior semicircular canal (PSCC)-BPPV.</p><p><strong>Methods: </strong>Sixty-two patients were included in this study and divided into the study (n = 32, patients with isolated PSCC-BPPV) and control (n = 30, age- and sex-matched healthy individuals) groups. While VOR gains were measured with vHIT in both groups and compared between groups, the SPV values of nystagmus observed during the Dix-Hallpike maneuver in the study group were recorded using VNG and compared with the VOR gains of the study group.</p><p><strong>Results: </strong>There were significant differences in posterior canal VOR gains between the study and control groups (p < 0.001 and p < 0.01, respectively). Although the affected PSCC had decreased VOR gains versus the control group, it was still within the normal range. However, there was no significant relationship between the VOR gains of the affected PSCC and the SPV of the nystagmus.</p><p><strong>Conclusions: </strong>vHIT can help detect semicircular canal dysfunction in patients with PSCC-BPPV. The SPV values of nystagmus on VNG during the Dix-Hallpike maneuver do not correlate with the level of VOR gain.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 2","pages":"115-125"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9231905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of vestibular rehabilitation on body composition and daily-living physical activity in chronic unilateral vestibular hypofunction. 前庭康复对慢性单侧前庭功能障碍患者身体组成和日常生活体力活动的影响。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220019
Alessandro Micarelli, Andrea Viziano, Valentina Carbini, Ilaria Misici, Federico Guzzo, Beatrice Micarelli, Marco Alessandrini
{"title":"Effects of vestibular rehabilitation on body composition and daily-living physical activity in chronic unilateral vestibular hypofunction.","authors":"Alessandro Micarelli,&nbsp;Andrea Viziano,&nbsp;Valentina Carbini,&nbsp;Ilaria Misici,&nbsp;Federico Guzzo,&nbsp;Beatrice Micarelli,&nbsp;Marco Alessandrini","doi":"10.3233/VES-220019","DOIUrl":"https://doi.org/10.3233/VES-220019","url":null,"abstract":"<p><strong>Background: </strong>Unilateral vestibular hypofunction (UVH) may lead to modifications on metabolism and body composition. Vestibular rehabilitation (VR) demonstrated its effectiveness in ameliorating balance function and several other daily-living aspects.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate metabolic composition, by means of bioelectrical impedance analysis (BIA) and daily activity, with the use of a wrist-worn movement tracker, in UVH participants before and after VR, and to compare data with a healthy control group (CG) of adults.</p><p><strong>Methods: </strong>46 UVH and 60 CG participants underwent otoneurological testing, self-report and performance questionnaires, BIA, and wore a device tracking daily movement and energy expenditure for one full day; this was performed before and after VR.</p><p><strong>Results: </strong>UVH participants demonstrated a significant (p = 0.008) increase in muscle mass after VR, and, when compared to CG, no differences were present with respect to visceral fat and muscle mass. UVH adults reported a significant increase in energy expenditure spent in movement (p = 0.008) and during the day (p = 0.009), daily number of strides (p = 0.009) and calories spent in sweeping (p = 0.009) and stairing (p = 0.008).</p><p><strong>Conclusions: </strong>Results from this study show that VR provided an improvement of metabolic function and body composition of people with UVH, possibly by contrasting structural modifications in neural pathways stemming from the vestibular nuclei and connected to autonomous function.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 1","pages":"71-83"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10788728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Response to: Commentary to "Bone conducted vibration is an effective stimulus for otolith testing in cochlear implant patients". 回应:对 "骨传导振动是人工耳蜗植入患者耳石测试的有效刺激 "的评论。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220203
L Fröhlich, M Wilke, S K Plontke, T Rahne
{"title":"Response to: Commentary to \"Bone conducted vibration is an effective stimulus for otolith testing in cochlear implant patients\".","authors":"L Fröhlich, M Wilke, S K Plontke, T Rahne","doi":"10.3233/VES-220203","DOIUrl":"10.3233/VES-220203","url":null,"abstract":"","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"433-434"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dynamic change of vestibular function and the long-term prognosis of vestibular neuritis. 前庭功能的动态变化和前庭神经炎的长期预后。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220104
Ping Guo, Jieli Zhao, Gaogan Jia, Huawei Li, Wenyan Li
{"title":"Dynamic change of vestibular function and the long-term prognosis of vestibular neuritis.","authors":"Ping Guo, Jieli Zhao, Gaogan Jia, Huawei Li, Wenyan Li","doi":"10.3233/VES-220104","DOIUrl":"10.3233/VES-220104","url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively evaluate the dynamic change of vestibular function during long-term follow-up of vestibular neuritis, as well as the co-relationship with the outcomes of vestibular neuritis (VN), which provides the recommendations for vestibular function tests during the course of VN.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 16 patients with acute VN. Caloric test, vHIT, rotatory chair tests, VEMP, dizziness handicap inventory (DHI) score, and dynamic dizzy scales (VAS-DD) was first performed within 7 days of neuritis onset, which were further re-evaluated during the 6-12 months of follow-up. The dynamic changes on multiple objective vestibular examinations were analyzed during the acute and recovery stage of VN. We further evaluated the co-relationship between the vestibular dysfunction scales and the prognosis of VN.</p><p><strong>Results: </strong>In more than 6 months of follow-up, 44% of the ultralow frequency, 94% of the low-to-mid frequency, and 44% of the high-frequency function of the horizontal semicircular canal returned to normal (p < 0.05). The change degree in symmetry of the rotatory chair test was correlated with the gain of the horizontal semicircular canal on the vHIT and the unilateral weakness (UW) value on the caloric test (p < 0.05). The change in DHI score was correlated with the phase; change in VAS-DD level correlated with the symmetry and TC of the rotatory chair test at VN recovery stage (p < 0.05). There was no significant correlation between the change in DHI score or change in VAS-DD and the degree of vestibular function recovery (p > 0.05).</p><p><strong>Conclusion: </strong>In general, vestibular function improved during the course of VN. The rotatory chair test can be used to evaluate the overall function of the vestibular system and the compensatory state in patients with VN.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"411-422"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic resonance imaging of endolymphatic hydrops: Controversies and common ground, comment on: "A plea for systematic literature analysis and conclusive study design". 内淋巴积液的磁共振成像:争议与共识,评论:“对系统文献分析和结论性研究设计的请求”。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-180663
Jose A Lopez-Escamez, Arnaud Attyé
{"title":"Magnetic resonance imaging of endolymphatic hydrops: Controversies and common ground, comment on: \"A plea for systematic literature analysis and conclusive study design\".","authors":"Jose A Lopez-Escamez,&nbsp;Arnaud Attyé","doi":"10.3233/VES-180663","DOIUrl":"https://doi.org/10.3233/VES-180663","url":null,"abstract":"","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 2","pages":"159-162"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/VES-180663","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Vestibular symptoms are related to the proportion of REM sleep in people with sleep complaints: A preliminary report. 前庭症状与睡眠抱怨者快速眼动睡眠的比例有关:一项初步报告。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220113
Ellemarije Altena, Estelle Buguet, Caitlin Higginson, Elliott Lee, Alan Douglass, Naomi Spitale, Rebecca Robillard
{"title":"Vestibular symptoms are related to the proportion of REM sleep in people with sleep complaints: A preliminary report.","authors":"Ellemarije Altena, Estelle Buguet, Caitlin Higginson, Elliott Lee, Alan Douglass, Naomi Spitale, Rebecca Robillard","doi":"10.3233/VES-220113","DOIUrl":"10.3233/VES-220113","url":null,"abstract":"<p><strong>Objective/background: </strong>Though sleep problems (apnea, insomnia) and related daytime symptoms (fatigue, anxiety, depression) have been associated with vestibular problems (falls, dizziness), it is not well known which particular sleep features relate to vestibular problems. We thus assessed symptoms of vestibular problems in patients visiting a sleep clinic and evaluated how they were associated with objective sleep parameters derived from polysomnography and relevant daytime symptoms.</p><p><strong>Patients/methods: </strong>The polysomnography data of thirty-one patients (61% female, between 20 and 79 years of age) who were referred for clinical sleep assessment was collated with subjective measures of symptoms linked to vestibular problems (rated on the Situational Characteristics Questionnaire), as well as fatigue, anxiety and depression symptoms. Multiple linear regression was used to identify factors associated with vestibular symptoms, including analyses adjusted for age, sex, medication use and total sleep time.</p><p><strong>Results: </strong>A higher percentage of REM sleep and more severe anxiety symptoms were independently associated with more severe vestibular symptoms, which survived adjusted analyses. Other sleep stages, as well as as sleep efficiency, apnea-hypopnea index and oxygen saturation were not significantly related to vestibular symptoms.</p><p><strong>Conclusions: </strong>These results point at vestibular symptoms as possible important and overlooked correlates of variations in sleep architecture in individuals with sleep complaints. Though replication is needed to confirm findings from this limited sample, the results highlight the importance of assessing vestibular symptoms in people with sleep complaints. In particular, further investigations will need to address the potential implication of REM sleep for vestibular functions and the directionality of this relation.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 3","pages":"165-172"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/f6/ves-33-ves220113.PMC10357186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9849029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cognitive functions in episodic vestibular disorders: Meniere's disease and vestibular migraine. 偶发性前庭疾病的认知功能:梅尼埃病和前庭偏头痛。
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220025
Mehmet Alp Demirhan, Nese Celebisoy
{"title":"Cognitive functions in episodic vestibular disorders: Meniere's disease and vestibular migraine.","authors":"Mehmet Alp Demirhan,&nbsp;Nese Celebisoy","doi":"10.3233/VES-220025","DOIUrl":"https://doi.org/10.3233/VES-220025","url":null,"abstract":"<p><strong>Background: </strong>Cognitive deficits have been defined in patients with bilateral and unilateral vestibular loss.</p><p><strong>Objective: </strong>To investigate cognitive functions in patients with episodic vestibular disorders.</p><p><strong>Methods: </strong>Nineteen patients with Meniere's disease (MD), 19 patients with vestibular migraine (VM) and 21 age and education matched healthy controls were studied. Mini Mental State Examination assessing global mental status, Reading Span Test and the Stroop Test evaluating working memory, cognitive processing, reading comprehension and attention, Trail Making Test and Benton's Judgment of Line Orientation Test investigating visual processing, visuospatial skills, processing speed were used. Beck depression and anxiety inventories were given to evaluate the emotional status.</p><p><strong>Results: </strong>Cognitive test results of the MD and VM patients were not significantly different from the healthy controls (p > 0.05) as well as Beck depression scores (p = 0.14). Beck anxiety scores showed significant difference (p = 0.003). VM patients had significantly higher scores than the healthy controls (p = 0.002) on pairwise comparisons. The scores of the MD patients did not reach statistical significance (p = 0.15).</p><p><strong>Conclusion: </strong>Episodic vestibular disorders like MD and VM without inter-ictal vestibular deficits do not seem to be associated with cognitive impairment. Patients with VM have significantly higher anxiety scores than the healthy controls and MD patients.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 1","pages":"63-70"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10771024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Diagnosis of dizziness in the emergency department: A 1-year prospective single-center study. 急诊科眩晕诊断:一项为期1年的前瞻性单中心研究
IF 2.3 3区 医学
Journal of Vestibular Research-Equilibrium & Orientation Pub Date : 2023-01-01 DOI: 10.3233/VES-220109
Adrâa Nouini, Quentin Mat, Christian Van Nechel, Alionka Bostan, Bernard Dachy, Anissa Ourtani
{"title":"Diagnosis of dizziness in the emergency department: A 1-year prospective single-center study.","authors":"Adrâa Nouini, Quentin Mat, Christian Van Nechel, Alionka Bostan, Bernard Dachy, Anissa Ourtani","doi":"10.3233/VES-220109","DOIUrl":"10.3233/VES-220109","url":null,"abstract":"<p><strong>Background: </strong>The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions.</p><p><strong>Objective: </strong>This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED.</p><p><strong>Methods and results: </strong>The cohort was comprised of 66 patients with a mean age 56 years; 48% were women and 52% men. Among dizzy patients, 14% had VBS. We used Cohen's kappa test to quantify the agreement between two raters -namely, emergency physicians and neurologists -regarding the causes of dizziness in the ED. The Kappa value was 0.27 regarding the final diagnosis of central vertigo disorders and VBS, thus showing the low agreement. We used the χi2 test to show the association between the presence of two or more cardiovascular risk factors and admission to the stroke unit (p = 0.015).</p><p><strong>Conclusion: </strong>There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neurovestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse test could help reduce the rate of misdiagnosis of VBS in the ED.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":"33 3","pages":"195-202"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10056098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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