Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,...Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.展开更多
BACKGROUND Persistent postural-perceptual dizziness(PPPD)is a functional disorder,typically preceded by acute vestibular disorders.It is characterized by a shift in processing spatial orientation information,to favor ...BACKGROUND Persistent postural-perceptual dizziness(PPPD)is a functional disorder,typically preceded by acute vestibular disorders.It is characterized by a shift in processing spatial orientation information,to favor visual over vestibular and somatosensory inputs,and a failure of higher cortical mechanisms.To date,no therapies for PPPD have been approved.Kampo medicine hangebyakujutsutemmato(HBT)has been reported to alleviate disturbances of equilibrium.We hypothesized that HBT would be a beneficial treatment for PPPD.AIM To examine the efficacy of HBT for the treatment of PPPD.METHODS Patients with PPPD were enrolled and divided into two groups:The HBT group(n=24)and the non-HBT group(n=14).The participants completed questionnaire surveys[Niigata PPPD questionnaire(NPQ),dizziness handicap inventory,hospital anxiety and depression scale(HADS),orthostatic dysregulation questionnaire,pittsburg sleep quality index(PSQI),and motion sickness scores]before and after HBT treatment.Additionally,to identify HBT responders,multivariate regression analysis was performed using the results of the ques-tionnaire surveys and equilibrium tests;including stabilometry,and caloric,vestibular evoked myogenic response,and head-up tilt tests.RESULTS Thirty-eight outpatients were included in this study,of which 14 patients(3 men,11 women;mean age,63.5±15.9 years)received treatment without HBT,and 24(1 man,23 women;mean age,58.2±18.7 years)received combination treatment with HBT.Following HBT treatment,NPQ scores decreased significantly(baseline 40.1±10.0 vs 2 mo 24.6±17.7,P<0.001).No statistically significant changes were observed in the NPQ scores in the non-HBT group(baseline 38.6±12.2 vs 2 mo 39.4±14.4,P=0.92).Multivariable regression analysis revealed that the results of stabilometry(P=0.02)and the caloric(P=0.03),and head-up tilt tests(P<0.001),HADS(P=0.003),and PSQI(P=0.01)were associated with HBT responsiveness in PPPD patients.CONCLUSION HBT may be an effective adjunct therapy for PPPD.Patients with autonomic dysfunction,unstable balance,semicircular canal paresis,anxiety,and poor sleep quality may be high responders to HBT.展开更多
This case report describes a woman aged approximately 50 years who has suffered from balance dysregulation and dizziness for more than 10 years. Although the subject underwent several examinations to confirm the etiol...This case report describes a woman aged approximately 50 years who has suffered from balance dysregulation and dizziness for more than 10 years. Although the subject underwent several examinations to confirm the etiology of her symptoms, the root cause remained unknown. The symptoms were thought to be caused by electromagnetic wave hypersensitivity because the subject experienced uneasiness and dizziness when a cell phone was held close to her body. A cell phone was used to diagnose the collection of harmful electromagnetic waves, and an amalgam filling was determined to be the cause. The amalgam filling was removed under strict protection, and the subject’s symptoms completely disappeared soon after the filling was removed.展开更多
BACKGROUND Dizziness is a common symptom in adults and usually due to peripheral causes affecting semicircular canal function or central causes affecting the pons,medulla,or cerebellum.Arrhythmia is a recognized cause...BACKGROUND Dizziness is a common symptom in adults and usually due to peripheral causes affecting semicircular canal function or central causes affecting the pons,medulla,or cerebellum.Arrhythmia is a recognized cause of dizziness in people with structural or ischemic heart disease.We report a case of exercise-induced transient ventricular tachycardia and dizziness in a man with no evidence of organic heart disease.CASE SUMMARY A 42-year-old man presented with a 6 mo history of transient exercise-induced dizziness and prodromal palpitations.The patient was otherwise asymptomatic.Physical examination,otoscopy,vestibular tests,cerebellar tests,laboratory investigations,and imaging investigations were all unremarkable.Twenty-four hour Holter monitoring revealed four episodes of transient ventricular tachycardia during exercise.The patient was started on metoprolol and subsequently underwent radiofrequency catheter ablation.The patient reported a full recovery and no dizziness during daily activities.These results were maintained at the 6 mo follow-up.CONCLUSION Ventricular tachycardia is an uncommon but potentially serious cause of dizziness.The outcome of this case illustrates the benefits of careful clinical examination and communication with specialized centers.High clinical suspicion of arrhythmia in a patient with dizziness merits consultation with a cardiologist and referral to a specialized center to ensure timely diagnosis and treatment.展开更多
Dizziness and vertigo is a commonly encountered disease in clinic. There has been the saying from ancient times that "there would be no dizziness if without wind", " there would be no dizziness if witho...Dizziness and vertigo is a commonly encountered disease in clinic. There has been the saying from ancient times that "there would be no dizziness if without wind", " there would be no dizziness if without phlegm", "there would be no dizziness if without deficiency", and " there would be no dizziness if without fire". However, in the author's view, the dizziness and vertigo caused by blood stasis blocking the collaterals is most commonly seen in clinic, which should deserve more attention. The following is an introduction about the author's experience in treating 3 cases of dizziness and vertigo with acupuncture.展开更多
Note: HLY = hyperactivity of the liver-yang, STPMJ = stagnation of turbid phlegm in middle-Jiao, DQB = deficiency of qi and blood, DKE = deficiency of the kidney-essence, OCBS = obstruction of collaterals by blood
Abstract: The Nagoya University Hospital otolaryngology department is doing the prospective cohort study in Yakumo-cho, Hokkaido, Japan from 2005, because this place is a little transfer of the population. Most of inh...Abstract: The Nagoya University Hospital otolaryngology department is doing the prospective cohort study in Yakumo-cho, Hokkaido, Japan from 2005, because this place is a little transfer of the population. Most of inhabitants of Yakumo-cho engage in fishery and agriculture as work mainly. We perform questionary survey using an interview vote. The item is “having feeling of dizziness or not”,“quality of hearing” and “having tinnitus or not”. Furthermore, we go for the examination of stabilometry, too. We compared 2015, 2017 with 2005, 2007 among Yakumo-cho inhabitant examination data this time. As a result, participant with a feeling of conscious dizziness got a bad reputation of the hearing consciously. In addition, participant with a feeling of conscious dizziness had tinnitus consciously. Furthermore, the participant with a feeling of conscious dizziness had bad stabilometry result. As a result of having compared ten years later, we understood that stabilometry result worsened if 60s became in 70s with or without a feeling of dizziness consciously. When there is a feeling of conscious dizziness, it is necessary to perform an examination of stabilometry as routine work. In addition, it is necessary to inspect stabilometry if participants have the bad hearing or tinnitus with a feeling of dizziness in particularly.展开更多
With the development of an IT (Information Technology) society, the opportunity to use electronic devices, such as cell phones and personal computers, has increased. These electronic devices pro-vide many benefits to ...With the development of an IT (Information Technology) society, the opportunity to use electronic devices, such as cell phones and personal computers, has increased. These electronic devices pro-vide many benefits to society. However, there have been a number of reports of electromagnetic hypersensitivity (EHS) related to the use of electronic devices. The symptoms of EHS may include headaches, fatigue, tinnitus, dizziness, memory loss, irregular heartbeat, and skin trouble. Since the pathogenic mechanism of such conditions is not yet clear, further research is required. This report shows how a subject’s dizziness and joint mobility disorder, caused by electromagnetic waves emitted by electronic devices, were cured by removing an onlay from the patient’s mouth and replacing it with a gold alloy onlay. The result indicates that the subject’s symptoms were caused by EHS. Although the symptoms were improved after the dental treatment, the underlying mechanism of the symptoms and the reason why this treatment is successful remain unclear. Further research is required to clarify these issues.展开更多
Introduction: Systemic processes and inappropriate use of medications may affect vestibular adaptation. Objectives: To assess the efficacy of isolated and combined drug therapy for treating metabolic dizziness and to ...Introduction: Systemic processes and inappropriate use of medications may affect vestibular adaptation. Objectives: To assess the efficacy of isolated and combined drug therapy for treating metabolic dizziness and to determine the effect of multidrug treatment. Methodology: We analyzed 100 questionnaires of patients diagnosed with dizziness of metabolic origin. Results: The group treated with vestibular rehabilitation alone showed improvement with 9 months of therapy (p = 0.01). The group treated with vestibular rehabilitation and medication showed improvement with 45 days of therapy (p = 0.01). The group treated with a single type of drug did not show significant improvement. The group treated with several drugs showed improvement with 45 days of therapy (p = 0.03). Conclusion: Combined vestibular rehabilitation resulted in immediate improvement of symptoms without contributing to long-term compensation. Vestibular rehabilitation alone resulted in improve- ment of symptoms over time. Multidrug treatment was beneficial for immediate relief of dizziness.展开更多
Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the tr...Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases.In recent years,huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss,tinnitus,and vertigo.Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy.The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies.Methods:This is a prospective interventional pilot study in which pre and post intervention outcomes(tinnitus handicap inventory and dizziness handicap inventory)were assessed and compared.27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy.Results:There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing.No adverse events were reported in this study.Conclusion:Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus.A large scale randomized controlled trial is recommended.展开更多
The theory of"all winds and dizziness belong to the liver"provides a basis for 1ater plysicians to study the etiologic and pathogenesis of vertigo diseases.This theory of pathogenesis suggests that vertigo d...The theory of"all winds and dizziness belong to the liver"provides a basis for 1ater plysicians to study the etiologic and pathogenesis of vertigo diseases.This theory of pathogenesis suggests that vertigo diseases are most closely related to the liver,so the mechanism can be simply understood as liver and spleen damage.Water dampness is unfavourable for transportation and transformation as dampness gathers phlegm,and liver‘wind’carries phlegm to the ear orifice,causing dizziness,or the ear orifice can be attacked due to the deficiency of yin and hyperactivity of yang in liver and kidney,resulting in sudden dizziness.Based on the pathogenesis theory of liver and spleen damage,the treatment principles should be based on strengthening the spleen and dispelling dampness,eliminating phlegm and extinguishing‘wind’.For‘yang-type'hyperactive liver,nourishing yin and suppressing yang,and the clearing of yang in the ears should always be the standard.展开更多
Objective:The effectiveness and safety of Tianma Gouteng Granules(天麻钩藤颗粒)in the treatment of dizziness were systematically evaluated.Methods:A randomized controlled trial of Tianma Gouteng Granules for dizziness...Objective:The effectiveness and safety of Tianma Gouteng Granules(天麻钩藤颗粒)in the treatment of dizziness were systematically evaluated.Methods:A randomized controlled trial of Tianma Gouteng Granules for dizziness was screened out by searching CNKI,Wanfang Data,VIP,SinoMed,Cochrane Library,PubMed,Embase,Web of Science in a systematic way and was based on Handbook 5.1 evaluation criteria and tools and RevMan 5.3 software for meta-analysis of the final inclusion of the study.Results:A total of 7 studies were included,6 studies were included in meta-anlysis and 1 other study,with a total sample size of 568 cases,including 328 cases in the experiential group and 240 cases in the control group.The systolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness is better than conventional treatment alone(MD=-3.38,95%CI[-4.90,-1.86],P<0.00001).The diastolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness had no difference compared with conventional treatment alone(MD=-1.35,95%CI[-2.36,-0.34],P=0.72).The TCM syndromes score of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness was better than conventional treatment(MD=-5.18,95%CI[-6.89,-5.47],P<0.00001).The marked effective rate of Tianma Gouteng Granules combined with conventional treatment in the treatment of dizziness was better than conventional treatment(RR=2.09,95%CI[1.35,3.24],P=0.001).The marked effective rate of Tianma Gouteng Granules in the treatment of dizziness was better than conventional treatment(RR=1.85,95%CI[1.34,2.54],P=0.0002).Adverse actions included stomach discomfort,dry mouth,headache,dizziness,nausea,insomnia,rash,etc.The number of reported cases in both groups was small.Conclusion:The treatment of systolic pressure,TCM syndrome score and marked effective rate of Tianma Gouteng Granules alone or combined with conventional treatment for dizziness was better than conventional treatment.There was no difference between Tianma Gouteng Granules alone or combined with conventional treatment on diastolic pressure.No serial reverse actions were reported,and all reverse actions were reported after drug withdrawal or dose reduction,and the sample size was small,requiring large samples for further verification.However,the quality of the study is not high,and it is necessary to improve the level of evidence quality by using clinical trial schemes with large samples,rational design and compliance with international standards.展开更多
OBJECTIVE:To evaluate the effectiveness and safety of Ginkgo biloba extract(GBE50)in the treatment of dizziness caused by cerebral arteriosclerosis.METHODS:This was a multi-center,double-blind,double-dummy,positive-co...OBJECTIVE:To evaluate the effectiveness and safety of Ginkgo biloba extract(GBE50)in the treatment of dizziness caused by cerebral arteriosclerosis.METHODS:This was a multi-center,double-blind,double-dummy,positive-controlled,parallel randomized controlled clinical trial with 1∶1 allocation.We recruited 404 patients with dizziness caused by cerebral arteriosclerosis(blood stasis symptom pattern)in 10 hospitals in China.GBE50 group received GBE50 and Naoxinqing tablet(NXQ)of mimetic agent,control group received NXQ and GBE50 of mimetic agent.The main outcome was Traditional Chinese Medicine(TCM)symptom pattern score of blood stasis after 6 weeks.The secondary outcomes were changes in the dizziness handicap inventory(DHI)score,vertigo visual analogue scale(VAS)score,the university of California vertigo questionnaire(UCLA-DQ)score and single-item symptom score of TCM from baseline to 2,4 and 6 weeks.Safety indicators included the incidence of adverse events,severe adverse events and laboratory examination including blood routine,liver function,renal function,and so forth.RESULTS:The total effective rate of TCM symptom pattern score in the GBE50 group after 6 weeks of treatment was higher than that in the control group,the difference in rate was statistically significant(92.67%vs 83.07%,P=0.004).Compared with the control group,there was no difference in the incidence of adverse reactions(9.95%vs 14.85%,P=0.136).CONCLUSION:The treatment of dizziness caused by cerebral arteriosclerosis with GBE50 is effective,safe and reliable.展开更多
Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Partic...Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Participants included Seventy-three adults with diagnoses of acute,episodic,or chronic vestibular syndromes.They were classified into the following two groups:group 1 included 46 individuals treated with ISIT plus VRT,and group 2 included 27 individuals treated only with ISIT.Results:The Sensory Organization Test(SOT)for both groups showed a statistical significance for all three sensory inputs;visual systems(G1:p=0.0003;G2:p=0.0337),vestibular system(G1:p<0.0001;G2:p=0.0003),and balance as demonstrated by compound balance score(G1:p<0.0001;G2:p=0.0035),and balance percentage deficit(G1:p<0.0001;G2:p=0.0078).Conclusions:The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions,and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.展开更多
Dynamic visual acuity test(DVAT)plays a key role in the assessment of vestibular function,the visual function of athletes,as well as various ocular diseases.As the visual pathways conducting dynamic and static signals...Dynamic visual acuity test(DVAT)plays a key role in the assessment of vestibular function,the visual function of athletes,as well as various ocular diseases.As the visual pathways conducting dynamic and static signals are different,DVATs may have potential advantages over the traditional visual acuity tests commonly used,such as static visual acuity,contrast sensitivity,and static perimetry.Here,we provide a review of commonly applied DVATs and their several uses in clinical ophthalmology.These data indicate that the DVAT has its unique clinical significance in the evaluation of several ocular disorders.展开更多
Objective: Establish normative data for tympanic electrocochleography(TM ECoch G) parameters in normal hearing adults without Meniere's disease's(MD) symptoms. Describe TM ECoch G variables that help to distin...Objective: Establish normative data for tympanic electrocochleography(TM ECoch G) parameters in normal hearing adults without Meniere's disease's(MD) symptoms. Describe TM ECoch G variables that help to distinguish normal from MD ears.Material and methods: We enrolled 100 subjects(N =200 ears), 59 females, aged between 19 and 71 years from 09/2010 to 04/2014. Inclusion criteria: normal otomicroscopy, hearing thresholds≤25 dB nHL from 250 to 4000 Hz, normal tympanogram, no symptoms of MD according to the AAO-HNS 1995 criteria and Gibson's score <7. We excluded subjects with dizziness, aural fullness or other symptoms of endolymphatic hydrops. The following parameters were analyzed: SP/AP amplitude ratio, SP/AP area ratio and the difference between AP latency with rarefaction and condensation stimuli.Results: There was no significant difference between right and left ears(Intraclass correlation coefficient < 0.6). SP/AP amplitude ratio varied between 0.084 and 0.356 and SP/AP area ratio between 0.837 and 1.671(percentiles 5 and 95). The AP latency difference to rarefaction and condensation clicks was between 0.0 and 0.333 ms.Conclusion: Normative data for TM ECoch G parameters were established in 100 normal hearing subjects without MD. These data can be used to distinguish normal from pathological findings and in follow-up of MD patients.展开更多
Sudden deafness is one of the commonest acute symptoms in otolaryngology.In recent years,the incidence of sudden deafness is on the rise all over the world,but its etiology is still unclear,and the prognosis is greatl...Sudden deafness is one of the commonest acute symptoms in otolaryngology.In recent years,the incidence of sudden deafness is on the rise all over the world,but its etiology is still unclear,and the prognosis is greatly different.Traditional Chinese medicine(TCM)believes that the onset of sudden deafness is related to the liver,gallbladder,heart and triple energizer meridians.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of sudden deafness.展开更多
Standardized </span><i><span style="font-family:Verdana;">Ginkgo biloba</span></i><span style="font-family:Verdana;"> extract (GBE) is an established herbal trea...Standardized </span><i><span style="font-family:Verdana;">Ginkgo biloba</span></i><span style="font-family:Verdana;"> extract (GBE) is an established herbal treatment used for a variety of indications, including vertigo and/or tinnitus. The evidence base in human clinical studies for a clear benefit of GBE in vertigo and/or tinnitus is limited and contradictory due to poor reporting as well as variations in study quality and outcome measures used. The aim of this review is to identify and discuss the rationale for using GBE in the treatment of vertigo and/or tinnitus based on the known pleiotropic actions of GBE and the pathophysiology of vertigo and/or tinnitus. The rationale will be substantiated by a review of the literature in order to identify and evaluate clinical trials investigating the efficacy of GBE in individuals with vertigo and/or tinnitus. The review identifie</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">d </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">randomized controlled trials (RCTs) investigating the effectiveness of GBE in vertigo and/or tinnitus published</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">in PubMed up to 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> January 2020.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">In total, 17 RCTs were included 8 of the 9 studies investigating tinnitus and/or vertigo/dizziness found improvements, and 6 of 8 included studies investigating solely tinnitus showed positive effects. Based on the known mechanisms of action of GBE as well as evidence from animal models and human clinical trials identified in this review, GBE</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">is a rational alternative treatment that might provide benefits to individuals with vertigo and/or tinnitus. However, further well-defined RCTs in patients with defined pathological entities are necessary to further substantiate the beneficial effects of GBE for vertigo and/or tinnitus.展开更多
文摘Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.
文摘BACKGROUND Persistent postural-perceptual dizziness(PPPD)is a functional disorder,typically preceded by acute vestibular disorders.It is characterized by a shift in processing spatial orientation information,to favor visual over vestibular and somatosensory inputs,and a failure of higher cortical mechanisms.To date,no therapies for PPPD have been approved.Kampo medicine hangebyakujutsutemmato(HBT)has been reported to alleviate disturbances of equilibrium.We hypothesized that HBT would be a beneficial treatment for PPPD.AIM To examine the efficacy of HBT for the treatment of PPPD.METHODS Patients with PPPD were enrolled and divided into two groups:The HBT group(n=24)and the non-HBT group(n=14).The participants completed questionnaire surveys[Niigata PPPD questionnaire(NPQ),dizziness handicap inventory,hospital anxiety and depression scale(HADS),orthostatic dysregulation questionnaire,pittsburg sleep quality index(PSQI),and motion sickness scores]before and after HBT treatment.Additionally,to identify HBT responders,multivariate regression analysis was performed using the results of the ques-tionnaire surveys and equilibrium tests;including stabilometry,and caloric,vestibular evoked myogenic response,and head-up tilt tests.RESULTS Thirty-eight outpatients were included in this study,of which 14 patients(3 men,11 women;mean age,63.5±15.9 years)received treatment without HBT,and 24(1 man,23 women;mean age,58.2±18.7 years)received combination treatment with HBT.Following HBT treatment,NPQ scores decreased significantly(baseline 40.1±10.0 vs 2 mo 24.6±17.7,P<0.001).No statistically significant changes were observed in the NPQ scores in the non-HBT group(baseline 38.6±12.2 vs 2 mo 39.4±14.4,P=0.92).Multivariable regression analysis revealed that the results of stabilometry(P=0.02)and the caloric(P=0.03),and head-up tilt tests(P<0.001),HADS(P=0.003),and PSQI(P=0.01)were associated with HBT responsiveness in PPPD patients.CONCLUSION HBT may be an effective adjunct therapy for PPPD.Patients with autonomic dysfunction,unstable balance,semicircular canal paresis,anxiety,and poor sleep quality may be high responders to HBT.
文摘This case report describes a woman aged approximately 50 years who has suffered from balance dysregulation and dizziness for more than 10 years. Although the subject underwent several examinations to confirm the etiology of her symptoms, the root cause remained unknown. The symptoms were thought to be caused by electromagnetic wave hypersensitivity because the subject experienced uneasiness and dizziness when a cell phone was held close to her body. A cell phone was used to diagnose the collection of harmful electromagnetic waves, and an amalgam filling was determined to be the cause. The amalgam filling was removed under strict protection, and the subject’s symptoms completely disappeared soon after the filling was removed.
基金Supported by the Fujian Provincial Health Commission,No.2019-ZQN-78the National Natural Science Foundation of China,No.81503431the Natural Science Foundation of the Fujian Province,No.2020J01247.
文摘BACKGROUND Dizziness is a common symptom in adults and usually due to peripheral causes affecting semicircular canal function or central causes affecting the pons,medulla,or cerebellum.Arrhythmia is a recognized cause of dizziness in people with structural or ischemic heart disease.We report a case of exercise-induced transient ventricular tachycardia and dizziness in a man with no evidence of organic heart disease.CASE SUMMARY A 42-year-old man presented with a 6 mo history of transient exercise-induced dizziness and prodromal palpitations.The patient was otherwise asymptomatic.Physical examination,otoscopy,vestibular tests,cerebellar tests,laboratory investigations,and imaging investigations were all unremarkable.Twenty-four hour Holter monitoring revealed four episodes of transient ventricular tachycardia during exercise.The patient was started on metoprolol and subsequently underwent radiofrequency catheter ablation.The patient reported a full recovery and no dizziness during daily activities.These results were maintained at the 6 mo follow-up.CONCLUSION Ventricular tachycardia is an uncommon but potentially serious cause of dizziness.The outcome of this case illustrates the benefits of careful clinical examination and communication with specialized centers.High clinical suspicion of arrhythmia in a patient with dizziness merits consultation with a cardiologist and referral to a specialized center to ensure timely diagnosis and treatment.
文摘Dizziness and vertigo is a commonly encountered disease in clinic. There has been the saying from ancient times that "there would be no dizziness if without wind", " there would be no dizziness if without phlegm", "there would be no dizziness if without deficiency", and " there would be no dizziness if without fire". However, in the author's view, the dizziness and vertigo caused by blood stasis blocking the collaterals is most commonly seen in clinic, which should deserve more attention. The following is an introduction about the author's experience in treating 3 cases of dizziness and vertigo with acupuncture.
文摘Note: HLY = hyperactivity of the liver-yang, STPMJ = stagnation of turbid phlegm in middle-Jiao, DQB = deficiency of qi and blood, DKE = deficiency of the kidney-essence, OCBS = obstruction of collaterals by blood
文摘Abstract: The Nagoya University Hospital otolaryngology department is doing the prospective cohort study in Yakumo-cho, Hokkaido, Japan from 2005, because this place is a little transfer of the population. Most of inhabitants of Yakumo-cho engage in fishery and agriculture as work mainly. We perform questionary survey using an interview vote. The item is “having feeling of dizziness or not”,“quality of hearing” and “having tinnitus or not”. Furthermore, we go for the examination of stabilometry, too. We compared 2015, 2017 with 2005, 2007 among Yakumo-cho inhabitant examination data this time. As a result, participant with a feeling of conscious dizziness got a bad reputation of the hearing consciously. In addition, participant with a feeling of conscious dizziness had tinnitus consciously. Furthermore, the participant with a feeling of conscious dizziness had bad stabilometry result. As a result of having compared ten years later, we understood that stabilometry result worsened if 60s became in 70s with or without a feeling of dizziness consciously. When there is a feeling of conscious dizziness, it is necessary to perform an examination of stabilometry as routine work. In addition, it is necessary to inspect stabilometry if participants have the bad hearing or tinnitus with a feeling of dizziness in particularly.
文摘With the development of an IT (Information Technology) society, the opportunity to use electronic devices, such as cell phones and personal computers, has increased. These electronic devices pro-vide many benefits to society. However, there have been a number of reports of electromagnetic hypersensitivity (EHS) related to the use of electronic devices. The symptoms of EHS may include headaches, fatigue, tinnitus, dizziness, memory loss, irregular heartbeat, and skin trouble. Since the pathogenic mechanism of such conditions is not yet clear, further research is required. This report shows how a subject’s dizziness and joint mobility disorder, caused by electromagnetic waves emitted by electronic devices, were cured by removing an onlay from the patient’s mouth and replacing it with a gold alloy onlay. The result indicates that the subject’s symptoms were caused by EHS. Although the symptoms were improved after the dental treatment, the underlying mechanism of the symptoms and the reason why this treatment is successful remain unclear. Further research is required to clarify these issues.
文摘Introduction: Systemic processes and inappropriate use of medications may affect vestibular adaptation. Objectives: To assess the efficacy of isolated and combined drug therapy for treating metabolic dizziness and to determine the effect of multidrug treatment. Methodology: We analyzed 100 questionnaires of patients diagnosed with dizziness of metabolic origin. Results: The group treated with vestibular rehabilitation alone showed improvement with 9 months of therapy (p = 0.01). The group treated with vestibular rehabilitation and medication showed improvement with 45 days of therapy (p = 0.01). The group treated with a single type of drug did not show significant improvement. The group treated with several drugs showed improvement with 45 days of therapy (p = 0.03). Conclusion: Combined vestibular rehabilitation resulted in immediate improvement of symptoms without contributing to long-term compensation. Vestibular rehabilitation alone resulted in improve- ment of symptoms over time. Multidrug treatment was beneficial for immediate relief of dizziness.
基金The Medical Research Center t Hamad Medical Corporation approved this study(Protocol:#13322/13).
文摘Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases.In recent years,huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss,tinnitus,and vertigo.Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy.The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies.Methods:This is a prospective interventional pilot study in which pre and post intervention outcomes(tinnitus handicap inventory and dizziness handicap inventory)were assessed and compared.27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy.Results:There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing.No adverse events were reported in this study.Conclusion:Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus.A large scale randomized controlled trial is recommended.
基金Shaanxi Province Famous TCM Doctor Zhang Xiong Studio[Shaan Wei TCM Development(2018)No.95]。
文摘The theory of"all winds and dizziness belong to the liver"provides a basis for 1ater plysicians to study the etiologic and pathogenesis of vertigo diseases.This theory of pathogenesis suggests that vertigo diseases are most closely related to the liver,so the mechanism can be simply understood as liver and spleen damage.Water dampness is unfavourable for transportation and transformation as dampness gathers phlegm,and liver‘wind’carries phlegm to the ear orifice,causing dizziness,or the ear orifice can be attacked due to the deficiency of yin and hyperactivity of yang in liver and kidney,resulting in sudden dizziness.Based on the pathogenesis theory of liver and spleen damage,the treatment principles should be based on strengthening the spleen and dispelling dampness,eliminating phlegm and extinguishing‘wind’.For‘yang-type'hyperactive liver,nourishing yin and suppressing yang,and the clearing of yang in the ears should always be the standard.
基金2018 National Key R&D Program of the Ministry of Science and Technology"Research on modernization of traditional Chinese medicine"project"Demonstration study on evidence-based evaluation and effect mechanism of the treatment of major diseases after the marketing of ten large varieties of proprietary Chinese medicines and classic formulas"(2018YFC1707400)。
文摘Objective:The effectiveness and safety of Tianma Gouteng Granules(天麻钩藤颗粒)in the treatment of dizziness were systematically evaluated.Methods:A randomized controlled trial of Tianma Gouteng Granules for dizziness was screened out by searching CNKI,Wanfang Data,VIP,SinoMed,Cochrane Library,PubMed,Embase,Web of Science in a systematic way and was based on Handbook 5.1 evaluation criteria and tools and RevMan 5.3 software for meta-analysis of the final inclusion of the study.Results:A total of 7 studies were included,6 studies were included in meta-anlysis and 1 other study,with a total sample size of 568 cases,including 328 cases in the experiential group and 240 cases in the control group.The systolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness is better than conventional treatment alone(MD=-3.38,95%CI[-4.90,-1.86],P<0.00001).The diastolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness had no difference compared with conventional treatment alone(MD=-1.35,95%CI[-2.36,-0.34],P=0.72).The TCM syndromes score of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness was better than conventional treatment(MD=-5.18,95%CI[-6.89,-5.47],P<0.00001).The marked effective rate of Tianma Gouteng Granules combined with conventional treatment in the treatment of dizziness was better than conventional treatment(RR=2.09,95%CI[1.35,3.24],P=0.001).The marked effective rate of Tianma Gouteng Granules in the treatment of dizziness was better than conventional treatment(RR=1.85,95%CI[1.34,2.54],P=0.0002).Adverse actions included stomach discomfort,dry mouth,headache,dizziness,nausea,insomnia,rash,etc.The number of reported cases in both groups was small.Conclusion:The treatment of systolic pressure,TCM syndrome score and marked effective rate of Tianma Gouteng Granules alone or combined with conventional treatment for dizziness was better than conventional treatment.There was no difference between Tianma Gouteng Granules alone or combined with conventional treatment on diastolic pressure.No serial reverse actions were reported,and all reverse actions were reported after drug withdrawal or dose reduction,and the sample size was small,requiring large samples for further verification.However,the quality of the study is not high,and it is necessary to improve the level of evidence quality by using clinical trial schemes with large samples,rational design and compliance with international standards.
基金Supported by National Major Scientific and Technological Special Project for"Significant New Drugs development"(No.2017ZX09304019)National Major Scientific and Technological Special Project for Clinical Evaluation Technology Platform of"Disease,Symptom Pattern and Symptom Correlation"of New Traditional Chinese Medicine。
文摘OBJECTIVE:To evaluate the effectiveness and safety of Ginkgo biloba extract(GBE50)in the treatment of dizziness caused by cerebral arteriosclerosis.METHODS:This was a multi-center,double-blind,double-dummy,positive-controlled,parallel randomized controlled clinical trial with 1∶1 allocation.We recruited 404 patients with dizziness caused by cerebral arteriosclerosis(blood stasis symptom pattern)in 10 hospitals in China.GBE50 group received GBE50 and Naoxinqing tablet(NXQ)of mimetic agent,control group received NXQ and GBE50 of mimetic agent.The main outcome was Traditional Chinese Medicine(TCM)symptom pattern score of blood stasis after 6 weeks.The secondary outcomes were changes in the dizziness handicap inventory(DHI)score,vertigo visual analogue scale(VAS)score,the university of California vertigo questionnaire(UCLA-DQ)score and single-item symptom score of TCM from baseline to 2,4 and 6 weeks.Safety indicators included the incidence of adverse events,severe adverse events and laboratory examination including blood routine,liver function,renal function,and so forth.RESULTS:The total effective rate of TCM symptom pattern score in the GBE50 group after 6 weeks of treatment was higher than that in the control group,the difference in rate was statistically significant(92.67%vs 83.07%,P=0.004).Compared with the control group,there was no difference in the incidence of adverse reactions(9.95%vs 14.85%,P=0.136).CONCLUSION:The treatment of dizziness caused by cerebral arteriosclerosis with GBE50 is effective,safe and reliable.
文摘Objective:We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological&Balance Center patients.Design:This is a retrospective descriptive study.Participants included Seventy-three adults with diagnoses of acute,episodic,or chronic vestibular syndromes.They were classified into the following two groups:group 1 included 46 individuals treated with ISIT plus VRT,and group 2 included 27 individuals treated only with ISIT.Results:The Sensory Organization Test(SOT)for both groups showed a statistical significance for all three sensory inputs;visual systems(G1:p=0.0003;G2:p=0.0337),vestibular system(G1:p<0.0001;G2:p=0.0003),and balance as demonstrated by compound balance score(G1:p<0.0001;G2:p=0.0035),and balance percentage deficit(G1:p<0.0001;G2:p=0.0078).Conclusions:The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions,and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.
基金Supported by Chinese Capital’s Funds for Health Improvement and Research(No.CFH2018-2-4093)National Science and Technology Major Project(No.2018ZX10101-004)。
文摘Dynamic visual acuity test(DVAT)plays a key role in the assessment of vestibular function,the visual function of athletes,as well as various ocular diseases.As the visual pathways conducting dynamic and static signals are different,DVATs may have potential advantages over the traditional visual acuity tests commonly used,such as static visual acuity,contrast sensitivity,and static perimetry.Here,we provide a review of commonly applied DVATs and their several uses in clinical ophthalmology.These data indicate that the DVAT has its unique clinical significance in the evaluation of several ocular disorders.
文摘Objective: Establish normative data for tympanic electrocochleography(TM ECoch G) parameters in normal hearing adults without Meniere's disease's(MD) symptoms. Describe TM ECoch G variables that help to distinguish normal from MD ears.Material and methods: We enrolled 100 subjects(N =200 ears), 59 females, aged between 19 and 71 years from 09/2010 to 04/2014. Inclusion criteria: normal otomicroscopy, hearing thresholds≤25 dB nHL from 250 to 4000 Hz, normal tympanogram, no symptoms of MD according to the AAO-HNS 1995 criteria and Gibson's score <7. We excluded subjects with dizziness, aural fullness or other symptoms of endolymphatic hydrops. The following parameters were analyzed: SP/AP amplitude ratio, SP/AP area ratio and the difference between AP latency with rarefaction and condensation stimuli.Results: There was no significant difference between right and left ears(Intraclass correlation coefficient < 0.6). SP/AP amplitude ratio varied between 0.084 and 0.356 and SP/AP area ratio between 0.837 and 1.671(percentiles 5 and 95). The AP latency difference to rarefaction and condensation clicks was between 0.0 and 0.333 ms.Conclusion: Normative data for TM ECoch G parameters were established in 100 normal hearing subjects without MD. These data can be used to distinguish normal from pathological findings and in follow-up of MD patients.
文摘Sudden deafness is one of the commonest acute symptoms in otolaryngology.In recent years,the incidence of sudden deafness is on the rise all over the world,but its etiology is still unclear,and the prognosis is greatly different.Traditional Chinese medicine(TCM)believes that the onset of sudden deafness is related to the liver,gallbladder,heart and triple energizer meridians.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of sudden deafness.
文摘Standardized </span><i><span style="font-family:Verdana;">Ginkgo biloba</span></i><span style="font-family:Verdana;"> extract (GBE) is an established herbal treatment used for a variety of indications, including vertigo and/or tinnitus. The evidence base in human clinical studies for a clear benefit of GBE in vertigo and/or tinnitus is limited and contradictory due to poor reporting as well as variations in study quality and outcome measures used. The aim of this review is to identify and discuss the rationale for using GBE in the treatment of vertigo and/or tinnitus based on the known pleiotropic actions of GBE and the pathophysiology of vertigo and/or tinnitus. The rationale will be substantiated by a review of the literature in order to identify and evaluate clinical trials investigating the efficacy of GBE in individuals with vertigo and/or tinnitus. The review identifie</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">d </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">randomized controlled trials (RCTs) investigating the effectiveness of GBE in vertigo and/or tinnitus published</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">in PubMed up to 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> January 2020.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">In total, 17 RCTs were included 8 of the 9 studies investigating tinnitus and/or vertigo/dizziness found improvements, and 6 of 8 included studies investigating solely tinnitus showed positive effects. Based on the known mechanisms of action of GBE as well as evidence from animal models and human clinical trials identified in this review, GBE</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">is a rational alternative treatment that might provide benefits to individuals with vertigo and/or tinnitus. However, further well-defined RCTs in patients with defined pathological entities are necessary to further substantiate the beneficial effects of GBE for vertigo and/or tinnitus.
