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Importance Can be a sign of serious diseases Can be seen in other specialties Hard to diagnose because it integrates several organs and systems together and the underlying cause is not clear. INTRODUCTION Dizziness is a common symptom that accounted for more than 5.6 million clinic visits in the United States 15% to 30% of patients, most often women and the elderly, will experience dizziness severe enough to seek medical attention at some time in their life. Physiology Function of vestibular system: “Input” resulting from a stimulus that needs to be corrected through the vestibular system such as falling down.
It is not surprisingly that vestibular lesion cause: Imbalance posture and gait imbalance visual distortion (oscillopsia ).
VERTIGO The word "vertigo" comes from the Latin "vertere", to turn + the suffix "-igo", a condition = a condition of turning about).
Vestibular Neuritis Viral infection of vestibular organ Affect all ages but rare in children – mostly adults Affected patient presents acutely with spontaneous nystagmus,vertigo and nausea &vomiting stays for hours and sometimes days.
BPPV The most common cause of vertigo in patient > 40 years Repeated attacks of vertigo usually of short duration less than a minute.
BPPV Diagnosis History Dix-Halpike maneuver : putting the patient in a certain position to stimulate the attack, and to look at the eye (causes nystagmus) to see which canal is mostly affected by trying to push the particles inside the canal and inducing the sense of dizziness. Migraine associated vertigo (MAV): common in females between the ages of 20 to 35 Classical presentation, preceded by aura or without aura then headache followed by couple of hours of dizziness. Acoustic tumor Benign tumor Arise from vestibular division of VIII Clinical presentation: Unilateral tinnitus Hearing loss Dizziness The only way to differentiate between Meniere's disease and the Acoustic tumor is by MRI.
Graham Medd had always put his sporadic dizzy spells down to a€?funny turnsa€™ or a reaction to something dodgy hea€™d eaten.But four years ago, the attacks took on a new intensity a€” Graham felt so dizzy and sick that he collapsed on the sofa.
The attacks became more frequent a€” two or three times a month hea€™d feel the strange whirling and numbness in the head.
Though ita€™s not clear why this build-up of fluid occurs, possible causes include an auto-immune condition a€” where your immune system starts attacking cells in the ear a€” a virus that damages the ear or simply because of the shape of the inner ear (in up to 10 per cent of cases, Menierea€™s runs in families).Some experts think it may be caused by a problem in the blood vessels a€” it has been linked to migraines, which are triggered by the narrowing and widening of blood vessels. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. YOU can’t see it and you can’t hear it (although your dog can!) but it's being blamed for the chronic tiredness associated with modern life. A British academic from Southampton University published an article in the January 2016 edition of the journal Proceedings of the Royal Society A that casts doubt on the existing guidelines for high-frequency ultrasound in public areas.
He warned that the guidelines for such exposure were more than 40 years old, and that they did not take into account the levels to which people are now exposed and the amount of time for which they are so exposed. This is likely to be a problem anywhere where there are devices like loudspeakers, door sensors, modern humidifiers, and public address systems; in other words, just about everywhere.
Most people can hear sound waves only up to 20 kHz, but there are clearly exceptional cases where people can detect it and are made ill by it.
In fact, a lot of research is currently being conducted to use high-frequency ultrasound to deter teenage troublemakers like, for example, the British teenage looters that went on a rampage in 2012, precisely because teenagers can detect these waves.
Other researchers have been tasked with developing high-frequency ultrasound crowd control weapons to make political and economic protesters fall ill, obviously as a way to make them go home and end their protests.
In other words, everyone agrees that these waves can make people sick; that is why they are being used as weapons. The key is to formulate new guidelines to protect people who are sensitive to these frequencies.

This problem is now more acute than ever, not just because of all the users of high sound frequencies in public areas, but also because the technology is being extended into people’s homes. But first, I’d really appreciate it if you click the Facebook button below and share this articles with your friends. An “output” results from responses of the vestibular system to the input such as the eyes, cerebellum..
B) central vestibular loss – above the level of the vestibular nerve and towards the brain. Patient requires only symptomatic treatment It takes 3 weeks to recover from vestibular neuritis Diagnosis – no other tool other than history.
Pathophysiology: Calcium carbonate particles shear off and enter the canal leading to brief episodes of vertigo.
Provoked by cert" title="BPPV The most common cause of vertigo in patient > 40 years Repeated attacks of vertigo usually of short duration less than a minute.
Treatment: repositioning of the head to get particles out of the canal (Epley or particle repositioning maneuver).
This would last for a couple of hours, the room spinning as though hea€™d just staggered off a childa€™s roundabout. This is made up of a a€?labyrintha€™ of fluid-filled channels that help transmit sound vibrations to the brain. Something that used to be only found in shopping malls and other public areas but is now sneaking into your home. These places included sports arenas, shopping malls, schools, libraries, museums, and railway stations. He especially highlighted that children and people between the ages of 40 and 49 were sensitive to these high frequencies.
And you don’t know whether you are being affected, because you cannot hear those high-frequency sounds. Police in several countries around the world, including the United States, already use these. For example, if you connect your mobile phone to your television or sound system through, for example, Google Chromecast, you are using these high sound frequencies. The results of overabundance weight include absence of vitality, loss of self esteem and confidence in your life.
More frequently the patient might complain of nausea when smelling something in the car or while driving around.
The labyrinth is also key to our sense of balance, sensing when the head moves and transmitting this information, via the vestibular nerve, to the brain. Alternatively, you can buy a set of industrial earplugs used by workers in industries where high-frequency ultrasound waves are used.
People need hard surfaces to get the full effect of their proprioception or it will feel like they are walking on sand “ shaky grounds”. The physical stimulus (input) will be transformed into a biological stimulas in the brain stem which will in turn be sent afterwards to the corresponding areas in the vestibular system.
Transform of the forces associate with head acceleration and gravity into a biological signals that the brain can use to develop subjective awareness of head position in space (orientation) produce motor reflexes that will maintain posture and ocular stability to prevent the feeling of dizziness.

And after each attack, it took almost a week to recover.a€™After six months, Graham saw his GP, who prescribed anti-sickness medication, but it didna€™t help. Menierea€™s disease is thought to be caused by the pressure of this fluid changing, or the fluid building up, triggering inflammation in the inner ear. The condition may burn itself out over two to eight years, but in some cases it can last for decades. Recent data suggests that one in 20 people aged 40-49 years have hearing thresholds that are at least 20 decibels (dB) more sensitive at 20 kHZ than that of the average 30-39 year old. Being pushed from behind will lead to all the previous systems to work together to maintain balance. If there is a defect in the input and output processes the patient will present with vertigo, defects in the gait or ocular distortions. Faulty messages are sent to the brain so it feels as if the head is moving when ita€™s not, hence the characteristic feelings of dizziness and nausea, which can last for ten hours.Menierea€™s can also cause hearing loss and tinnitus a€” phantom ringing sounds. A consultant recommended that Graham stick to a low-salt diet a€” this helps to draw excess fluid out of the inner ear a€” and prescribed betahistine, which reduces pressure on the fluid in the inner ear, and anti-sickness drugs.
Therefore have you ever wondered about some questions by yourself like this: Have you ever felt embarrassed about your small breast size? But nothing helped and Grahama€™s attacks were getting worse a€” when an attack started just as he arrived home, he would have to lie on the hall floor for hours.
The dizzy spells had been going on for two years when Grahama€™s consultant told him about a trial testing injecting drugs into the ear to stop Menierea€™s.In the past, if medication didna€™t help, the only cure for Menierea€™s was surgery a€” a two-hour operation to remove some of the bone in the ear to release pressure on the fluids or to destroy the labyrinth of channels in the ear that regulate balance.
These procedures help with balance problems, but the latter would leave patients deaf on one side. Another option is to sever the vestibular nerve sending abnormal messages to the brain, but this involves brain surgery that many patients cannot face.But doctors hope drugs could ease the condition non-invasively. Because it can damage hearing and balance, gentamicin is never used on both ears a€” and up to half of patients develop Menierea€™s in both ears. The other drug on trial is the steroid prednisolone, which can dampen down inflammation in the ear temporarily.a€?We know steroids dona€™t cure Menierea€™s, but it may suppress it in 90 per cent of patients,a€™ says Mr Rea. This is the gold standard in clinical research and we hope to be able to show which treatment is best for particular patients.a€™In May 2010, Graham went to Charing Cross Hospital for two injections into his ear.
Now researchers hope that when the trial ends in two years, they will have conclusive evidence on which drug is better.
In bad cases, gentamicin is one effective treatment, but it can have unpleasant side effects. The trial will establish how true this is for sufferers.a€™Graham hopes the attacks will never return. Ita€™s wonderful not to suffer.a€™The trial is still recruiting patients with one-sided Menierea€™s disease with repeated vertigo who have not responded to other treatments for at least six months.

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17.12.2013 admin

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