Episodic Vertigo: A Narrative Review Based on a Single-Center Clinical Experience

Abstract

(1) Background: Usually, the majority of patients suffering from vertigo and dizziness can be identified in four major categories: acute spontaneous vertigo, episodic (recurrent) vertigo, recurrent positional vertigo, and chronic imbalance. Our purpose is to retrospectively evaluate the main causes of episodic vertigo and to find indications for a reliable clinical suspicion useful for a definitive diagnosis, comparing patients affected by different presenting symptomatology (acute vertigo, recurrent episodic vertigo, and imbalance). (2) Methods: we retrospectively evaluated the clinical records in a population of 249 consecutive patients observed for vertigo in our tertiary referral center in the period 1 January 2019–31 January 2020. On the basis of the reported clinical history, patients were divided into three groups: patients with their first ever attack of vertigo, patients with recurrent vertigo and dizziness, and patients with chronic imbalance. (3) Results: On the basis of the results of the instrumental examination, we arbitrarily divided (for each type of symptoms) the patients in a group with a normal vestibular instrumental examination and a group of patients in which the clinical–instrumental evaluation showed some pathological results; a highly significant difference (p: 0.157) was found between recurrent and acute vertigo and between recurrent vertigo and imbalance. (4) Conclusions: Patients with recurrent vertigo more frequently exhibit a negative otoneurological examination since they are often examined in the intercritical phase. A precise and in-depth research of the patient’s clinical history is the key to suspect or make a diagnosis together with the search for some instrumental or clinical hallmark, especially in cases where the clinical picture does not fully meet the international diagnostic criteria.

Editorial for This Special Issue “Synaptic Transmission: From Molecular to Neural Network Levels”

“…Altogether, these results suggest that the hyperpolarization of vestibular hair cells is related to the decrease in glutamate release due to the pimozide effect. It is known that vestibular dysfunctions are very common in adults [14], and vertigo is one of the main symptoms due to abnormal signaling from vestibular hair cells. Usually, the treatment in the case of severe vestibular symptoms, such as vertigo, is the chemical or surgical ablation of the vestibular nerve, but this can lead to permanent hearing loss.…”