Health care practice patterns for balance disorders in the elderly

Abstract

2b.

Idiopathic benign paroxysmal positional vertigo in the elderly: a long-term follow-up study

“…Dizziness and imbalance are one of the most common complaints among older people [1][2][3][4]. The prevalence of this condition in patients older than 65 years is around 30%, and due to an aging world population, the number of patients is rapidly increasing [5,6].…”

Bilateral Vestibular Hypofunction: Challenges in Establishing the Diagnosis in Adults

“…To establish a correct diagnosis in vestibular patients is difficult: a clear diagnosis is not possible in up to 40% of vertigo patient subgroups [4]. As may be concluded from the challenges mentioned above, establishing the diagnosis of BVH is not an exception to this: it can be complicated.…”

“…However, even the more common vestibular diagnoses such as benign paroxysmal positional vertigo and vestibular migraine are often under- or misdiagnosed [2]. The difficulty of making the right vestibular diagnosis is reflected in the fact that in some populations, more than one third of the patients with a vestibular disease consult more than one physician [3] - in some cases up to more than fifteen [4]. It is necessary to have a correct diagnosis, since an incorrect diagnosis of a vestibular disease may eventually result in increased health care utilization and chronicity [3].…”

Management of vertigo: from evidence to clinical practice

“…The most common vestibular disorders seen in the ED are benign paroxysmal positional vertigo (BPPV) and acute peripheral vestibulopathy (APV) -i.e., vestibular neuritis and labyrinthitis. 9 …”

“…Two main theories, namely cupulolithiasis and canalolithiasis have been propounded over time in an attempt to explain the pathogenesis of BPPV. 9 Cupulolithiasis theory opined that the degeneration of the utricular otolithic membrane occurs following trauma, ischemia, infections, and other insults of the vestibular organ which results in the release of otoconia which gets deposited at the posterior semicircular (PSSC). This alters the specific gravity of cupula thus converting it to a gravity receptor and thereby provoking a rotatory nystagmus on rapid change of the head position.…”