Vértigo posicional paroxístico benigno: criterios diagnósticos. Documento de consenso del Comité para la Clasificación de los Trastornos Vestibulares de la Bárány Society

Brevern, Michael von; Bertholon, P.; Brandt, Thomas; Fife, Terry D.; Imai, Toshio; Nuti, Daniele; Newman‐Toker, David E.

doi:10.1016/j.otorri.2017.02.007

Cited by 63 publications

(33 citation statements)

References 73 publications

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“…Among them, 17 (14.5%) patients presented with residual dizziness after undergoing appropriate canalith repositioning procedures in another hospital [17]. No positional nystagmus was observed in 26 (22.2%) patients who had a typical history of benign paroxysmal positional vertigo and who were diagnosed as possible BPPV [18]. The second most common disease was psychiatric dizziness, occurring in 64 (16.3%) patients.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

Pan¹,

Zhang²,

Long³

et al. 2018

Eur Neurol

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Background: Dizziness and vertigo are frequent complaints of outpatients in the neurological department. Our objective was to explore the epidemiological category and clinical features of patients with dizziness or vertigo in the neurological outpatient department of a tertiary hospital. Methods: We consecutively recruited all patients with dizziness and/or vertigo visiting the neurological outpatient clinic of the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2017. All patients were interviewed by 4 neurologists and they completed self-administered questionnaires. General physical and standardized neuro-otology bedside examinations were performed in all participants. Instrumental examinations and other related examinations were prescribed as needed. Results: A total of 392 patients, 272 female and 120 male, were enrolled and the ratio of males to females was 1: 2.27. The mean age was 52.39 ± 13.87 years (range 11–90). Elderly patients (≥60 years) accounted for about one-third of the patients. Peripheral vestibular disorders accounted for 54.6% of patients, central vestibular disorders (including vestibular migraine [VM]) accounted for 22.4% of patients, psychogenic vertigo in 64 (16.3%), other reasons in 9 (2.3%) and unknown in 17 (4.3%). Benign paroxysmal positional vertigo (BPPV; 30.8%), psychiatric dizziness (20.5%), and VM (14.4%) were the 3 major vestibular diseases in patients under 60 years of age; however, BPPV (27.9%), central vertigo (21.7%), and Meniere’s disease (11.7%) were more common in patients over 60 years of age. Conclusions: This study provided a classification and clinical features of vestibular disorders in a neurological outpatient department of a tertiary hospital in China. The spectrum of vertigo or dizziness is different between different age groups and clinicians should pay attention to this difference in clinical reasoning.

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Section: Resultsmentioning

confidence: 99%

Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

Pan¹,

Zhang²,

Long³

et al. 2018

Eur Neurol

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“…Several recent studies have reported the occurrence of spontaneous nystagmus in the sitting position in patients with lateral semicircular canal-BPPV [ 4 – 6 ]. Because the spontaneous nystagmus is observed without imbalance in bilateral vestibular tone that usually develops in acute unilateral vestibulopathy, it has been named ‘pseudo-spontaneous nystagmus’, which was possibly associated with BPPV and not provoked by positioning but not yet sufficiently understood, formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pseudo-spontaneous nystagmus in patients with geotropic direction-changing positional nystagmus

et al. 2018

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BackgroundPseudo-spontaneous nystagmus has been reported in patients with direction-changing positional nystagmus (DCPN). Recently, the concept of a “light cupula” has been introduced as a pathophysiology that can exhibit persistent geotropic DCPN. Patients with persistent DCPN could have different characteristics of nystagmus. Therefore, we investigated the pseudo-spontaneous nystagmus in patients with transient (canalolithiasis) and persistent (belong to light cupula theory) geotropic DCPN.MethodsIn this study, prospectively, 49 patients with persistent geotropic DCPN and 67 patients with transient geotropic DCPN were enrolled. We compared the incidence of pseudo-spontaneous nystagmus between persistent and transient DCPN patients and characteristics of pseudo-spontaneous nystagmus and positional nystagmus by the head roll test in these patients. A prospective study was conducted at a dizziness clinic.ResultsPatients with persistent geotropic DCPN exhibited significantly higher incidence of pseudo-spontaneous nystagmus than patients with transient geotropic DCPN. Patients with transient DCPN showed a significantly higher mean SPV value during the head roll test than patients with persistent DCPN. All patients exhibiting pseudo-spontaneous nystagmus in patients with persistent DCPN had a null plane, and all patients had nystagmus beats to the opposite side of the null plane or the lesion side.ConclusionOur results support the possibility that the mechanism between persistent and transient geotropic DCPN may be different. However, more studies are needed on the pathogenesis and mechanism of the two diseases, including the occurrence of pseudo-spontaneous nystagmus in the disease entity.

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“…Patients were clinically diagnosed according to the international guidelines, most of the classification committee of the international Bárány Society (www.jvr-web.org/ICVD.html or www.baran ysoci ety.nl) for the diagnosis of vestibular migraine [23], Menière's disease [24], vestibular paroxysmia [25], bilateral vestibulopathy [26], acute unilateral vestibulopathy/vestibular neuritis [27] and benign paroxysmal positional vertigo [28]. The diagnoses of the patients within D1 and D3 can be viewed in Table 1.…”

Section: D1 and D3-clinical Diagnosis And Measurement Of The Auditorymentioning

confidence: 99%

VOLT: a novel open-source pipeline for automatic segmentation of endolymphatic space in inner ear MRI

et al. 2020

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Background Objective and volumetric quantification is a necessary step in the assessment and comparison of endolymphatic hydrops (ELH) results. Here, we introduce a novel tool for automatic volumetric segmentation of the endolymphatic space (ELS) for ELH detection in delayed intravenous gadolinium-enhanced magnetic resonance imaging of inner ear (iMRI) data. Methods The core component is a novel algorithm based on Volumetric Local Thresholding (VOLT). The study included three different data sets: a real-world data set (D1) to develop the novel ELH detection algorithm and two validating data sets, one artificial (D2) and one entirely unseen prospective real-world data set (D3). D1 included 210 inner ears of 105 patients (50 male; mean age 50.4 ± 17.1 years), and D3 included 20 inner ears of 10 patients (5 male; mean age 46.8 ± 14.4 years) with episodic vertigo attacks of different etiology. D1 and D3 did not differ significantly concerning age, gender, the grade of ELH, or data quality. As an artificial data set, D2 provided a known ground truth and consisted of an 8-bit cuboid volume using the same voxel-size and grid as real-world data with different sized cylindrical and cuboid-shaped cutouts (signal) whose grayscale values matched the real-world data set D1 (mean 68.7 ± 7.8; range 48.9-92.8). The evaluation included segmentation accuracy using the Sørensen-Dice overlap coefficient and segmentation precision by comparing the volume of the ELS. Results VOLT resulted in a high level of performance and accuracy in comparison with the respective gold standard. In the case of the artificial data set, VOLT outperformed the gold standard in higher noise levels. Data processing steps are fully automated and run without further user input in less than 60 s. ELS volume measured by automatic segmentation correlated significantly with the clinical grading of the ELS (p < 0.01). Conclusion VOLT enables an open-source reproducible, reliable, and automatic volumetric quantification of the inner ears' fluid space using MR volumetric assessment of endolymphatic hydrops. This tool constitutes an important step towards comparable and systematic big data analyses of the ELS in patients with the frequent syndrome of episodic vertigo attacks. A generic version of our three-dimensional thresholding algorithm has been made available to the scientific community via GitHub as an ImageJ-plugin.

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Vértigo posicional paroxístico benigno: criterios diagnósticos. Documento de consenso del Comité para la Clasificación de los Trastornos Vestibulares de la Bárány Society

Cited by 63 publications

References 73 publications

Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

Pseudo-spontaneous nystagmus in patients with geotropic direction-changing positional nystagmus

VOLT: a novel open-source pipeline for automatic segmentation of endolymphatic space in inner ear MRI

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