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Common Vestibular Disorders - II - ECAB

Common Vestibular Disorders - II - ECAB

N N Mathur

(2013)

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Book Details

Abstract

Common vestibular disorders presenting with vertigo contributes significantly to morbidity and mortality. The challenge is to identify the underlying cause of dizziness so as to streamline the treatment and improve quality of life. In day to day ENT practice incidence of dizziness is reported to be 10–15%. It is often associated with a range of otological, neurological, and psychiatric disorder. There are fewer subjects in medicine which keep us more confused than vertigo. Dizziness and vertigo may be disturbing and incapacitating causing problems to people doing regular or specialized tasks such as driving, operating heavy machinery or flying. As the sensations are hard to describe, patients often use the words "dizziness" and "vertigo" interchangeably and inconsistently. Patients with the same underlying disorder might describe the symptoms very differently and might also differently describe the same "dizzy" event depending upon the how the question is directed. The aim of this project is to explore the experience and learning of some of the eminent medical professionals, develop relevant updates, and make them easily available for utilization by the Indian clinical practitioners.


Table of Contents

Section Title Page Action Price
Front Cover Front Cover
Front Matter ia
Copyright id
ECAB Clinical Update:Otorhinolaryngology ie
Common Vestibular Disorders - II if
About the Authors ig
Contents ii
ECAB Clinical Update InformationCOMMON VESTIBULAR DISORDERS - II i
Preface v
Tinnitus 1a
ABSTRACT 1a
KEYWORDS 1a
Introduction 1a
Definition 1a
Other Definitions 2
Risk Factors 2
Tinnitus Sound 2
Classification 3
Epidemiology 4
Neurophysiology 4
Neurophysiological Evidences 6
Factors Influencing Reaction to Tinnitus 7
Tinnitus and Hearing Loss 8
Evaluation 8
Audiological Tests in Tinnitus Patients 8
Evaluation of a Case of Tinnitus Based on Questionnaires 8
Radiology in Tinnitus 13
Tinnitus in Children 14
Tinnitus in Pilots 14
Tinnitus in Otosclerosis 14
Tinnitus in Paget Disease 14
Tinnitus as a Side-effect of Medication 14
Treatment Options 15
Cognitive Behavioral Therapy 15
Biofeedback-based Behavioral Intervention 15
Tinnitus Masking 15
Phase-shift Treatment for Predominant Tone Tinnitus 16
Tinnitus Retraining Therapy (TRT) 16
Real Time Functional MRI Feedback Training 17
Tinnitus-targeted Therapy (TTT) 17
Hearing Aids 18
Acoustic Stimuli, Particularly Fractal Tones, Delivered Through Hearing Aids 18
Customized Sound Treatment 18
Cochlear Implant 19
Sound Generator 19
High-frequency and Ultrasonic External Acoustic Stimulation 19
Auditory Discrimination Therapy (ADT) 19
Use of Alprazolam 20
Use of Antidepressants 20
Gabapentin 20
Other Evaluated Treatments 21
Lignocaine 21
Intratympanic methyl prednisolone 21
Botox 21
Transmeatal Low Power Laser Irradiation 22
Transcranial Magnetic Stimulation (TMS) 22
Herbal/Mineral Supplementation 22
Music Therapy 22
Hypnosis and Reflexology 22
Hyperbaric Oxygen 22
Acupuncture 22
CONCLUSION 23
Benign Paroxysmal Positional Vertigo 29a
ABSTRACT 29a
KEYWORDS 29a
Etiology 30
Pathogenesis 30
Diagnosis Of Benign Paroxysmal Positional Vertigo 32
Criteria Outlined for Diagnosis of Benign Paroxysmal Positional Vertigo10 33
Dix-Hallpike Test 34
Treatment 35
Conservative Treatment 35
Office Management 36
Semont's Maneuver 36
Epley's Maneuver 37
Post-procedural Instructions 38
Gan's Maneuver 39
Recurrence 39
Surgical Treatment 40
Testing Prior to Surgery 40
Goals of Surgery 40
Contraindications 40
Atypical Benign Paroxysmal Positional Vertigo 41
Lateral Canal Benign Paroxysmal Positional Vertigo 42
Anterior Canal Benign Paroxysmal Positional Vertigo 42
Vestibulolithiasis 42
Multiconal Variety 42
Unrecognized Benign Paroxysmal Positional Vertigo in Elderly Patients 43
Summary 43
Vestibular Neuritis 47a
ABSTRACT 47a
KEYWORDS 47a
Introduction 47a
Prevalence 47a
Diagnostic Features 48
Presenting Features 48
Clinical Features 49
Investigations 51
Pathophysiology 59
Prognosis 62
Differential Diagnosis 64
Treatment 65
Summary 66
Disequilibrium in Elderly 69a
ABSTRACT 69a
KEYWORDS 69a
Background 69a
Prevalence 69a
Changes In Vestibular System With Aging 70
Etiology 71
Evaluation 73
History 73
Physical Examination 73
Investigations 74
Caloric Stimulation 74
Rotary Stimulation 74
Posturography 75
Clinical Implications 75
Management 76
Vestibular Rehabilitation 76
Pharmacotherapy 78
Surgical Treatment 78
Devices 79
Conclusion 79
Perilymphatic (Labyrinthine) Fistula 83a
ABSTRACT 83a
KEYWORDS 83a
Introduction And Global Background 83a
Indian Scenario 85
Presenting Symptoms 86
Signs 87
The Limitations of Fistula Test 88
Pathophysiology 89
Management 94
Medical Management 96
Surgical Management 96
Postoperative Care 98
Postoperative Progress 99
Complications 99
Prognosis 99
Summary 100
Case Studies Perilymphatic Fistula 104
Case 1 104
Points to Learn 105
Case 2 105
Points to Learn 107
Case 3 108
Points to Learn 108
Case 4 109
Points to Learn 110
The Neuropsychiatric Aspects of Vertigo 113a
ABSTRACT 113a
KEYWORDS 113a
Introduction 113a
Global Update 115
Update In Indian Context 118
Personal Clinical Experience/Management 119
Treatment 122
Patient Education 122
Medications 123
Psychotherapy 123
Conclusions 124
Case Studies The Neuropsychiatric Aspects of Vertigo 128
Case 1 128
General Physical and Systemic Examination 128
Ear, Nose and Throat Examination 128
Neurotological Examination 128
Neurotological Investigations 128
Remarks 128
Case 2 129
General Physical and Systemic Examination 129
Ear, Nose and Throat Examination 129
Neurotological Examination 129
Neur otological Investigations 129
Radiological Examination 130
Remarks 130
Case 3 130
General Physical Examination 130
Ear, Nose and Throat Examination 130
Neurotological Examination 131
Neurotological Investigations 131
Remarks 131
Case StudiesThe Neuropsychiatric Aspects of Vertigo 128