Spotlight on Positional vertigo

In this article, Dr. Michael von Brevern of Humboldt University discusses positional vertigo, which is triggered by and occurs after a change of head position in space relative to gravity. The most common cause is benign paroxysmal positional vertigo, which can be cured highly effectively with positioning maneuvers. The differentiation from central positional vertigo is discussed by the authors. This article includes a rare differential diagnosis to positional vertigo: rotational vertebral artery syndrome. In rotational vertebral artery syndrome, vertigo is not induced by positional maneuvers but by rotation of the head to 1 side. Studies with eye movement recordings support the view that ischemia of the labyrinth leading to transient excitation of vestibular hair cells is the cause of rotational vertebral artery syndrome.

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Spotlight on Vestibular migraine

Vestibular migraine presents with attacks of spontaneous or positional vertigo (head motion–induced) and visual vertigo lasting 5 minutes to 3 days. The diagnosis requires a history of migraine, temporal association of migraine symptoms with vertigo attacks, and exclusion of other causes. Because headache is often absent during acute attacks, other migraine features such as photophobia or auras have to be specifically inquired about. The pathophysiology of vestibular migraine is unknown, but several mechanisms link the trigeminal system, which is activated during migraine attacks, and the vestibular system. Treatment includes antiemetics for severe acute attacks, pharmacological migraine prophylaxis, and lifestyle changes.

In this clinical article, Dr. Thomas Lempert of Charité University Hospital and Dr. Michael von Brevern of Humboldt University discuss the manifestations, biological basis, diagnosis, and mananagement of vestibular migraine.

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Spotlight on Vestibular migraine

In this clinical summary, Dr. Thomas Lempert of Charité University Hospital and Dr. Michael von Brevern of Humbolt University in Berlin, Germany discuss vestibular migraine, which presents with attacks of spontaneous or positional vertigo, head motion-induced vertigo or dizziness, and visual vertigo lasting 5 minutes to 3 days. The diagnosis requires a history of migraine, temporal association of migraine symptoms with vertigo attacks, and exclusion of other causes. Because headache is often absent during acute attacks, other migraine features such as photophobia or auras must be questioned. The pathophysiology of vestibular migraine is unknown, but several mechanisms link the trigeminal system, which is activated during migraine attacks, and the vestibular system. Treatment includes antiemetics for severe acute attacks as well as pharmacological migraine prophylaxis, and lifestyle changes.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Positional vertigo

Positional vertigo is triggered by and occurs after a change of head position in space relative to gravity. The most common cause is benign paroxysmal positional vertigo, which can be effectively cured with positioning maneuvers. The differentiation from central positional vertigo is discussed by Dr. Michael von Brevern and Dr. Thomas Lempert of Charité, Berlin. This summary includes a rare differential diagnosis to positional vertigo: rotational vertebral artery syndrome. In rotational vertebral artery syndrome, vertigo is not induced by positional maneuvers but by rotation of the head to one side. Recent studies with eye movement recordings support the view that ischemia of the labyrinth leading to transient excitation of vestibular hair cells is the cause of rotational vertebral artery syndrome.

To view the complete clinical summary, click here.

MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Inner ear concussion

Symptoms of inner ear concussion (also known as “labyrinthine concussion”) may include vertigo, postural imbalance, hearing loss, tinnitus, nausea, vomiting, or some combination after head trauma. In some cases, onset may be delayed for several days. In this clinical summary, Dr. Douglas Lanska, staff neurologist at the VA Medical Center in Tomah, Wisconsin explains the clinical presentation, pathophysiology, and differential diagnosis of inner ear concussion, a common cause of auditory and vestibular symptoms after closed head injury. Full recovery is the rule for posttraumatic dizziness or vertigo, which seldom persists longer than 3 months after minor traumatic brain injury.

To view the complete clinical summary, click here.

MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Benign paroxysmal positional vertigo

Clinical Summary: Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo is the most common vestibular disorder. Canalolithiasis of the posterior semicircular canal is now widely accepted as the biological basis for typical benign paroxysmal positional vertigo. Better understanding of its pathophysiological concepts has led to specific therapeutic strategies, which aim to clear the affected semicircular canal from mobile particles. In this clinical summary, Drs. Michael von Brevern and Thomas Lempert, neurologists at Charité University Hospital in Berlin, present recent studies on the treatment of benign paroxysmal positional vertigo.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles.
We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.