Benign paroxysmal positional vertigo differential diagnosis: Difference between revisions
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/ | [[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Benign_paroxysmal_positional_vertigo]] | ||
'''For the WikiDoc page for this topic, click [[Benign paroxysmal positional vertigo|here]]''' | '''For the WikiDoc page for this topic, click [[Benign paroxysmal positional vertigo|here]]''' | ||
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==Overview== | ==Overview== | ||
BPPV must be differentiated from other diseases that cause vertigo, nystagmus, and hearing problems, such as vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson. | BPPV must be differentiated from other [[Disease|diseases]] that cause [[vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], such as [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]]. | ||
==Differentiating BPPV from other Diseases== | ==Differentiating BPPV from other Diseases== | ||
BPPV | BPPV must be differentiated from other [[Disease|diseases]] that cause [[vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], such as [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]]. | ||
===Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems=== | ===Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems=== | ||
On the basis of vertigo, nystagmus, and hearing problems, BPPV must be differentiated from vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson. | On the basis of [[Vertigo MRI|vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], BPPV must be differentiated from [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation]], and [[Parkinson's disease|Parkinson]]. | ||
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| colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |'''Peripheral''' | | colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |'''Peripheral''' | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign paroxysmal positional vertigo|BPPV]]<ref name="pmid20607044">{{cite journal |vauthors=Lee SH, Kim JS |title=Benign paroxysmal positional vertigo |journal=J Clin Neurol |volume=6 |issue=2 |pages=51–63 |date=June 2010 |pmid=20607044 |pmc=2895225 |doi=10.3988/jcn.2010.6.2.51 |url=}}</ref><ref name="pmid11771020">{{cite journal |vauthors=Chang MB, Bath AP, Rutka JA |title=Are all atypical positional nystagmus patterns reflective of central pathology? |journal=J Otolaryngol |volume=30 |issue=5 |pages=280–2 |date=October 2001 |pmid=11771020 |doi= |url=}}</ref><ref name="pmid24642523">{{cite journal |vauthors=Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W |title=Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo |journal=Otolaryngol Head Neck Surg |volume=150 |issue=6 |pages=919–24 |date=June 2014 |pmid=24642523 |doi=10.1177/0194599814527233 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign paroxysmal positional vertigo|BPPV]]<br><ref name="pmid20607044">{{cite journal |vauthors=Lee SH, Kim JS |title=Benign paroxysmal positional vertigo |journal=J Clin Neurol |volume=6 |issue=2 |pages=51–63 |date=June 2010 |pmid=20607044 |pmc=2895225 |doi=10.3988/jcn.2010.6.2.51 |url=}}</ref><ref name="pmid11771020">{{cite journal |vauthors=Chang MB, Bath AP, Rutka JA |title=Are all atypical positional nystagmus patterns reflective of central pathology? |journal=J Otolaryngol |volume=30 |issue=5 |pages=280–2 |date=October 2001 |pmid=11771020 |doi= |url=}}</ref><ref name="pmid24642523">{{cite journal |vauthors=Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W |title=Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo |journal=Otolaryngol Head Neck Surg |volume=150 |issue=6 |pages=919–24 |date=June 2014 |pmid=24642523 |doi=10.1177/0194599814527233 |url=}}</ref> | ||
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* May be associated with [[nausea]], [[vomiting]], and [[Gait abnormality|gait instability]] | * May be associated with [[nausea]], [[vomiting]], and [[Gait abnormality|gait instability]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular neuronitis|Vestibular neuritis]]<ref name="pmid18283159">{{cite journal |vauthors=Mandalà M, Nuti D, Broman AT, Zee DS |title=Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis |journal=Arch. Otolaryngol. Head Neck Surg. |volume=134 |issue=2 |pages=164–9 |date=February 2008 |pmid=18283159 |doi=10.1001/archoto.2007.35 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular neuronitis|Vestibular neuritis]]<br><ref name="pmid18283159">{{cite journal |vauthors=Mandalà M, Nuti D, Broman AT, Zee DS |title=Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis |journal=Arch. Otolaryngol. Head Neck Surg. |volume=134 |issue=2 |pages=164–9 |date=February 2008 |pmid=18283159 |doi=10.1001/archoto.2007.35 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | ||
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* May be associated with [[nausea]], [[vomiting]], [[Gait abnormality|gait instability]] and previous [[upper respiratory infection]] | * May be associated with [[nausea]], [[vomiting]], [[Gait abnormality|gait instability]] and previous [[upper respiratory infection]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ramsay Hunt syndrome type II|HSV oticus]]<ref name="Wackym1997">{{cite journal|last1=Wackym|first1=Phillip A.|title=Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)|journal=The Laryngoscope|volume=107|issue=9|year=1997|pages=1165–1175|issn=0023852X|doi=10.1097/00005537-199709000-00003}}</ref><ref name="ZhuPyatkevich2014">{{cite journal|last1=Zhu|first1=S.|last2=Pyatkevich|first2=Y.|title=Ramsay Hunt syndrome type II|journal=Neurology|volume=82|issue=18|year=2014|pages=1664–1664|issn=0028-3878|doi=10.1212/WNL.0000000000000388}}</ref><ref name="pmid2113244">{{cite journal |vauthors=Mishell JH, Applebaum EL |title=Ramsay-Hunt syndrome in a patient with HIV infection |journal=Otolaryngol Head Neck Surg |volume=102 |issue=2 |pages=177–9 |date=February 1990 |pmid=2113244 |doi=10.1177/019459989010200215 |url=}}</ref><ref name="TadaAoyagi2009">{{cite journal|last1=Tada|first1=Yuichiro|last2=Aoyagi|first2=Masaru|last3=Tojima|first3=Hitoshi|last4=Inamura|first4=Hiroo|last5=Saito|first5=Osamu|last6=Maeyama|first6=Hiroyuki|last7=Kohsyu|first7=Hidehiro|last8=Koike|first8=Yoshio|title=Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome|journal=Acta Oto-Laryngologica|volume=114|issue=sup511|year=2009|pages=170–174|issn=0001-6489|doi=10.3109/00016489409128326}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ramsay Hunt syndrome type II|HSV oticus]]<br><ref name="Wackym1997">{{cite journal|last1=Wackym|first1=Phillip A.|title=Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)|journal=The Laryngoscope|volume=107|issue=9|year=1997|pages=1165–1175|issn=0023852X|doi=10.1097/00005537-199709000-00003}}</ref><ref name="ZhuPyatkevich2014">{{cite journal|last1=Zhu|first1=S.|last2=Pyatkevich|first2=Y.|title=Ramsay Hunt syndrome type II|journal=Neurology|volume=82|issue=18|year=2014|pages=1664–1664|issn=0028-3878|doi=10.1212/WNL.0000000000000388}}</ref><ref name="pmid2113244">{{cite journal |vauthors=Mishell JH, Applebaum EL |title=Ramsay-Hunt syndrome in a patient with HIV infection |journal=Otolaryngol Head Neck Surg |volume=102 |issue=2 |pages=177–9 |date=February 1990 |pmid=2113244 |doi=10.1177/019459989010200215 |url=}}</ref><ref name="TadaAoyagi2009">{{cite journal|last1=Tada|first1=Yuichiro|last2=Aoyagi|first2=Masaru|last3=Tojima|first3=Hitoshi|last4=Inamura|first4=Hiroo|last5=Saito|first5=Osamu|last6=Maeyama|first6=Hiroyuki|last7=Kohsyu|first7=Hidehiro|last8=Koike|first8=Yoshio|title=Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome|journal=Acta Oto-Laryngologica|volume=114|issue=sup511|year=2009|pages=170–174|issn=0001-6489|doi=10.3109/00016489409128326}}</ref> | ||
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* May be associated with [[otalgia]], [[dry mouth]], and [[dry eyes]] | * May be associated with [[otalgia]], [[dry mouth]], and [[dry eyes]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ménière's disease|Meniere disease]]<ref name="Watanabe1980">{{cite journal|last1=Watanabe|first1=Isamu|title=Ménière’s Disease|journal=ORL|volume=42|issue=1-2|year=1980|pages=20–45|issn=1423-0275|doi=10.1159/000275477}}</ref><ref name="pmid9487176">{{cite journal |vauthors=Saeed SR |title=Fortnightly review. Diagnosis and treatment of Ménière's disease |journal=BMJ |volume=316 |issue=7128 |pages=368–72 |date=January 1998 |pmid=9487176 |pmc=2665527 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ménière's disease|Meniere disease]]<br><ref name="Watanabe1980">{{cite journal|last1=Watanabe|first1=Isamu|title=Ménière’s Disease|journal=ORL|volume=42|issue=1-2|year=1980|pages=20–45|issn=1423-0275|doi=10.1159/000275477}}</ref><ref name="pmid9487176">{{cite journal |vauthors=Saeed SR |title=Fortnightly review. Diagnosis and treatment of Ménière's disease |journal=BMJ |volume=316 |issue=7128 |pages=368–72 |date=January 1998 |pmid=9487176 |pmc=2665527 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | ||
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* May be associated with [[Nausea and vomiting|nausea]], [[Nausea and vomiting|vomiting]], and [[tinnitus]] | * May be associated with [[Nausea and vomiting|nausea]], [[Nausea and vomiting|vomiting]], and [[tinnitus]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Labyrinthine concussion<ref name="DürrerPoláčková1971">{{cite journal|last1=Dürrer|first1=J.|last2=Poláčková|first2=J.|title=Labyrinthine Concussion|journal=ORL|volume=33|issue=3|year=1971|pages=185–190|issn=1423-0275|doi=10.1159/000274994}}</ref><ref name="pmid24653897">{{cite journal |vauthors=Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK |title=Clinical characteristics of labyrinthine concussion |journal=Korean J Audiol |volume=17 |issue=1 |pages=13–7 |date=April 2013 |pmid=24653897 |pmc=3936518 |doi=10.7874/kja.2013.17.1.13 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Labyrinthine concussion<br><ref name="DürrerPoláčková1971">{{cite journal|last1=Dürrer|first1=J.|last2=Poláčková|first2=J.|title=Labyrinthine Concussion|journal=ORL|volume=33|issue=3|year=1971|pages=185–190|issn=1423-0275|doi=10.1159/000274994}}</ref><ref name="pmid24653897">{{cite journal |vauthors=Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK |title=Clinical characteristics of labyrinthine concussion |journal=Korean J Audiol |volume=17 |issue=1 |pages=13–7 |date=April 2013 |pmid=24653897 |pmc=3936518 |doi=10.7874/kja.2013.17.1.13 |url=}}</ref> | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Semicircular canal | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Semicircular canal | ||
dehiscence syndrome<ref name="pmid15655395">{{cite journal |vauthors=Lempert T, von Brevern M |title=Episodic vertigo |journal=Curr. Opin. Neurol. |volume=18 |issue=1 |pages=5–9 |date=February 2005 |pmid=15655395 |doi= |url=}}</ref><ref name="pmid10680810">{{cite journal |vauthors=Watson SR, Halmagyi GM, Colebatch JG |title=Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment |journal=Neurology |volume=54 |issue=3 |pages=722–8 |date=February 2000 |pmid=10680810 |doi= |url=}}</ref> | dehiscence syndrome<br><ref name="pmid15655395">{{cite journal |vauthors=Lempert T, von Brevern M |title=Episodic vertigo |journal=Curr. Opin. Neurol. |volume=18 |issue=1 |pages=5–9 |date=February 2005 |pmid=15655395 |doi= |url=}}</ref><ref name="pmid10680810">{{cite journal |vauthors=Watson SR, Halmagyi GM, Colebatch JG |title=Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment |journal=Neurology |volume=54 |issue=3 |pages=722–8 |date=February 2000 |pmid=10680810 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | ||
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* It may be provoked by [[Valsalva maneuver]], [[Cough|coughing]], and [[Sneeze|sneezing]] | * It may be provoked by [[Valsalva maneuver]], [[Cough|coughing]], and [[Sneeze|sneezing]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular paroxysmia<ref name="HufnerBarresi2008">{{cite journal|last1=Hufner|first1=K.|last2=Barresi|first2=D.|last3=Glaser|first3=M.|last4=Linn|first4=J.|last5=Adrion|first5=C.|last6=Mansmann|first6=U.|last7=Brandt|first7=T.|last8=Strupp|first8=M.|title=Vestibular paroxysmia: Diagnostic features and medical treatment|journal=Neurology|volume=71|issue=13|year=2008|pages=1006–1014|issn=0028-3878|doi=10.1212/01.wnl.0000326594.91291.f8}}</ref><ref name="pmid23400324">{{cite journal |vauthors=Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC |title=Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia |journal=Neurology |volume=80 |issue=7 |pages=e77 |date=February 2013 |pmid=23400324 |doi=10.1212/WNL.0b013e318281cc2c |url=}}</ref><ref name="pmid18809837">{{cite journal |vauthors=Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M |title=Vestibular paroxysmia: diagnostic features and medical treatment |journal=Neurology |volume=71 |issue=13 |pages=1006–14 |date=September 2008 |pmid=18809837 |doi=10.1212/01.wnl.0000326594.91291.f8 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular paroxysmia<br><ref name="HufnerBarresi2008">{{cite journal|last1=Hufner|first1=K.|last2=Barresi|first2=D.|last3=Glaser|first3=M.|last4=Linn|first4=J.|last5=Adrion|first5=C.|last6=Mansmann|first6=U.|last7=Brandt|first7=T.|last8=Strupp|first8=M.|title=Vestibular paroxysmia: Diagnostic features and medical treatment|journal=Neurology|volume=71|issue=13|year=2008|pages=1006–1014|issn=0028-3878|doi=10.1212/01.wnl.0000326594.91291.f8}}</ref><ref name="pmid23400324">{{cite journal |vauthors=Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC |title=Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia |journal=Neurology |volume=80 |issue=7 |pages=e77 |date=February 2013 |pmid=23400324 |doi=10.1212/WNL.0b013e318281cc2c |url=}}</ref><ref name="pmid18809837">{{cite journal |vauthors=Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M |title=Vestibular paroxysmia: diagnostic features and medical treatment |journal=Neurology |volume=71 |issue=13 |pages=1006–14 |date=September 2008 |pmid=18809837 |doi=10.1212/01.wnl.0000326594.91291.f8 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
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* They respond well to treatment with [[carbamazepine]] or [[oxcarbazepine]] | * They respond well to treatment with [[carbamazepine]] or [[oxcarbazepine]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cogan syndrome]]<ref name="pmid2189159">{{cite journal |vauthors=Vollertsen RS |title=Vasculitis and Cogan's syndrome |journal=Rheum. Dis. Clin. North Am. |volume=16 |issue=2 |pages=433–9 |date=May 1990 |pmid=2189159 |doi= |url=}}</ref><ref name="HughesKinney1983">{{cite journal|last1=Hughes|first1=Gordon B.|last2=Kinney|first2=Sam E.|last3=Barna|first3=Barbara P.|last4=Tomsak|first4=Robert L.|last5=Calabrese|first5=Leonard H.|title=Autoimmune reactivity in Cogan's syndrome: A preliminary report|journal=Otolaryngology–Head and Neck Surgery|volume=91|issue=1|year=1983|pages=24–32|issn=0194-5998|doi=10.1177/019459988309100106}}</ref><ref name="MajoorAlbers2009">{{cite journal|last1=Majoor|first1=M. H. J. M.|last2=Albers|first2=F. W. J.|last3=Casselman|first3=J. W.|title=Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome|journal=Acta Oto-Laryngologica|volume=113|issue=5|year=2009|pages=625–631|issn=0001-6489|doi=10.3109/00016489309135875}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cogan syndrome]]<br><ref name="pmid2189159">{{cite journal |vauthors=Vollertsen RS |title=Vasculitis and Cogan's syndrome |journal=Rheum. Dis. Clin. North Am. |volume=16 |issue=2 |pages=433–9 |date=May 1990 |pmid=2189159 |doi= |url=}}</ref><ref name="HughesKinney1983">{{cite journal|last1=Hughes|first1=Gordon B.|last2=Kinney|first2=Sam E.|last3=Barna|first3=Barbara P.|last4=Tomsak|first4=Robert L.|last5=Calabrese|first5=Leonard H.|title=Autoimmune reactivity in Cogan's syndrome: A preliminary report|journal=Otolaryngology–Head and Neck Surgery|volume=91|issue=1|year=1983|pages=24–32|issn=0194-5998|doi=10.1177/019459988309100106}}</ref><ref name="MajoorAlbers2009">{{cite journal|last1=Majoor|first1=M. H. J. M.|last2=Albers|first2=F. W. J.|last3=Casselman|first3=J. W.|title=Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome|journal=Acta Oto-Laryngologica|volume=113|issue=5|year=2009|pages=625–631|issn=0001-6489|doi=10.3109/00016489309135875}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | − | | style="background: #F5F5F5; padding: 5px; text-align: center;" | − | ||
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* It may cause [[Ménière's disease|Ménière]]-like attacks | * It may cause [[Ménière's disease|Ménière]]-like attacks | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular schwannoma]]<ref>{{Cite journal | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vestibular schwannoma]]<br><ref>{{Cite journal | ||
| author = [[Robert W. Foley]], [[Shahram Shirazi]], [[Robert M. Maweni]], [[Kay Walsh]], [[Rory McConn Walsh]], [[Mohsen Javadpour]] & [[Daniel Rawluk]] | | author = [[Robert W. Foley]], [[Shahram Shirazi]], [[Robert M. Maweni]], [[Kay Walsh]], [[Rory McConn Walsh]], [[Mohsen Javadpour]] & [[Daniel Rawluk]] | ||
| title = Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis | | title = Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis | ||
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* [[Gadolinium]]-enhanced [[MRI]] scan is definitive diagnostic test of [[Vestibular schwannoma|acoutic neuroma]] | * [[Gadolinium]]-enhanced [[MRI]] scan is definitive diagnostic test of [[Vestibular schwannoma|acoutic neuroma]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Otitis media]]<ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref><ref name="pmid25213276">{{cite journal |vauthors=Rettig E, Tunkel DE |title=Contemporary concepts in management of acute otitis media in children |journal=Otolaryngol. Clin. North Am. |volume=47 |issue=5 |pages=651–72 |year=2014 |pmid=25213276 |pmc=4393005 |doi=10.1016/j.otc.2014.06.006 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Otitis media]]<br><ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref><ref name="pmid25213276">{{cite journal |vauthors=Rettig E, Tunkel DE |title=Contemporary concepts in management of acute otitis media in children |journal=Otolaryngol. Clin. North Am. |volume=47 |issue=5 |pages=651–72 |year=2014 |pmid=25213276 |pmc=4393005 |doi=10.1016/j.otc.2014.06.006 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
Line 243: | Line 243: | ||
* Patient may show other [[signs]] and [[symptoms]] of [[upper respiratory infection]] such az [[cough]], [[nasal discharge]], and [[fever]] | * Patient may show other [[signs]] and [[symptoms]] of [[upper respiratory infection]] such az [[cough]], [[nasal discharge]], and [[fever]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Aminoglycoside toxicity<ref name="pmid8597959">{{cite journal |vauthors=Ernfors P, Duan ML, ElShamy WM, Canlon B |title=Protection of auditory neurons from aminoglycoside toxicity by neurotrophin-3 |journal=Nat. Med. |volume=2 |issue=4 |pages=463–7 |date=April 1996 |pmid=8597959 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Aminoglycoside toxicity<br><ref name="pmid8597959">{{cite journal |vauthors=Ernfors P, Duan ML, ElShamy WM, Canlon B |title=Protection of auditory neurons from aminoglycoside toxicity by neurotrophin-3 |journal=Nat. Med. |volume=2 |issue=4 |pages=463–7 |date=April 1996 |pmid=8597959 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
Line 259: | Line 259: | ||
* [[Gentamicin]] is the most common one | * [[Gentamicin]] is the most common one | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Recurrent vestibulopathy<ref name="pmid11343320">{{cite journal |vauthors=Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW |title=Familial benign recurrent vertigo |journal=Am. J. Med. Genet. |volume=100 |issue=4 |pages=287–91 |date=May 2001 |pmid=11343320 |doi= |url=}}</ref><ref name="pmid3712538">{{cite journal |vauthors=Rutka JA, Barber HO |title=Recurrent vestibulopathy: third review |journal=J Otolaryngol |volume=15 |issue=2 |pages=105–7 |date=April 1986 |pmid=3712538 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Recurrent vestibulopathy<br><ref name="pmid11343320">{{cite journal |vauthors=Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW |title=Familial benign recurrent vertigo |journal=Am. J. Med. Genet. |volume=100 |issue=4 |pages=287–91 |date=May 2001 |pmid=11343320 |doi= |url=}}</ref><ref name="pmid3712538">{{cite journal |vauthors=Rutka JA, Barber HO |title=Recurrent vestibulopathy: third review |journal=J Otolaryngol |volume=15 |issue=2 |pages=105–7 |date=April 1986 |pmid=3712538 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
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! colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Central | ! colspan="10" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Central | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular migrain<ref name="pmid14979299">{{cite journal |vauthors= |title=The International Classification of Headache Disorders: 2nd edition |journal=Cephalalgia |volume=24 Suppl 1 |issue= |pages=9–160 |date=2004 |pmid=14979299 |doi= |url=}}</ref><ref name="pmid22714135">{{cite journal |vauthors=Absinta M, Rocca MA, Colombo B, Copetti M, De Feo D, Falini A, Comi G, Filippi M |title=Patients with migraine do not have MRI-visible cortical lesions |journal=J. Neurol. |volume=259 |issue=12 |pages=2695–8 |date=December 2012 |pmid=22714135 |doi=10.1007/s00415-012-6571-x |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Vestibular migrain<br><ref name="pmid14979299">{{cite journal |vauthors= |title=The International Classification of Headache Disorders: 2nd edition |journal=Cephalalgia |volume=24 Suppl 1 |issue= |pages=9–160 |date=2004 |pmid=14979299 |doi= |url=}}</ref><ref name="pmid22714135">{{cite journal |vauthors=Absinta M, Rocca MA, Colombo B, Copetti M, De Feo D, Falini A, Comi G, Filippi M |title=Patients with migraine do not have MRI-visible cortical lesions |journal=J. Neurol. |volume=259 |issue=12 |pages=2695–8 |date=December 2012 |pmid=22714135 |doi=10.1007/s00415-012-6571-x |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |– | | style="background: #F5F5F5; padding: 5px; text-align: center;" |– | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
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* It may be associated with [[anxiety]] and [[depression]] | * It may be associated with [[anxiety]] and [[depression]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Epileptic vertigo<ref name="pmid25795644">{{cite journal |vauthors=Tarnutzer AA, Lee SH, Robinson KA, Kaplan PW, Newman-Toker DE |title=Clinical and electrographic findings in epileptic vertigo and dizziness: a systematic review |journal=Neurology |volume=84 |issue=15 |pages=1595–604 |date=April 2015 |pmid=25795644 |pmc=4408281 |doi=10.1212/WNL.0000000000001474 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Epileptic vertigo<br><ref name="pmid25795644">{{cite journal |vauthors=Tarnutzer AA, Lee SH, Robinson KA, Kaplan PW, Newman-Toker DE |title=Clinical and electrographic findings in epileptic vertigo and dizziness: a systematic review |journal=Neurology |volume=84 |issue=15 |pages=1595–604 |date=April 2015 |pmid=25795644 |pmc=4408281 |doi=10.1212/WNL.0000000000001474 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
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* They response well to anti-[[seizure]] drugs | * They response well to anti-[[seizure]] drugs | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]]<br><ref name="pmid11456302">{{cite journal |vauthors=McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS |title=Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis |journal=Ann. Neurol. |volume=50 |issue=1 |pages=121–7 |date=July 2001 |pmid=11456302 |doi= |url=}}</ref><ref name="pmid3985583">{{cite journal |vauthors=Barrett L, Drayer B, Shin C |title=High-resolution computed tomography in multiple sclerosis |journal=Ann. Neurol. |volume=17 |issue=1 |pages=33–8 |date=January 1985 |pmid=3985583 |doi=10.1002/ana.410170109 |url=}}</ref><ref name="pmid10449103">{{cite journal |vauthors=Fazekas F, Barkhof F, Filippi M, Grossman RI, Li DK, McDonald WI, McFarland HF, Paty DW, Simon JH, Wolinsky JS, Miller DH |title=The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis |journal=Neurology |volume=53 |issue=3 |pages=448–56 |date=August 1999 |pmid=10449103 |doi= |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
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* The onset of [[symptoms]] is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty | * The onset of [[symptoms]] is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain tumor|Brain tumors]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain tumor|Brain tumors]]<br><ref name="DunniwayWelling2016">{{cite journal|last1=Dunniway|first1=Heidi M.|last2=Welling|first2=D. Bradley|title=Intracranial Tumors Mimicking Benign Paroxysmal Positional Vertigo|journal=Otolaryngology–Head and Neck Surgery|volume=118|issue=4|year=2016|pages=429–436|issn=0194-5998|doi=10.1177/019459989811800401}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/− | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
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* It may be associated with [[subclavian steal syndrome]] | * It may be associated with [[subclavian steal syndrome]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Chiari malformation]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Chiari malformation]]<br><ref name="pmid15034729">{{cite journal |vauthors=Caldarelli M, Di Rocco C |title=Diagnosis of Chiari I malformation and related syringomyelia: radiological and neurophysiological studies |journal=Childs Nerv Syst |volume=20 |issue=5 |pages=332–5 |date=May 2004 |pmid=15034729 |doi=10.1007/s00381-003-0880-4 |url=}}</ref><ref name="pmid18809020">{{cite journal |vauthors=Sarnat HB |title=Disorders of segmentation of the neural tube: Chiari malformations |journal=Handb Clin Neurol |volume=87 |issue= |pages=89–103 |date=2008 |pmid=18809020 |doi=10.1016/S0072-9752(07)87006-0 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" |− | | style="background: #F5F5F5; padding: 5px; text-align: center;" |− | ||
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* Patient may experience ringing in the [[Ear|ears]] | * Patient may experience ringing in the [[Ear|ears]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Parkinson's disease|Parkinson]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Parkinson's disease|Parkinson]]<br><ref name="van Wensenvan Leeuwen2013">{{cite journal|last1=van Wensen|first1=E.|last2=van Leeuwen|first2=R.B.|last3=van der Zaag-Loonen|first3=H.J.|last4=Masius-Olthof|first4=S.|last5=Bloem|first5=B.R.|title=Benign paroxysmal positional vertigo in Parkinson's disease|journal=Parkinsonism & Related Disorders|volume=19|issue=12|year=2013|pages=1110–1112|issn=13538020|doi=10.1016/j.parkreldis.2013.07.024}}</ref><ref name="pmid3990948">{{cite journal |vauthors=Steiner I, Gomori JM, Melamed E |title=Features of brain atrophy in Parkinson's disease. A CT scan study |journal=Neuroradiology |volume=27 |issue=2 |pages=158–60 |date=1985 |pmid=3990948 |doi= |url=}}</ref><ref name="pmid15981079">{{cite journal |vauthors=Kosta P, Argyropoulou MI, Markoula S, Konitsiotis S |title=MRI evaluation of the basal ganglia size and iron content in patients with Parkinson's disease |journal=J. Neurol. |volume=253 |issue=1 |pages=26–32 |date=January 2006 |pmid=15981079 |doi=10.1007/s00415-005-0914-9 |url=}}</ref> | ||
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Latest revision as of 14:05, 29 October 2019
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.
Overview
BPPV must be differentiated from other diseases that cause vertigo, nystagmus, and hearing problems, such as vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.
Differentiating BPPV from other Diseases
BPPV must be differentiated from other diseases that cause vertigo, nystagmus, and hearing problems, such as vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.
Differentiating BPPV from other diseases on the basis of vertigo, nystagmus, and hearing problems
On the basis of vertigo, nystagmus, and hearing problems, BPPV must be differentiated from vestibular neuritis, HSV oticus, Meniere disease, labyrinrhine concussion, perilymphatic fistula, semicircular canal dehiscence syndrome, vestibular paroxysmia, Cogan syndrome, vestibular schwannoma, otitis media, aminoglycoside toxicity, recurrent vestibulopathy, vestibular migraine, epileptic vertigo, multiple sclerosis, brain tumors, cerebellar infarction/hemorrhage, brain stem ischemia, chiari malformation, and Parkinson.
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||
---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | ||||||||
Lab Findings | Imaging | ||||||||
Acute onset | Recurrency | Nystagmus | Hearing problems | ||||||
Peripheral | |||||||||
BPPV [1][2][3] |
+ | + | +/− | − | − | − |
| ||
Vestibular neuritis [4] |
+ | +/− | + /−
(unilateral) |
− |
|
− | − |
| |
HSV oticus [5][6][7][8] |
+ | +/− | − | +/− |
|
+ VZV antibody titres |
|
||
Meniere disease [9][10] |
+/− | + | +/− | + (Progressive) | − |
|
|
||
Labyrinthine concussion [11][12] |
+ | − | − | + | − |
|
| ||
Perilymphatic fistula [13][14][15] |
+/− | + | − | + | − |
|
| ||
Semicircular canal | +/− | + | − | +
(air-bone gaps on audiometry) |
− |
|
| ||
Vestibular paroxysmia [18][19][20] |
+ | + | +/−
(Induced by hyperventilation) |
− |
|
− |
|
|
|
Cogan syndrome [21][22][23] |
− | + | +/− | + | Increased ESR and cryoglobulins |
|
| ||
Vestibular schwannoma [24][25] |
− | + | +/− | + |
|
− |
| ||
Otitis media [26][27] |
+ | − | − | +/− |
|
Increased acute phase reactants |
|
| |
Aminoglycoside toxicity [28] |
+ | − | − | + | − | − |
| ||
Recurrent vestibulopathy [29][30] |
+ | − | − | − | − | − | − |
| |
Central | |||||||||
Vestibular migrain [31][32] |
– | + | +/− | +/− |
|
− |
|
|
|
Epileptic vertigo [33] |
− | + | +/− | − |
|
− | − |
| |
Multiple sclerosis [34][35][36] |
− | + | +/− | − | Elevated concentration of CSF oligoclonal bands |
|
|||
Brain tumors [37] |
+/− | + | + | + | Cerebral spinal fluid (CSF) may show cancerous cells |
|
| ||
Cerebellar infarction/hemorrhage | + | − | ++/− | − | − |
| |||
Brain stem ischemia | + | − | +/− | − |
|
− |
|
| |
Chiari malformation [38][39] |
− | + | + | − |
|
− |
|
| |
Parkinson [40][41][42] |
− | + | − | − | − |
|
|
ABBREVIATIONS
VZV= Varicella zoster virus, MRI= Magnetic resonance imaging, ESR= Erythrocyte sedimentation rate, EEG= Electroencephalogram, CSF= Cerebrospinal fluid, GPe= Globus pallidus externa, ICHD= International Classification of Headache Disorders
References
- ↑ Lee SH, Kim JS (June 2010). "Benign paroxysmal positional vertigo". J Clin Neurol. 6 (2): 51–63. doi:10.3988/jcn.2010.6.2.51. PMC 2895225. PMID 20607044.
- ↑ Chang MB, Bath AP, Rutka JA (October 2001). "Are all atypical positional nystagmus patterns reflective of central pathology?". J Otolaryngol. 30 (5): 280–2. PMID 11771020.
- ↑ Dorresteijn PM, Ipenburg NA, Murphy KJ, Smit M, van Vulpen JK, Wegner I, Stegeman I, Grolman W (June 2014). "Rapid Systematic Review of Normal Audiometry Results as a Predictor for Benign Paroxysmal Positional Vertigo". Otolaryngol Head Neck Surg. 150 (6): 919–24. doi:10.1177/0194599814527233. PMID 24642523.
- ↑ Mandalà M, Nuti D, Broman AT, Zee DS (February 2008). "Effectiveness of careful bedside examination in assessment, diagnosis, and prognosis of vestibular neuritis". Arch. Otolaryngol. Head Neck Surg. 134 (2): 164–9. doi:10.1001/archoto.2007.35. PMID 18283159.
- ↑ Wackym, Phillip A. (1997). "Molecular Temporal Bone Pathology: II. Ramsay Hunt Syndrome (Herpes Zoster Oticus)". The Laryngoscope. 107 (9): 1165–1175. doi:10.1097/00005537-199709000-00003. ISSN 0023-852X.
- ↑ Zhu, S.; Pyatkevich, Y. (2014). "Ramsay Hunt syndrome type II". Neurology. 82 (18): 1664–1664. doi:10.1212/WNL.0000000000000388. ISSN 0028-3878.
- ↑ Mishell JH, Applebaum EL (February 1990). "Ramsay-Hunt syndrome in a patient with HIV infection". Otolaryngol Head Neck Surg. 102 (2): 177–9. doi:10.1177/019459989010200215. PMID 2113244.
- ↑ Tada, Yuichiro; Aoyagi, Masaru; Tojima, Hitoshi; Inamura, Hiroo; Saito, Osamu; Maeyama, Hiroyuki; Kohsyu, Hidehiro; Koike, Yoshio (2009). "Gd-DTPA Enhanced MRI in Ramsay Hunt Syndrome". Acta Oto-Laryngologica. 114 (sup511): 170–174. doi:10.3109/00016489409128326. ISSN 0001-6489.
- ↑ Watanabe, Isamu (1980). "Ménière's Disease". ORL. 42 (1–2): 20–45. doi:10.1159/000275477. ISSN 1423-0275.
- ↑ Saeed SR (January 1998). "Fortnightly review. Diagnosis and treatment of Ménière's disease". BMJ. 316 (7128): 368–72. PMC 2665527. PMID 9487176.
- ↑ Dürrer, J.; Poláčková, J. (1971). "Labyrinthine Concussion". ORL. 33 (3): 185–190. doi:10.1159/000274994. ISSN 1423-0275.
- ↑ Choi MS, Shin SO, Yeon JY, Choi YS, Kim J, Park SK (April 2013). "Clinical characteristics of labyrinthine concussion". Korean J Audiol. 17 (1): 13–7. doi:10.7874/kja.2013.17.1.13. PMC 3936518. PMID 24653897.
- ↑ Fox, Eileen J.; Balkany, Thomas J.; Arenberg, Kaufman (1988). "The Tullio Phenomenon and Perilymph Fistula". Otolaryngology–Head and Neck Surgery. 98 (1): 88–89. doi:10.1177/019459988809800115. ISSN 0194-5998.
- ↑ Casselman JW (February 2002). "Diagnostic imaging in clinical neuro-otology". Curr. Opin. Neurol. 15 (1): 23–30. PMID 11796947.
- ↑ Seltzer S, McCabe BF (January 1986). "Perilymph fistula: the Iowa experience". Laryngoscope. 96 (1): 37–49. PMID 3941579.
- ↑ Lempert T, von Brevern M (February 2005). "Episodic vertigo". Curr. Opin. Neurol. 18 (1): 5–9. PMID 15655395.
- ↑ Watson SR, Halmagyi GM, Colebatch JG (February 2000). "Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment". Neurology. 54 (3): 722–8. PMID 10680810.
- ↑ Hufner, K.; Barresi, D.; Glaser, M.; Linn, J.; Adrion, C.; Mansmann, U.; Brandt, T.; Strupp, M. (2008). "Vestibular paroxysmia: Diagnostic features and medical treatment". Neurology. 71 (13): 1006–1014. doi:10.1212/01.wnl.0000326594.91291.f8. ISSN 0028-3878.
- ↑ Strupp M, von Stuckrad-Barre S, Brandt T, Tonn JC (February 2013). "Teaching neuroimages: Compression of the eighth cranial nerve causes vestibular paroxysmia". Neurology. 80 (7): e77. doi:10.1212/WNL.0b013e318281cc2c. PMID 23400324.
- ↑ Hüfner K, Barresi D, Glaser M, Linn J, Adrion C, Mansmann U, Brandt T, Strupp M (September 2008). "Vestibular paroxysmia: diagnostic features and medical treatment". Neurology. 71 (13): 1006–14. doi:10.1212/01.wnl.0000326594.91291.f8. PMID 18809837.
- ↑ Vollertsen RS (May 1990). "Vasculitis and Cogan's syndrome". Rheum. Dis. Clin. North Am. 16 (2): 433–9. PMID 2189159.
- ↑ Hughes, Gordon B.; Kinney, Sam E.; Barna, Barbara P.; Tomsak, Robert L.; Calabrese, Leonard H. (1983). "Autoimmune reactivity in Cogan's syndrome: A preliminary report". Otolaryngology–Head and Neck Surgery. 91 (1): 24–32. doi:10.1177/019459988309100106. ISSN 0194-5998.
- ↑ Majoor, M. H. J. M.; Albers, F. W. J.; Casselman, J. W. (2009). "Clinical Relevance of Magnetic Resonance Imaging and Computed Tomography in Cogan's Syndrome". Acta Oto-Laryngologica. 113 (5): 625–631. doi:10.3109/00016489309135875. ISSN 0001-6489.
- ↑ Robert W. Foley, Shahram Shirazi, Robert M. Maweni, Kay Walsh, Rory McConn Walsh, Mohsen Javadpour & Daniel Rawluk (2017). "Signs and Symptoms of Acoustic Neuroma at Initial Presentation: An Exploratory Analysis". Cureus. 9 (11): e1846. doi:10.7759/cureus.1846. PMID 29348989. Unknown parameter
|month=
ignored (help) - ↑ E. P. Lin & B. T. Crane (2017). "The Management and Imaging of Vestibular Schwannomas". AJNR. American journal of neuroradiology. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMID 28546250. Unknown parameter
|month=
ignored (help) - ↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
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