1/2. dizziness in childhood.dizziness in childhood is not an infrequent symptom. Accurate history taking and close co-operation between otologist, paediatrician and neurologist are necessary in the approach to the dizzy child. Most cases of childhood dizziness settle in time and investigations should be carefully selected; those with severe and persistent dizziness or ataxia should be thoroughly investigated including: EEG, ENG, calorics and CT scan. The conditions causing dizziness in children are discussed and are illustrated with case histories from our series of 27 children. dizziness of unknown aetiology, serous otitis media and benign paroxysmal vertigo were the most common diagnostic labels applied to our patients. Treatment is rarely necessary but dimenhydrinate or a labyrinthine sedative in those with troublesome vertigo, or the adjustment of the medical regime in those epileptics on phenytoin, may be beneficial. Surgical intervention is only required in those with an operable lesion.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
2/2. vestibular nerve pathology in cases of intractable vertigo: an electronmicroscopic study.OBJECTIVE: This study aimed to determine the absence or presence and the nature of pathology of the vestibular nerve in case of intractable vertigo. STUDY DESIGN: This was a prospective study. SETTING: The study was performed at a private practice tertiary referral center. patients: There-were 42 patients with intractable vertigo in the study. INTERVENTIONS: All patients received thorough diagnostic examinations and surgical excision of the vestibular nerves. MAIN OUTCOME MEASURES: Segments of the superior and inferior vestibular nerves were surgically removed, preserved in glutaraldehyde, examined by electronmicroscopy, and the findings were correlated with the clinical diagnosis. RESULTS: A variety of different types of pathologic lesions were identified, including axon and supporting cell degeneration, herpes zoster virus, other viruses, results of bacterial infection, and regrowth of nerve after surgical resection. CONCLUSION: The vestibular nerves were found to be histologically normal in lesions primarily involving the end organ such as most early Meniere's disease cases, benign paroxysmal postural vertigo (BPPV), and mild labyrinthine concussion. Vestibular nerve degeneration was seen with advanced Meniere's disease, severe labyrinthine concussion, and with vascular loops in the internal auditory canal. Herpes zoster involves Scarpa ganglion in herpes zoster oticus. viruses were found in the nuclei of vestibular nerve cells in a patient with delayed hydrops. Regrowth of the vestibular nerve after surgical resection was confirmed in three cases.- - - - - - - - - - ranking = 3.5keywords = vertigo (Clic here for more details about this article) |