1/5. depersonalization, vertigo and Meniere's disease.Meniere's disease is generally accepted to be a consequence of distention of the endolymphatic sac of the inner ear. Although the exact etiology is unclear, there is a body of research suggesting that Meniere's disease is of psychosomatic origin. While we do not intend to review the literature exhaustively, we briefly review several frequently cited studies. Even though this literature is so severely flawed that no solid conclusions may be drawn from it, certain questions about the psychological aspect of this disorder continue to surface. Our limited access to patients with vertigo has not allowed us to undertake a carefully designed study. However, in clinical practice we have noted that many persons who complain of vertigo (whether due to Meniere's disease or other causes) also report symptoms of depersonalization and derealization. In this paper we present the cases of two women with Meniere's disease who also experienced concurrent feelings of unreality. It appears likely that feelings of unreality may occur regularly in association with syndromes causing vertigo, presumably as a consequence of vestibular dysfunction. We argue that emotional disturbances previously identified as predisposing causes of Meniere's disease are more likely effects of the disease. Although the discussion of two uncontrolled cases can do little to help solve nagging questions about a psychosomatic component to this disorder, we believe it may suggest a different perspective from which to investigate these complex phenomena.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
2/5. role of the visceral brain in body equilibrium.A series of examinations were carried out to determine whether the limbic system, particularly the hippocampus and the amygdaloid nucleus, participates in the production of disequilibrium of the eyes and the body and to clarify the conditions which induce disequilibrium. Over-stimulation of the rabbit's hippocampus induces over-excitation of adrenergic components involved in this part of the brain, through which dysfunction of equilibrium center in the brain stem is eventually brought about. This dysfunction leads to disequilibrium of the eyes and the body. On the basis of these results, equilibrium tests for neurotic vertigo were devised. Using these equilibrium tests we noted that in a certain group of traumatized patients who suffer from vertigo of psychosomatic origin, there are two etiological factors: functional linkage between the temporal cortex and the limbic system, particularly the hippocampus in regard to a memory or a conditioned reflex relevant to vertigo, over-excitation of the adrenergic components involved in the brain connecting the hippocampus, the hypothalamus and equilibrium centers in the brain stem. These two etiological factors induce disequilibrium by a trigger-and-target relationship in which the former acts as a trigger and the latter as a target. The cerebellum is not an essential factor in producing vertigo of psychosomatic origin, but it enhances vertigo of this type through activation of the adrenergic components, particularly those in the hippocampus. Thus, in patients with both vertigo of psychosomatic origin and cerebellar symptoms recovery from vertigo tends to be delayed. Over-stimulation of the rabbit's amygdaloid nucleus, particularly its medial portion and the habenular nucleus induces over-excitation of adrenergic components involved in these parts of the brain. These animals develop disequilibrium of the eyes in response to an olfactory stimulus, such as extract of garlic. On the basis of these results, equilibrium tests for olfactory vertigo were devised. Using these equilibrium tests we noted that traumatized patients who suffered from vertigo due to inhalation of garlic vapor showed hyper-reactivity to adrenaline and developed disequilibrium of the eyes and the body when given a subcutaneous injection of this drug. These findings indicate that olfactory vertigo is induced by a mechanism in which olfactory stimulation affects the above adrenergic components, causing disequilibrium of the eyes and the body.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1.4285714285714keywords = vertigo (Clic here for more details about this article) |
3/5. Sudden deafness and vertigo in children and juveniles.The 17 cases of sudden deafness in children and juveniles treated in the HNO-Universitats-Klinik Erlangen between August 1977 and December 1980 are analyzed and correlations of symptoms and possible etiologies are discussed. There is no unique clinical picture. Vascular reasons do not play an important role contrary to adult patients. Unexpectedly viral infections are not of great importance. Young patients who had a sensorineural hearing loss prior to the sudden deafness seem to have a bad prognosis for therapy. Vestibular involvement seems to be of no meaning for a successful therapy in children and juveniles.- - - - - - - - - - ranking = 0.57142857142857keywords = vertigo (Clic here for more details about this article) |
4/5. Juvenile kearns-sayre syndrome initially misdiagnosed as a psychosomatic disorder.We have investigated a 15 year old girl with progressive external ophthalmoplegia, including bilateral ptosis and retinal rod and cone cell dysfunction with atypical retinal pigmentation, complicated by cerebellar ataxia, partial cardiac conduction block, and diabetes mellitus. In infancy she had a severe crisis of bone marrow depression, and as a child she suffered from hypersensitivity to light, increasing fatigue, and vertigo, signs that were initially though to be psychosomatic. Histological examination showed mitochondrial myopathy, and subsequent mitochondrial dna (mtDNA) analysis showed a deletion of approximately 5500 base pairs in 35 to 40% of her muscle mtDNA. We therefore conclude that this patient has developed the kearns-sayre syndrome after a Pearson syndrome-like crisis in her first year of life.- - - - - - - - - - ranking = 0.14285714285714keywords = vertigo (Clic here for more details about this article) |
5/5. Basilar migraine.Basilar migraine is a complicated headache which the International headache Society describes as 'migraine with aura symptoms clearly originating from the brainstem or from both occipital lobes'. For years this headache was thought to originate from a transient disturbance in the vertebrobasilar circulation, but more recent studies suggest that a central neuronal disorder may be the source of migraine. Basilar migraines may have certain symptoms which are similar to other neurologic, vascular, psychiatric and metabolic diseases, yet there are specific criteria which can help differentiate it from other diagnoses. It is characterized by a throbbing occipital headache which may be preceded by an aura. The unusual symptoms of basilar migraine, which may precede and continue throughout the duration of the headache and even after it, include bilateral visual symptoms, altered mental status, vertigo, gait ataxia, bilateral paresthesia, bilateral paralysis and dysarthria. We describe a 29-year-old black female whose husband brought her to the emergency department complaining of confusion, headache, and left-sided weakness for 2 h prior to arrival.- - - - - - - - - - ranking = 0.14285714285714keywords = vertigo (Clic here for more details about this article) |