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Sample records for positional vertigo bppv

  1. Benign Paroxysmal Positional Vertigo (BPPV)

    MedlinePlus

    ... it look like the room is spinning. The eye movement is the clue that something must be happening ... while the practitioner watches for the tell-tale eye movements, or nystagmus. There are two types of BPPV: ...

  2. Benign Paroxysmal Positional Vertigo (BPPV): History, Pathophysiology, Office Treatment and Future Directions

    PubMed Central

    Hornibrook, Jeremy

    2011-01-01

    BPPV is the most common cause of vertigo. It most often occurs spontaneously in the 50 to 70 year age group. In younger individuals it is the commonest cause of vertigo following head injury. There is a wide spectrum of severity from inconsistent positional vertigo to continuous vertigo provoked by any head movement. It is likely to be a cause of falls and other morbidity in the elderly. Misdiagnosis can result in unnecessary tests. The cardinal features and a diagnostic test were clarified in 1952 by Dix and Hallpike. Subsequently, it has been established that the symptoms are attributable to detached otoconia in any of the semicircular canals. BPPV symptoms can resolve spontaneously but can last for days, weeks, months, and years. Unusual patterns of nystagmus and nonrepsonse to treatment may suggest central pathology. Diagnostic strategies and the simplest “office” treatment techniques are described. Future directions for research are discussed. PMID:21808648

  3. The test and treatment methods of benign paroxysmal positional vertigo and an addition to the management of vertigo due to the superior vestibular canal (BPPV-SC).

    PubMed

    Rahko, T

    2002-10-01

    A review of the tests and treatment manoeuvres for benign paroxysmal positional vertigo of the posterior, horizontal and superior vestibular canals is presented. Additionally, a new way to test and treat positional vertigo of the superior vestibular canal is presented. In a prospective study, 57 out of 305 patients' visits are reported. They had residual symptoms and dizziness after the test and the treatment of benign paroxysmal positional vertigo of the horizontal canal (BPPV-HC) and posterior canal (PC). They were tested with a new test and treated with a new manoeuvre for superior canal benign paroxysmal positional vertigo (BPPV-SC). Results for vertigo in 53 patients were good; motion sickness and acrophobia disappeared. Reactive neck tension to BPPV was relieved. Older people were numerous among patients and their quality of life (QOL) improved.

  4. Benign positional vertigo - aftercare

    MedlinePlus

    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare; Dizziness - positional vertigo ... Your health care provider may have treated your vertigo with the Epley maneuver . These are head movements ...

  5. [CROATIAN GUIDELINES FOR DIAGNOSIS AND MANAGEMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)].

    PubMed

    Maslovara, Sinisa; Butković-Soldo, Silva; Drvis, Petar; Roje-Bedeković, Marina; Trotić, Robert; Branica, Srećko; Habek, Mario; Cvjetko, Tereza; Vesligaj, Tihana; Adamec, Ivan; Gabelić, Tereza; Jurić, Stjepan; Vceva, Andrijana; Vranjes, Zeljko; Sarić, Ingrid; Cejić, Olivera; Zivić, Tihomir

    2015-01-01

    BPPV is generally the most common cause of vertigo, caused by a pinch-off of tiny calcium carbonate crystals (called the otoconia or the otoliths) from the macula utriculi, most frequently due to the degenerative processes or a trauma, whereby the crystals, under the action of gravity in certain head positions coinciding with its direction, arrive to some of the semicircular canals, usually the posterior one, due to the existent anatomical circumstances and relationships, thus creating an inadequate stimulus of the cupular senses while floating through the endolymph and provoking symptoms of a strong and short-term dizziness. Two main clinical forms can be distinguished: canalolythiasis, with an accommodation of otolithic debris in the semicircular canal, and cupulolythiasis, with their location immediately next to the cupular sense. The diagnosis is established by a positive positioning test, Dix-Hallpike for the posterior and the supine roll for the lateral canal. Although one can expect a spontaneous recovery subsequent to few weeks or months, various methods of otolith repositioning to a less sensitive place lead to a prompt improvement while reducing or withdrawing the symptoms completely. These guidelines are intended for all who treat the BPPV in their work, with an intention to assist in the diagnosis and application of an appropriate therapeutic method.

  6. Horizontal canal paroxysmal positional vertigo (HCPPV) vs classical BPPV (new concepts about mechanism and domiciliary repositioning of particles).

    PubMed

    Ghosh, P

    2002-07-01

    Some new modificutiont of existing diagnostic and therapeutic manoeuvres (repositioning of particles) have been proposed, basing an the applications of the principles of hydrodynamics, inertial and gravitational forces in the semicircular canals. The above has been tried successfully on patients with benign paroxysmal positional vertigo (BPPV) and horizontal eanal paroxysmal positional vertigo (HCPPV) which can be executed by the patients themselves at home without the kelp of a therapist.Benign paroxysmal positional vertigo (BPPV) is a well-established entity whereas Horizontal Canal Paroxysmal Positional Vertigo (HCPPV) is a recently proposed one. In positional vertigo any canal may be involved. It is quite possible that in the past this diagnosis (HCPPV) was missed in many of the cases of positional vertigo. Kapfschuttel nystagmus (head-shaking nystanmas) is induced by side to side (to and fro) movements of the head around a vertical axis in the plane of the horizontal semicircular canal which is thought to be sensitise the labyrinth, Any manoeuvres that in induce nystagmus with or without vertino is hound to he a manifestation of an organic lesion and not a non-organic one. In a number of instances the postionul test Jor BPPV may yield negative results; but doing this test after kopfschuttel test a dormant positional nystagmus may appear on the surface i.e. uncovered in a number of cases which may have remained undetected if Kopfschutlel manoeuvre were not done. This implies- that by Kopfsi huttel test both the horizontal and vertical canals are sensitised.Moreover, Kopfschuttel nystaagmus is likely to be a manifestation of the horizontal canal stimulation, at leastin some cases, since the movements are executed in the plane of the horizontal canal (vide infra) when displaced otoconia impinges on the cupula /. crista bringing about its stimulation leading to vertigo and or nystagmus.

  7. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis.

    PubMed

    Califano, L; Vassallo, A; Melillo, M G; Mazzone, S; Salafia, F

    2013-08-01

    Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position). In the geotropic variant, which is more frequent, the fast phase of the nystagmus is directed towards the lowermost ear, when the patient lies on the affected side or on the healthy side; in the apogeotropic variant, which is less frequent, the fast phase is directed always toward the uppermost ear, regardless of which side the patient lies on. Paroxysmal nystagmus is more intense on the affected side in the geotropic form, and more intense on the healthy side in the apogeotropic form. The authors describe five cases of another primitive and rare form of lateral BPPV, defined as "direction-fixed paroxysmal nystagmus lateral canal BPPV", which has previously been described by other authors as a transitory step observed during the transformation from an apogeotropic into a geotropic form. It is characterized by typical BPPV symptoms and diagnosed by the presence of a paroxysmal horizontal unidirectional positioning nystagmus, evoked through Pagnini-McClure's test, which is apogeotropic on the affected side and geotropic on the healthy side. In the reported cases, direction-fixed horizontal paroxysmal nystagmus was always transformed into a typical geotropic form. The clinical features and pathophysiology of direction-fixed nystagmus lateral canal BPPV are discussed.

  8. Benign Paroxysmal Positional Vertigo

    PubMed Central

    Lee, Seung-Han

    2010-01-01

    Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by changes in head position. BPPV is the most common etiology of recurrent vertigo and is caused by abnormal stimulation of the cupula by free-floating otoliths (canalolithiasis) or otoliths that have adhered to the cupula (cupulolithiasis) within any of the three semicircular canals. Typical symptoms and signs of BPPV are evoked when the head is positioned so that the plane of the affected semicircular canal is spatially vertical and thus aligned with gravity. Paroxysm of vertigo and nystagmus develops after a brief latency during the Dix-Hallpike maneuver in posterior-canal BPPV, and during the supine roll test in horizontal-canal BPPV. Positioning the head in the opposite direction usually reverses the direction of the nystagmus. The duration, frequency, and symptom intensity of BPPV vary depending on the involved canals and the location of otolithic debris. Spontaneous recovery may be expected even with conservative treatments. However, canalithrepositioning maneuvers usually provide an immediate resolution of symptoms by clearing the canaliths from the semicircular canal into the vestibule. PMID:20607044

  9. Benign paroxysmal positional vertigo Part II: A qualitative review of non-pharmacological, conservative treatments and a case report presenting Epley’s “canalith repositioning procedure”, a non-invasive bedside manoeuvre for treating BPPV

    PubMed Central

    van der Velde, Gabrielle M

    1999-01-01

    Purpose: To review the range of treatment interventions for benign paroxysmal positional vertigo (BPPV) with a focus on recent physical treatments (repositioning manoeuvres) inspired by the theoretical pathophysiology canalithiasis. To qualitatively review clinical trials which have examined the efficacy of these repositioning manoeuvres for treating BPPV and present a case report of BPPV treated with a repositioning manoeuvre. Data sources: Relevant studies were identified using the bibliographic database MEDLINE spanning from 1966 to March 1997. Study selection: A total of 21 studies were selected on the basis of their relevance to Part II of this review. Data extraction: The findings and results of relevant studies, and their subsequent conclusions were compared and compiled into a historical summary of the physical treatment of BPPV, focusing on the state of the knowledge regarding the efficacy of repositioning manoeuvres. Results of the data synthesis: The most recent pathophysiological theories for BPPV, cupulolithiasis and canalithiasis, have inspired a number of physical treatments which seek to reverse the pathological mechanisms believed to be responsible for BPPV. The most recent physical treatments, Epley’s canalith repositioning procedure and its variations, are “bedside” procedures which seeks to reverse canalithiasis by the application of a series of positioning manoeuvres. Conclusion: The efficacy of these repositioning manoeuvres has not been satisfactorily determined, but despite this, their popularity is apparently growing. The repositioning manoeuvre can easily be performed in the chiropractic practice setting. However, prior to undertaking these physical treatments, the chiropractor should be confident in the diagnosis of BPPV, given that numerous causes of vertigo are serious and life-threatening.

  10. Vertigo during the Epley maneuver and success rate in patients with BPPV.

    PubMed

    Fyrmpas, Georgios; Barkoulas, Eustathios; Haidich, Anna Bettina; Tsalighopoulos, Miltiadis

    2013-09-01

    To investigate whether reported vertigo during the Epley maneuver predicts therapeutic success in patients with benign paroxysmal positioning vertigo of the posterior semicircular canal (pc-BPPV). Fifty consecutive adult patients with pc-BPPV, based on a positive Dix-Hallpike test (DHT), were treated with the Epley maneuver and retested after 2 days. Patients were asked to report the presence of vertigo upon assuming each of the four positions of the maneuver. Thirty seven patients (74 %) were treated successfully in one session. Twenty out of 23 patients who reported vertigo at turning the head to the opposite side (2nd position) had a negative DHT on follow-up. These patients had a higher chance of a successful outcome compared to patients who did not report vertigo in the 2nd position (Odds ratio 5.3, 95 % CI: 1.3-22.2, p = 0.022). Report of vertigo at the other positions was not associated with the outcome. Report of vertigo at the second position of a single modified Epley maneuver is associated with therapeutic success.

  11. Epley and beyond: an update on treating positional vertigo.

    PubMed

    Kaski, Diego; Bronstein, Adolfo M

    2014-08-01

    Benign paroxysmal positional vertigo (BPPV) is the commonest cause of dizziness. It is characterised by brief episodes of vertigo and imbalance with nystagmus. The direction of nystagmus allows the identification of the culprit semicircular canal. As it is readily treatable--and often curable--BPPV should not be missed. Although recurrent episodes of vertigo triggered by movement suggest BPPV, the diagnosis can only be confirmed with the Dix-Hallpike manoeuvre. Here we review the diagnostic manoeuvres required to diagnose BPPV, and the various repositioning manoeuvres for treating different types of BPPV.

  12. Clinical features of paroxysmal positional vertigo presenting combined lesions.

    PubMed

    Suzuki, M; Yukawa, K; Horiguchi, S; Ichimura, A; Kitamura, K; Okamoto, N; Hayashi, K

    1999-03-01

    Benign paroxysmal positional vertigo (BPPV) is one of the common vestibular disorders. Canalolithiasis is thought to be a likely lesion. A canalith repositioning procedure (CRP by Epley) generally yields good resolution of vertigo and nystagmus. The authors confirmed the efficacy of this procedure on typical BPPV of the posterior semicircular canal type. We designed a new procedure for BPPV of the lateral canal type, which also yielded satisfactory results. BPPV sometimes presents a nystagmus pattern, which suggests multiple lesions. We have seen eight cases of BPPV showing nystagmus that combines both the posterior and the lateral canal types. Combined CRP was performed on these cases, which again gave good clinical results. Other BPPV cases were associated with central lesions. We must be aware that BPPV may involve multiple canals and may be associated with central lesions. PMID:10320057

  13. Benign paroxysmal positional vertigo after use of noise-canceling headphones.

    PubMed

    Dan-Goor, Eric; Samra, Monica

    2012-01-01

    Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. We describe a case of a woman presenting acutely with a severe episode of disabling positional vertigo. Although she had no known etiologic risk factors, this attack followed 12 hours of continuously wearing digital noise-canceling headphones. This is the first such reported association between BPPV and the use of this gadget. We also provide a short review of BPPV and speculate on the possible pathogenic mechanisms involved.

  14. Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus

    PubMed Central

    Büki, Béla; Simon, László; Garab, Sándor; Lundberg, Yunxia W.; Jünger, Heinz; Straumann, Dominik

    2013-01-01

    Background Presently, the unambiguous diagnosis of benign paroxysmal positioning vertigo (BPPV) requires the detection of positioning or positional nystagmus provoked by Dix–Hallpike (for vertical semicircular canals) or supine roll (for horizontal semicircular canals) manoeuvres, which indicates canalo- or cupolithiasis of affected semicircular canals. There are patients, however, in whom—despite typical complaints of BPPV—no positional nystagmus can be documented; this is called ‘subjective BPPV’ (sBPPV). These patients usually complain of short vertigo spells during and after sitting up, sometimes with abnormal retropulsion of the trunk. Aim In this study, the authors aimed to ascertain whether these patients in fact demonstrate abnormal sitting-up trunk oscillations when measured by posturography. Of 200 unselected patients with vertigo or dizziness, 43% had sBPPV with vertigo spells while sitting up, and 20% classical BPPV. Methods Posturographic recordings were performed in 20 patients with sBPPV and sitting-up vertigo. Results and discussion Seven of the 20 patients had trunk oscillations during the act of sitting up and for a short time immediately afterwards. Based on their findings, the authors propose a new type of BPPV, the so-called Type 2 BPPV (typical complaints of BPPV, no nystagmus in Dix–Hallpike positions but short vertigo spell while sitting up), which may be the result of chronic canalolithiasis within the short arm of a posterior canal. Furthermore, the authors suggest that Type 2 BPPV, which could be identical to sBPPV or constitute a major subgroup of it, occurs frequently among patients with vertigo. For therapy, the authors recommend repetitive sit-ups from the Dix–Hallpike positions to liberate the short arm of the posterior canal from canaloliths. PMID:20660923

  15. Combined horizontal and posterior canal benign paroxysmal positional vertigo in three patients with head trauma.

    PubMed

    Bertholon, Pierre; Chelikh, Larbi; Tringali, Stéphane; Timoshenko, Andrei; Martin, Christian

    2005-02-01

    We report 3 patients who complained of positional vertigo shortly after head trauma. Positional maneuvers performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position with the head raised 30 degrees) revealed a complex positional nystagmus that could only be interpreted as the result of combined PC and HC benign paroxysmal positional vertigo (BPPV). Two patients had a right PC BPPV and an ageotropic HC BPPV, and 1 patient had a bilateral PC BPPV and a left geotropic HC BPPV. All 3 patients were rapidly free of vertigo after the PC BPPV was cured by the Epley maneuver and the geotropic HC BPPV was cured by the Vannucchi method. The ageotropic HC BPPV resolved spontaneously. Neuroimaging (brain computed tomography and/or magnetic resonance imaging scans) findings were normal in all 3 patients. From a physiopathological viewpoint, it is easy to conceive that head trauma could throw otoconial debris into different canals of each labyrinth and be responsible for these combined forms of BPPV. Consequently, in trauma patients with vertigo, it is mandatory to perform the Dix-Hallpike maneuver, as well as supine lateral head turns, in order to diagnose PC BPPV, HC BPPV, or the association of both. Early diagnosis and treatment of BPPV may help to reduce the postconcussion syndrome.

  16. Benign paroxysmal positional vertigo Part I: Background and clinical presentation

    PubMed Central

    van der Velde, Gabrielle M

    1999-01-01

    Purpose: To review recent theories regarding the aetiology and pathophysiology of benign paroxysmal positional vertigo (BPPV), including its epidemiology, clinical presentation, diagnosis, and differential diagnosis. Data sources: Relevant studies were identified by searching MEDLINE from 1966 - March, 1997. Study selection: A total of 35 studies were selected on the basis of their relevance to Part I of this review. Data extraction: The findings and results of relevant studies and their subsequent theories and conclusions are discussed and compiled into a general overview of BPPV. Results of data synthesis: BPPV is considered the most common cause of vertigo of peripheral origin. A potential causal association has been observed with numerous apparent aetiological factors, all of which may lead to peripheral vestibular trauma. Findings of densities within the posterior semi-circular canal have given rise to the most recent theories regarding the pathophysiology for BPPV, canalithiasis and cupulolithiasis. Conclusions: BPPV is a multiaetiological peripheral vestibular disease whose underlying cause remains an enigma. The existing evidence supports two recent pathophysiological theories, cupulolithiasis and canalithiasis. Two conditions of special concern to the chiropractor, vertebrobasilar insufficiency and cervicogenic vertigo, closely ressemble BPPV, and can be differentiated by certain identifying features. BPPV may be diagnosed clinically, after ruling out conditions in which vertigo is a central feature. A review of the treatment for BPPV, focusing on recent physical treatments will be discussed in Part II of this paper.

  17. [Benign paroxysmal positional vertigo in children after head trauma].

    PubMed

    Nørgaard, Maria Schøler; Rokkjær, Malene Sine; Berg, Jette; Lüscher, Michael

    2015-06-15

    We present an eight-year-old boy with benign paroxysmal positional vertigo (BPPV) after a head trauma, successfully treated with Epley's manoeuvre. BPPV is a common cause of vestibular vertigo in adults, but it is rarely seen in children. Diagnostic work-up is challenging as children often lack the ability to describe their symptoms accurately and to cooperate in clinical examination. The diagnosis should be suspected in children with a relevant medical history and verified by positional testing. BPPV of childhood is treated with otolith repositioning manoeuvres, and the prognosis is good.

  18. Does benign paroxysmal positional vertigo explain age and gender variation in patients with vertigo by mechanical assistance maneuvers?

    PubMed

    Wang, Jing; Chi, Fang-Lu; Jia, Xian-Hao; Tian, Liang; Richard-Vitton, Th

    2014-11-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular diseases. The aim of this study was to explore the prevalence of BPPV in vertigo patients and the characteristics of BPPV in diagnosis and repositioning using mechanical assistance maneuvers and to analyze and summarize the reasons showing these characteristics. Seven hundred and twenty-six patients with vertigo were enrolled in this study. All patients were inspected by TRV armchair (SYNAPSYS, model TRV, France). BPPV patients were identified by the examination results. The characteristics and results using TRV armchair in diagnosis and treatment of BPPV were compared and analyzed. Of 726 vertigo patients, 209 BPPV patients were diagnosed, including 58 men and 151 women, aged from 16 to 87 (mean 52.90 ± 11.93) years. There were significant differences in the proportion of BPPV in male and female vertigo patients (P = 0.0233), but no differences among all age groups (P = 0.3201). Of 209 BPPV patients, 208 cases were repositioned by TRV armchair and no one appeared to have otolithic debris relocated into another canal in the repositioning procedures. 202 cases (97.12 %) were successful and six cases (2.87 %) were effective. None of them failed. This study suggests that BPPV is one of the most common diseases in the young vertigo patients, just like that in the old ones. Female of the species has predilection for BPPV and the site of predilection is the right posterior semicircular canals (PC-BPPV). The results of repositioning are perfect using mechanical assistance maneuvers.

  19. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients.

    PubMed

    van der Zaag-Loonen, H J; van Leeuwen, R B; Bruintjes, Tj D; van Munster, B C

    2015-06-01

    Dizziness is a relatively common complaint which occurs more often with increasing age. Benign paroxysmal positional vertigo (BPPV) is an important cause which can easily be treated but is frequently not recognized by professionals. The aim of this study was to assess the prevalence of unrecognized BPPV in older patients. Patients ≥70 years of age (n = 989) indicated whether they experienced dizziness, and if so whether the symptoms were typical for BPPV. If affirmed, a diagnostic maneuver was performed. Positive patients were treated at once. All suspected patients completed quality of life questionnaires and were followed for 3 and 6 months. Positive BPPV patients were compared with negative (but suspected) patients. Almost one quarter of the patients (226 patients, 23 %) suffered from dizziness, among whom 101 were suspected of BPPV. Less than half (n = 45) underwent the diagnostic maneuver, of whom 13 (29 %) were positive for BPPV. At follow-up, one patient developed BPPV, leading to a total of 14 positive patients (overall prevalence 1.4 %). BPPV positive patients did not differ from BPPV negative patients. Among a large group of older patients, one quarter experiences dizziness, and 1.4 % has definite BPPV.

  20. Benign paroxysmal positional vertigo as a complication of orthognathic surgery.

    PubMed

    Beshkar, Majid; Hasheminasab, Mahboobe; Mohammadi, Farnoush

    2013-01-01

    Benign paroxysmal positional vertigo (BPPV) is a clinical disorder that may develop following surgical trauma to the maxilla, for example as a result of closed sinus lifting with the use of mallet and osteotome during implant surgery. We proposed that BPPV may also occur following maxillary Le Fort osteotomy during orthognathic surgery. In a prospective study of 50 consecutive cases of orthognathic surgery, we observed that one patient developed BPPV in the postoperative period following bimaxillary orthognathic surgery. The patient was a 23-year-old woman who met the strict criteria for a diagnosis of BPPV, including a positive Dix-Hallpike test. We have described BPPV in more detail and have discussed the necessity of increasing awareness and knowledge of surgeons about BPPV as a possible complication of craniomaxillofacial surgery.

  1. Protracted benign paroxysmal positional vertigo following osteotome sinus floor elevation: a case report.

    PubMed

    Su, George Nan-Chang; Tai, Pei-Wei; Su, Po-Tsang; Chien, Hua-Hong

    2008-01-01

    Benign paroxysmal positional vertigo (BPPV) is a relatively rare condition characterized by onset of rotation dizziness triggered by head movements or change in posture. BPPV etiology includes head injury, infection, vascular disorders, surgical trauma, and idiopathic events. This report presents a case of protracted BPPV following osteotome sinus floor elevation and simultaneous implant placement. A 49-year-old female suffered intense vertigo and nausea immediately after implant placement using an osteotome sinus floor elevation procedure, especially when changing head position while sitting upright. Despite antivertigo medications, the condition did not improve. Following referral to a neurotologist, BPPV contralateral to the operation site was diagnosed 14 days after the osteotome sinus floor elevation procedure. The Epley's maneuver was then applied and, gradually, symptoms of BPPV disappeared 3 months after the implant surgery. No recurrence of BPPV was observed during further 3-month follow-up. Prevention and management of osteotome sinus floor elevation-related BPPV are reviewed in this report.

  2. A Geriatric Perspective on Benign Paroxysmal Positional Vertigo.

    PubMed

    Parham, Kourosh; Kuchel, George A

    2016-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in older adults. Beyond the unpleasant sensation of vertigo, BPPV also negatively affects older adults' gait and balance and increases their risk of falling. As such it has a profound effect on function, independence, and quality of life. Otoconia are the inner ear structures that help detect horizontal and vertical movements. Aging contributes to the fragmentation of otoconia, whose displacement into the semicircular, most commonly posterior canals, can produce rotatory movement sensations with head movement. BPPV is more commonly idiopathic in older adults than in younger individuals, can present atypically, and has a more-protracted course and higher risk of recurrence. Medications such as meclizine that are commonly prescribed for BPPV can be associated with significant side effects. Dix-Hallpike and Head Roll tests can generally identify the involved canal. Symptoms resolve as otoconia fragments dissolve into the endolymph, but appropriate canalith repositioning (e.g., Epley maneuver) can expedite recovery and reduce the burden of this disorder. Observations suggesting an association between idiopathic BPPV and vitamin D deficiency and osteoporosis indicate that BPPV may share risk factors with other common geriatric conditions, which highlights the importance of moving beyond purely otological considerations and addressing the needs of older adults with vertigo through a systems-based multidisciplinary approach. PMID:26804483

  3. Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals

    PubMed Central

    Shim, Dae Bo; Song, Chang Eun; Jung, Eun Jung; Ko, Kyung Min; Park, Jin Woo

    2014-01-01

    Background and Objectives Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Materials and Methods Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. Results Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. Conclusions As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV. PMID:25558406

  4. Benign paroxysmal positional vertigo in mountain bikers.

    PubMed

    Vibert, Dominique; Redfield, Robin C; Häusler, Rudolf

    2007-12-01

    We evaluated 4 men who had benign paroxysmal positional vertigo (BPPV) that occured several hours after intensive mountain biking but without head trauma. The positional maneuvers in the planes of the posterior and horizontal canals elicited BPPV, as well as transitory nystagmus. This was attributed to both the posterior and horizontal semicircular canals (SCCs) on the left side in 1 patient, in these 2 SCCs on the right side in another patient, and to the right posterior SCC in the other 2 patients. The symptoms disappeared after physiotherapeutic maneuvers in 2 patients and spontaneously in the other 2 patients. Cross-country or downhill mountain biking generates frequent vibratory impacts, which are only partially filtered through the suspension fork and the upper parts of the body. Biomechanically, during a moderate jump, before landing, the head is subjected to an acceleration close to negative 1 g, and during impact it is subjected to an upward acceleration of more than 2g. Repeated acceleration-deceleration events during intensive off-road biking might generate displacement and/or dislocation of otoconia from the otolithic organs, inducing the typical symptoms of BPPV. This new cause of posttraumatic BPPV should be considered as an injury of minor severity attributed to the practice of mountain biking.

  5. Benign positional vertigo

    MedlinePlus

    ... Clinical practice guideline: Benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg . 2008;139(5 Suppl 4):S47-S81. ... BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015: ...

  6. Benign Paroxysmal Positional Vertigo Following Sinus Floor Elevation in Patient with Antecedents of Vertigo.

    PubMed

    Akcay, Huseyin; Ulu, Murat; Kelebek, Seyfi; Aladag, Ibrahim

    2016-07-01

    Benign paroxysmal positional vertigo (BPPV) is an unfamiliar and rare complication occurring following osteotome sinus floor elevation (OSFE) and simultaneous implant placement. Etiology of this disorder is commonly displacement of otoliths by vibratory forces transmitted by osteotomes and mallet along with the hyperextension of the head during the operation, causing them to float around in the endolymph. This report presents a case of protracted BPPV following OSFE and simultaneous implant placement. A 43-year-old female suffered intense vertigo and nausea immediately after implant placement using an OSFE procedure. Upon further questioning after the procedure she gave an account of two times vertigo history within the last 9 years. Despite nootropic drug medication and canalith repositioning procedure applied by a specialist at operation night, the condition did not improve. Patient did not totally recover and was admitted again after 1 month. After repeated maneuvers, nine dosage intravenous serous fluid and piracetam administration the patient recovered. Duration of these procedures took 10 days and the patient was successfully treated with no recurrence of dizziness. Prevention and management of OSFE related BPPV are reviewed especially in patients having prior vertigo history in this report. PMID:27408469

  7. A Case of Labyrinthine Fistula by Cholesteatoma Mimicking Lateral Canal Benign Paroxysmal Positional Vertigo

    PubMed Central

    Shim, Dae Bo; Ko, Kyung Min; Song, Mee Hyun

    2014-01-01

    Acute peripheral vestibulopathy, of which the chief complaint is positional vertigo, comprises benign paroxysmal positional vertigo (BPPV), labyrinthitis, labyrinthine fistula, and cerebellopontine angle tumors. Since the typical presentation of labyrinthine fistulas may be sensorineural hearing loss, positional vertigo, or disequilibrium, it is often difficult to distinguish from BPPV or Meniere's disease. Herein we report a 61-year-old female patient with typical symptoms and signs attributable to geotropic type variant of the lateral semicircular canal BPPV on the left side, who eventually was confirmed as having a labyrinthine fistula from chronic otitis media with cholesteatoma on the left side. This is another case where, even in the presence of isolated vertigo showing typical findings of acute peripheral vestibulopathy, other otologic symptoms and signs must not be overlooked. PMID:25558413

  8. Canalith Repositioning Variations for Benign Paroxysmal Positional Vertigo

    PubMed Central

    Cohen, Helen S.; Sangi-Haghpeykar, Haleh

    2010-01-01

    Objective To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy. Study Design Prospective, pseudo-randomized study. Setting Out-patient practice in a tertiary care facility Subjects and Methods Patients (n=118) with unilateral BPPV of the posterior canal, including 13 patients with BPPV of the lateral canal were tested at a tertiary care center on one of five interventions: canalith repositioning maneuver (CRP), CRP plus home exercise, modified CRP, CRP for patients with involvement of two semicircular canals, self-CRP home exercise. Self-CRP was also compared to previously published data on efficacy of the Brandt Daroff exercise. Main outcome measures were vertigo intensity and frequency, presence/ absence of Dix-Hallpike responses, Vestibular Disorders Activities of Daily Living Scale (VADL), computerized dynamic posturography. Results Vertigo intensity and frequency and Dix-Hallpike responses decreased significantly and posturography and VADL improved significantly from pre- to post tests. No other significant changes were found. The groups did not differ significantly. Vertigo intensity and frequency were not strongly related at pre-test but were related at post-test. Length of illness and age did not influence the results. Conclusions However the head is moved, as long as it is moved rapidly enough and through the correct planes in space repositioning treatments are likely to be effective. Therefore clinicians have a range of choices in selecting the treatment best suited for each patient’s unique needs. PMID:20723779

  9. [Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) with direction-changing apogeotropic nystagmus: a case with the more-triggering side altering over a short-term].

    PubMed

    Takaya, Shigetoshi; Yamamoto, Toru

    2002-04-01

    We report a 44-year-old man who had apogeotropic nystagmus with the rotation of his head to either side from the supine position. His nystagmus lasted more than 2 minutes and was difficult to treat with. There were no neurological abnormalities except for the nystagmus and no findings suggesting intracranial disease on MRI. The head-position in which more intense nystagmus was evoked changed again and again in a short term. We diagnosed his illness as cupulolithiasis of horizontal canal, however, the affected ear could not be explained by any of the previously supposed mechanisms. In our case, we speculate the following mechanism. Otoliths were located on the right utricular side of the cupula. All of them were attached on the cupula at the beginning(attached phase) and then, some of them were detached from it(detached phase). The extent of the cupular deviation differed in each phase when the otoliths were beneath the cupula with his head turned to the left lateral position. According to Ewald's second law, more intense nystagmus is evoked when the cupula deviates toward the utricle than away from it. The patient's head-position in which more intense nystagmus was evoked changed according to the balance between the effect of Ewald's second law and the amount of otoliths detached from cupula. Our case showed that, in HC-BPPV with direction-changing apogeotropic nystagmus, we could not be certain about which ear was diseased. Therefore, it may be difficult to apply exercise therapy by determining the affected ear based on the head-position in which more intense nystagmus is evoked.

  10. Apogeotropic Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Some Clinical and Therapeutic Considerations

    PubMed Central

    Vannucchi, Paolo; Pecci, Rudi; Giannoni, Beatrice; Di Giustino, Fabio; Santimone, Rossana; Mengucci, Arianna

    2015-01-01

    We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC). We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV). Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV) and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related. PMID:26557364

  11. Benign paroxysmal positional vertigo after radiologic scanning: a case series

    PubMed Central

    Aydin, Erdinc; Akman, Kubra; Yerli, Hasan; Ozluoglu, Levent N

    2008-01-01

    Introduction Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging. Case presentation The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients. Conclusion Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur. PMID:18371218

  12. Investigating the role of Sirt1-modulated oxidative stress in relation to benign paroxysmal positional vertigo and Parkinson's disease.

    PubMed

    Tsai, Kun-Ling; Cheng, Yuan-Yang; Leu, Hsin-Bang; Lee, Yi-Yen; Chen, Tzeng-Ji; Liu, Ding-Hao; Kao, Chung-Lan

    2015-09-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most frequently encountered primary complaints in dizziness clinics. The incidence of BPPV has been proven to increase with age. The relationship between BPPV and another neurodegenerative disease, Parkinson's disease (PD), has not been previously discussed. This study aimed to investigate the relationship of BPPV and PD with oxidative stress. A total of 30,811 subjects participated in our cohort study. The study cohort comprised 5057 BPPV patients and a comparison cohort of 25,754 nonBPPV patients. SIRT1 axis gene expression was investigated in BPPV patient blood samples and a PD cell model of 6-hydroxydopamine (6-OHDA)-treated PC-12 cells to elucidate the potential in vitro and in vivo mechanisms of degeneration in PD and BPPV. Our data suggest that BPPV patients with histories of head injuries show a significantly higher hazard to develop subsequent PD (hazard ratio, 3.942; confidence interval, 1.523-10.205, p = 0.005). We also observed that oxidative status is increased in blood samples from patients with BPPV. Our in vitro study suggests that SIRT1 function is inhibited by oxidative stress, which thereby promotes 6-hydroxydopamine-induced cell death. We conclude that BPPV is independently associated with an increased risk of PD. This finding may be attributed to oxidative stress-mediated inhibition of SIRT1 expression levels.

  13. Physical Activity in the Prevention of Benign Paroxysmal Positional Vertigo: Probable Association

    PubMed Central

    Bazoni, Jéssica Aparecida; Mendes, William Siqueira; Meneses-Barriviera, Caroline Luiz; Melo, Juliana Jandre; Costa, Viviane de Souza Pinho; Teixeira, Denilson de Castro; Marchiori, Luciana Lozza de Moraes

    2014-01-01

    Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV) and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01). Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women. PMID:25992128

  14. Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-Up Nationwide Population Study in Taiwan

    PubMed Central

    Kao, Chung-Lan; Cheng, Yuan-Yang; Leu, Hsin-Bang; Chen, Tzeng-Ji; Ma, Hsin-I; Chen, Jaw-Wen; Lin, Shing-Jong; Chan, Rai-Chi

    2014-01-01

    Benign paroxysmal positional vertigo (BPPV) is a common form of vertigo and is characterized by episodic dizziness related to changes in head position relative to gravity. BPPV symptoms can be similar to those of central nervous system vascular diseases. The association between BPPV and ischemic stroke has not yet been investigated. The study cohort consisted of patients who were diagnosed with BPPV at least twice in the previous year as an outpatient or for whom BPPV was the primary diagnosis as an inpatient (n = 4104). An age- and gender-matched sample that excluded patients with a diagnosis of any form of vertigo was selected as the comparison cohort (n = 8397). All cases were followed up from January 1, 2000, to December 31, 2008. The demographic characteristics, medical comorbidities, and use of medications in both groups were investigated using chi-square tests. A stratified analysis of stroke risk factors was performed to determine the hazard ratios of BPPV. During the 9-year follow-up period, 185 of the 4104 (4.5%) subjects with BPPV and 240 of the 8379 (2.9%) subjects without BPPV developed ischemic strokes. The crude hazard ratio of BPPV for developing ischemic strokes was 1.708. After adjusting for stroke risk factors, the risk of developing ischemic strokes in BPPV subjects was 1.415-fold higher than the risk among those without BPPV (confidence interval: 1.162–1.732, p = 0.001). After a subgroup analysis stratified according to stroke risk factors, BPPV remained independently associated with a higher risk of developing future ischemic stroke. We conclude that BPPV is independently associated with a risk of subsequent ischemic stroke. More aggressive control of modifiable risk factors for ischemic strokes should be conducted in patients with BPPV. PMID:24917815

  15. Quantitative analysis of benign paroxysmal positional vertigo fatigue under canalithiasis conditions.

    PubMed

    Boselli, F; Kleiser, L; Bockisch, C J; Hegemann, S C A; Obrist, D

    2014-06-01

    In our daily life, small flows in the semicircular canals (SCCs) of the inner ear displace a sensory structure called the cupula which mediates the transduction of head angular velocities to afferent signals. We consider a dysfunction of the SCCs known as canalithiasis. Under this condition, small debris particles disturb the flow in the SCCs and can cause benign paroxysmal positional vertigo (BPPV), arguably the most common form of vertigo in humans. The diagnosis of BPPV is mainly based on the analysis of typical eye movements (positional nystagmus) following provocative head maneuvers that are known to lead to vertigo in BPPV patients. These eye movements are triggered by the vestibulo-ocular reflex, and their velocity provides an indirect measurement of the cupula displacement. An attenuation of the vertigo and the nystagmus is often observed when the provocative maneuver is repeated. This attenuation is known as BPPV fatigue. It was not quantitatively described so far, and the mechanisms causing it remain unknown. We quantify fatigue by eye velocity measurements and propose a fluid dynamic interpretation of our results based on a computational model for the fluid-particle dynamics of a SCC with canalithiasis. Our model suggests that the particles may not go back to their initial position after a first head maneuver such that a second head maneuver leads to different particle trajectories causing smaller cupula displacements.

  16. Delayed diagnosis and treatment of benign paroxysmal positional vertigo associated with current practice.

    PubMed

    Wang, Hui; Yu, Dongzhen; Song, Ningying; Su, Kaiming; Yin, Shankai

    2014-02-01

    The purposes of this study were to demonstrate the current status of benign paroxysmal positional vertigo (BPPV) management and the advantages of repositioning maneuvers as well as to facilitate the accurate and efficient diagnosis and management of BPPV. Of 131 participants with severe dizziness/vertigo who were examined and treated, 31 (23.7%) fulfilled the diagnostic criteria for BPPV. All patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix-Hallpike test and/or roll test. All participants were comprehensively interviewed regarding their medical history, characteristics of the first attack of vertigo, associated symptoms, previous financial costs, and number of hospital visits. The average duration from the appearance of the first symptoms until a final diagnostic positional maneuver was >70 months. On average, patients visited hospitals more than eight times before the final diagnosis due to initial visits to inappropriate departments, including neurology, emergency, orthopaedic surgery, and Traditional Chinese Medicine, with a corresponding average financial cost of more than 5,000 RMB. The canalith repositioning procedure (CRP) was effective in 80.65% of patients after the first repositioning maneuver. Our data demonstrated that despite the significant prevalence of BPPV, delays in diagnosis and treatment frequently occur, which have both cost and quality-of-life impacts on both patients and their caregivers. The CRP is very effective for patients with BPPV. It is important for patients to pay more attention to the impact of BPPV on their lives and recognize its nature to ensure compliant follow-up in otolaryngology.

  17. Gender-Based Comorbidity in Benign Paroxysmal Positional Vertigo

    PubMed Central

    Ogun, Oluwaseye Ayoola; Janky, Kristen L.; Cohn, Edward S.; Büki, Bela; Lundberg, Yunxia Wang

    2014-01-01

    It has been noted that benign paroxysmal positional vertigo (BPPV) may be associated with certain disorders and medical procedures. However, most studies to date were done in Europe, and epidemiological data on the United States (US) population are scarce. Gender-based information is even rarer. Furthermore, it is difficult to assess the relative prevalence of each type of association based solely on literature data, because different comorbidities were reported by various groups from different countries using different patient populations and possibly different inclusion/exclusion criteria. In this study, we surveyed and analyzed a large adult BPPV population (n = 1,360 surveyed, 227 completed, most of which were recurrent BPPV cases) from Omaha, NE, US, and its vicinity, all diagnosed at Boys Town National Research Hospital (BTNRH) over the past decade using established and consistent diagnostic criteria. In addition, we performed a retrospective analysis of patients’ diagnostic records (n = 1,377, with 1,360 adults and 17 children). The following comorbidities were found to be significantly more prevalent in the BPPV population when compared to the age- and gender-matched general population: ear/hearing problems, head injury, thyroid problems, allergies, high cholesterol, headaches, and numbness/paralysis. There were gender differences in the comorbidities. In addition, familial predisposition was fairly common among the participants. Thus, the data confirm some previously reported comorbidities, identify new ones (hearing loss, thyroid problems, high cholesterol, and numbness/paralysis), and suggest possible predisposing and triggering factors and events for BPPV. PMID:25187992

  18. Anterior canal BPPV and apogeotropic posterior canal BPPV: two rare forms of vertical canalolithiasis.

    PubMed

    Califano, L; Salafia, F; Mazzone, S; Melillo, M G; Califano, M

    2014-06-01

    Posterior canal benign paroxysmal positional vertigo (BPPV) is the most frequent form of BPPV. It is characterized by a paroxysmal positioning nystagmus evoked through Dix-Hallpike and Semont positioning tests. Anterior canal BPPV (AC) is more rare than posterior canal BPPV; it presents a prevalent down beating positioning nystagmus, with a torsional component clockwise for the left canal, counterclockwise for the right canal. Due to the possible lack of the torsional component, it is sometimes difficult to identify the affected ear. An apogeotropic variant of posterior BPPV (APC) has recently been described, characterised by a paroxysmal positional nystagmus in the opposite direction to the one evoked in posterior canal BPPV: the linear component is down-beating, the torsional component is clockwise for the right canal, counter-clockwise for the left canal, so that a contra-lateral anterior canal BPPV could be simulated. During a 16 month period, of 934 BPPV patients observed, the authors identified 23 (2.5%) cases of apogeotropic posterior canal BPPV and 11 (1.2%) cases of anterior canal BPPV, diagnosed using the specific oculomotor patterns described in the literature. Anterior canal BPPV was treated with the repositioning manoeuvre proposed by Yacovino, which does not require identification of the affected side, whereas apogeotropic posterior canal BPPV was treated with the Quick Liberatory Rotation manoeuvre for the typical posterior canal BPPV, since in the Dix-Hallpike position otoliths are in the same position if they come either from the ampullary arm or from the non-ampullary arm. The direct resolution of BPPV (one step therapy) was obtained in 12/34 patients, 8/23 patients with APC and 4/11 patients with AC; canalar conversion into typical posterior canal BPPV, later treated through Quick Liberatory Rotation (two-step therapy), was obtained in 19 patients,14/23 with APC and 5/11 with AC. Three patients were lost to follow-up. Considering the effects of

  19. Image-based computer-assisted diagnosis system for benign paroxysmal positional vertigo

    NASA Astrophysics Data System (ADS)

    Kohigashi, Satoru; Nakamae, Koji; Fujioka, Hiromu

    2005-04-01

    We develop the image based computer assisted diagnosis system for benign paroxysmal positional vertigo (BPPV) that consists of the balance control system simulator, the 3D eye movement simulator, and the extraction method of nystagmus response directly from an eye movement image sequence. In the system, the causes and conditions of BPPV are estimated by searching the database for record matching with the nystagmus response for the observed eye image sequence of the patient with BPPV. The database includes the nystagmus responses for simulated eye movement sequences. The eye movement velocity is obtained by using the balance control system simulator that allows us to simulate BPPV under various conditions such as canalithiasis, cupulolithiasis, number of otoconia, otoconium size, and so on. Then the eye movement image sequence is displayed on the CRT by the 3D eye movement simulator. The nystagmus responses are extracted from the image sequence by the proposed method and are stored in the database. In order to enhance the diagnosis accuracy, the nystagmus response for a newly simulated sequence is matched with that for the observed sequence. From the matched simulation conditions, the causes and conditions of BPPV are estimated. We apply our image based computer assisted diagnosis system to two real eye movement image sequences for patients with BPPV to show its validity.

  20. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study

    PubMed Central

    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Monadi, Mohsen; Bakhshi, Enayatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency. This clinical trial aimed to determine the influence of vitamin D supplementation on intensity of BPPV. Methods: The study population was selected consecutively and the diagnosis of BPPV was made by history and clinical examination and exclusion of other conditions. Intensity of BPVV was assessed based on VAS score (0-10). Serum 25-hydroxyvitamin D (25-OHD) was measured using ELISA method and levels < 20 ng/ml was considered a deficiency. All patients received rehabilitation treatment using Epley's maneuver one time per week for one month. Serum 25-OHD deficient patients were classified as treated and non-treated groups (rehabilitation with or without 50.000 IU cholecalciferol weekly for two months).The results of treatment were compared with vitamin D sufficient group as control. All patients were followed-up for 6 months. Results: After two months of treatment, in both vitamin D treated and non-treated groups the intensity of BPPV decreased significantly as compared with control (P=0.001 for both groups) but at endpoint, the intensity of BPPV aggravated and regressed to the baseline value in vitamin D deficient non-treated group (P=0.001) whereas, in vitamin D treated group, improvement of BPPV remained stable and unchanged over the study period. Conclusion: This study indicates that correction of vitamin D deficiency in BPPV provides additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement. These findings suggest serum 25-OHD measurement in recurrent BPPV. PMID:27386060

  1. Benign paroxysmal positional vertigo and head position during sleep.

    PubMed

    Shigeno, Kohichiro; Ogita, Hideaki; Funabiki, Kazuo

    2012-01-01

    To determine whether any particular head positions during sleep are associated with BPPV, head position during sleep was monitored for 3 days in 50 BPPV patients after the disappearance of positional nystagmus and in 25 normal control subjects. A gravity sensor was attached to the center of the subject's forehead at home. The positional angle of the head was measured at 5-second intervals during sleep. In BPPV, the posterior semicircular canal was involved in 40 patients and the lateral semicircular canal in 10 patients. Recurrence was found in 22 of 50 BPPV patients. BPPV patients with recurrence were significantly more likely to sleep in the affected-ear-down 45-degree head position than were patients with no history of recurrence (P< 0.02). When the head is in the affected-ear-down 45-degree head position, the non-ampullated half of the posterior semicircular canal and the non-ampullated half of the lateral semicircular canal are nearly in the earth-vertical position, making it easier for detached otoconia to fall into the posterior or lateral semicircular canal and to agglomerate and attain a certain size in the lowest portion of each semicircular canal. Our findings showed that the affected-ear-down 45-degree head position during sleep could be an etiological factor of BPPV, more particularly in patients with recurrent BPPV. PMID:23142834

  2. Evaluation of the otolith function using sinusoidal off-vertical axis rotation in patients with benign paroxysmal positional vertigo.

    PubMed

    Sugita-Kitajima, Akemi; Azuma, Miki; Hattori, Kosuke; Koizuka, Izumi

    2007-07-01

    The vestibulo-ocular reflex (VOR) was studied via sinusoidal off-vertical axis rotation (OVAR) to evaluate the otolith function in patients with benign paroxysmal positional vertigo (BPPV). Subjects were sinusoidally rotated with eyes open in complete darkness at frequencies of 0.4 and 0.8 Hz with a maximum angular velocity of 60 degrees s(-1) in earth-vertical axis rotation (EVAR) and OVAR. Twenty-three controls and 24 BPPV patients were investigated. Results showed that VOR gain during OVAR at 0.8 Hz in a 30 degrees nose-up position in BPPV patients was significantly less than the gain during EVAR, whereas the gain was not significantly different between EVAR and OVAR in the controls in each condition. In addition, to examine each type of BPPV, we also investigated whether there were any differences between the patients who suffered from dizziness and those who did not. VOR gain in OVAR of BPPV patients who were suffering from dizziness was significantly less than that of BPPV patients without dizziness. Not only cupulolithiasis or canalolithiasis, but also otolith dysfunction was considered to be the possible origin of BPPV. Because sinusoidal OVAR produced minimal nausea compared to constant velocity OVAR, the stimulation of 0.8 Hz nose-up in sinusoidal OVAR may be used to evaluate otolith function without discomfort for patients. PMID:17597299

  3. Bilateral benign paroxysmal positional vertigo: an unusual complication of orthognathic surgery.

    PubMed

    Kim, Jeong Hong; Kim, Hak-Jin; Kang, Ju Wan

    2013-12-01

    Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo of labyrinthine origin and usually idiopathic. However, 15-20% of all cases occur after trauma to the head, and it has rarely been reported after maxillofacial surgery, so to the best of our knowledge this is the first report of its bilateral occurrence after orthognathic surgery. It resolves slowly, but symptoms are incapacitating. It can be diagnosed from the history and physical examination, including the Dix-Hallpike test. Maxillofacial surgeons should be aware of it in patients who complain of dizziness after orthognathic surgery, and should know how to manage it properly.

  4. Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients.

    PubMed

    Maranhão, Eliana Teixeira; Maranhão Filho, Péricles

    2015-06-01

    Benign paroxysmal positional vertigo (BPPV), the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%), the barbecue 360° maneuver in twelve patients (32.4%), both manoeuvers in four patients (10.8%), both manoeuvers plus head shaking in one patient (2.7%), and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0%) on the initial visit. PMID:26083883

  5. Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling

    PubMed Central

    Schultz, Adriane Rocha; Neves-Souza, Rejane Dias; Costa, Viviane de Souza Pinho; Meneses-Barriviera, Caroline Luiz; Franco, Pricila Perini Rigotti; Marchiori, Luciana Lozza de Moraes

    2015-01-01

    Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV) associated with feeding habits. Methods Cross-sectional study with elderly people living independently. We evaluated nutritional habits through the method of dietary 24-hour recall and manipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62%) had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21%) had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064). However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419) and insufficient fiber intake (p = 0.03), and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084). Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly. PMID:26491473

  6. [Evaluation of the treatment of benign paroxysmal positional vertigo with the DHI-S questionnaire].

    PubMed

    López-Escámez, J A; Gómez Fiñana, M; Fernández, A; Sánchez Canet, I; Palma, M J; Rodríguez, J

    2001-01-01

    Benign paroxysmal positional vertigo (BPPV) is a recurrent chronic disease and its handicap is usually underestimated. The aim of this study is to determine the impact of the treatment by Epley maneuver on short-term BPPV-related quality of life. Forty-two individuals with BPPV were included: 39 with posterior canal affected, 2 with the lateral canal and one with the anterior canal. Diagnosis was established if a consistent clinical history was found and Dix-Hallpike test (DHT) in cases with canal posterior involvement. Subjects with positive DHT were treated by a single Epley maneuver and were recommended to avoid supine for the next 48 hours. The BPPV relapses were investigated at 7th and 30th day post-treatment. BPPV-associated quality of life was evaluated by the Dizzness Handicap Inventory Short-form (DHI-S) at days 1st and 30th post-treatment. Total and partial scores for emotional, physical and functional subscales were compared by Wilcoxon test for paired samples. Dix-Hallpike test was found positive in el 59% individuals (23/39), and 41% cases did not required any treatment. Among 23 patients treated with Epley maneuver, DHT was found negative in 90% at 30th day follow-up. Mean and standard deviation of the total scores obtained in the DHI-S at the first day were 19.22 +/- 9.66 in the DHT positive-patients and 19.79 +/- 10.14 in the whole group (DHT positive or negative). These scores significantly decreased to 10.84 +/- 10.99 at 30 days post-treatment (p = 0.002 and p = 0.001, respectively). In conclusion, the DHI-S is a specific health questionnaire able to assess BPPV-related health and the effectiveness of treatment.

  7. Walk-rotate-walk test identifies patients responding to Lempert's maneuver, with benign paroxysmal positional vertigo of the horizontal canal.

    PubMed

    Rahko, T; Kotti, V

    2001-03-01

    Two hundred and fifteen patients were diagnosed and treated for benign paroxysmal positional vertigo of the horizontal canal (BPPV-HC). All patients were tested with conventional positional nystagmus tests lying supine and rotating head for geotropic nystagmus, registered with Frenzels glasses, and in 109 cases with ENG. The walk-rotate-walk (WRW) test, developed by one of us (T.R.) and described in the text, was applied to all patients. The immediate good treatment results with Lempert's maneuver verify the correct diagnosis of BPPV-HC. The WRW test is a more sensitive test for BPPV-HC than earlier positional tests. The unhabituated acute phase of vestibular neuritis shows positive test results and must be eliminated with caloric tests. The WRW test identifies as a dynamic test patients with symptoms of even lesser magnitude, where the compensatory capacity of the equilibrium system suppresses the diagnostic findings with earlier positional horizontal canal tests.

  8. [Peripheral, central and functional vertigo syndromes].

    PubMed

    Strupp, M; Dieterich, M; Zwergal, A; Brandt, T

    2015-12-01

    Depending on the temporal course, three forms of vertigo syndrome can be differentiated: 1) vertigo attacks, e.g. benign paroxysmal positional vertigo (BPPV), Menière's disease and vestibular migraine, 2) acute spontaneous vertigo lasting for days, e.g. acute unilateral vestibulopathy, brainstem or cerebellar infarction and 3) symptoms lasting for months or years, e.g. bilateral vestibulopathy and functional vertigo. The specific therapy of the various syndromes is based on three principles: 1) physical treatment with liberatory maneuvers for BPPV and balance training for vestibular deficits, 2) pharmacotherapy, e.g. for acute unilateral vestibulopathy (corticosteroids) and Menière's disease (transtympanic administration of gentamicin or steroids and high-dose betahistine therapy); placebo-controlled pharmacotherapy studies are currently being carried out for acute unilateral vestibulopathy, vestibular paroxysmia, prophylaxis of BPPV, vestibular migraine, episodic ataxia type 2 and cerebellar ataxia; 3) psychotherapy for functional dizziness.

  9. An unusual complication of osteotome sinus floor elevation: benign paroxysmal positional vertigo.

    PubMed

    Vernamonte, S; Mauro, V; Vernamonte, S; Messina, A M

    2011-02-01

    Maxillary sinus floor elevation in cases of reduced vertical bone height in the posterior maxilla allows predictable implant placement. The osteotome sinus floor elevation (OSFE) technique has shorter healing and waiting times because the fixture can be placed in the implant recipient site simultaneously with the ridge augmentation. Implant site preparation is more comfortable for the patient when performed with spiral drills than with continuous malleting of the osteotomes. Membrane perforation is the most frequent complication with the OSFE technique; postoperative infection is rare. Benign paroxysmal positional vertigo (BPPV) may be a complication of OSFE and may cause stress if not identified correctly and managed properly. The available treatment options, diagnostic strategies and the pathophysiology of this unusual complication are discussed. The authors present a case in which intense BPPV developed during OSFE, focusing on dental and maxillofacial surgery as risk factors for this pathology. PMID:20801616

  10. Validation of 5-item and 2-item questionnaires in Chinese version of Dizziness Handicap Inventory for screening objective benign paroxysmal positional vertigo.

    PubMed

    Chen, Wei; Shu, Liang; Wang, Qian; Pan, Hui; Wu, Jing; Fang, Jie; Sun, Xu-Hong; Zhai, Yu; Dong, You-Rong; Liu, Jian-Ren

    2016-08-01

    As possible candidate screening instruments for benign paroxysmal positional vertigo (BPPV), studies to validate the Dizziness Handicap Inventory (DHI) sub-scale (5-item and 2-item) and total scores are rare in China. From May 2014 to December 2014, 108(55 with and 53 without BPPV) patients complaining of episodic vertigo in the past week from a vertigo outpatient clinic were enrolled for DHI evaluation, as well as demographic and other clinical data. Objective BPPV was subsequently determined by positional evoking maneuvers under the record of optical Frenzel glasses. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of DHI total, 5-item and 2-item questionnaires to screen for BPPV was assessed by receiver operating characteristic (ROC) curves. It revealed that the DHI 5-item questionnaire had good internal consistency (Cronbach's coefficient α = 0.72). Area under the curve of total DHI, 5-item and 2-item scores for discriminating BPPV from those without was 0.678 (95 % CI 0.578-0.778), 0.873(95 % CI 0.807-0.940) and 0.895(95 % CI 0.836-0.953), respectively. It revealed 74.5 % sensitivity and 88.7 % specificity in separating BPPV and those without, with a cutoff value of 12 in the 5-item questionnaire. The corresponding rate of sensitivity and specificity was 78.2 and 88.7 %, respectively, with a cutoff value of 6 in 2-item questionnaire. The present study indicated that both 5-item and 2-item questionnaires in the Chinese version of DHI may be more valid than DHI total score for screening objective BPPV and merit further application in clinical practice in China.

  11. Benign paroxysmal positional vertigo and its variants.

    PubMed

    Nuti, D; Masini, M; Mandalà, M

    2016-01-01

    Benign paroxysmal positional vertigo is a common labyrinthine disorder caused by a mechanic stimulation of the vestibular receptors within the semicircular canals. It is characterized by positional vertigo and positional nystagmus, both provoked by changes in the position of the head with respect to gravity. The social impact of the disease and its direct and indirect costs to healthcare systems are significant owing to impairment of daily activities and increased risk of falls. The first description of a patient with benign paroxysmal positional vertigo is from Robert Bárány in 1921, but the features of the syndrome and the diagnostic maneuver were well described by Dix and Hallpike in 1952. Since then, the gradually increasing interest of otolaryngologists and neurologists has led to a progressive advance in the knowledge of this labyrinthine disorder with regard to its epidemiologic, pathophysiologic, clinical, and therapeutic aspects. Despite the often effective diagnosis and treatment of most cases of benign paroxysmal positional vertigo, the physiopathologic explanations of the disease are mainly speculative. In this chapter, we describe the epidemiologic, pathophysiologic, clinical, and therapeutic aspects of benign paroxysmal positional vertigo. PMID:27638076

  12. [Treatment approaches to benign paroxysmal positional vertigo. Clinical features in 228 cases of posterior and lateral canalolithiasis].

    PubMed

    Ferri, E; Armato, E; Ianniello, F

    1999-02-01

    After having discussed the etiopathogenesis, epidemiology and physiopathology of Benign Paroxysmal Positional Vertigo (BPPV), the authors present their case study covering audiovestibology out-patients treated in the last two years: 228 cases of canalotithiasis-derived BPPV, both posterior (186 cases) and lateral (42 cases). These patients were diagnosed and treated between July 1996 and July 1998 and account for 15% of the 1550 patients complaining of balance and postural disorders seen during that period. Analysis of the results shows BPPV epidemiological data that are practically the same those reported in the literature: greater incidence in females, predominance of posterior canalolithiasis and optimal use of the canalith repositioning techniques. The authors reconfirm the effectiveness of the Semont maneuver and its variations in the treatment of those forms involving the posterior semicircular canal (97% healing). As regards BPPV due to lateral canalolithiasis. The authors feel the vestibular "barbecue" rehabilitation techniques suggested by Lempert--i.e. a 270 degrees rotation starting from the decubitus position on the pathological side, rather than Baloh's traditional 360 degrees rotation--is most suitable for the treatment of BPPV stemming from lateral canalolithiasis. The Lempert technique provided satisfactory results (76% healing) and a reduction in the number of failures (24%). PMID:10418187

  13. Demographic Analysis of Benign Paroxysmal Positional Vertigo as a Common Public Health Problem

    PubMed Central

    Yetiser, S; Ince, D

    2015-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular problem. However, demographic analysis is few. Aim: The aim of this study was to document the demographic data of patients with BPPV regarding distribution of gender, age, associated problems, most common form, symptom duration, severity of nystagmus and cure rate. Subjects and Methods: A total of 263 patients with video-nystagmography confirmed BPPV were enrolled in this retrospective study (2009-2013). The data were collected in Anadolu Medical Center. Distribution of gender, age and affected side were reviewed. Associated problems were noted. Patients were analyzed according to the canal involvement, age, duration of symptoms, duration of nystagmus and recurrence. Mean values and standard deviations were calculated. One-way ANOVA test was used for the analysis of the data (Statistical Package for the Social Sciences 17.0 version, IBM, Chicago, III, USA). Statistical significance was set at P < 0.05. Results: Women were affected more frequently than men (1:1.5). Comparative analysis of average age between the two gender groups was not statistically significant (P = 0.84). BPPV was common at middle age group. The incidence of affected side was not significant (P = 0.74). Posterior canal-BPPV (PC-BPPV) was the most leading one (129/263; 49%) followed by lateral canal (LC)-canalolithiasis (60/263; 22.8%), LC-cupulolithiasis (38/263; 14.5%) and superior canal-BPPV (9/263; 3.4%). 55.1% of patients were defined as idiopathic (145/263). Associated problems were migraine (31/263; 11.8%), trauma (19/263; 7.2%), inner ear disorders (18/263; 6.8%) and other systemic problems (50/263; 19.1%). 72.6% of patients had symptoms <2 months (191/263). 23,6% of patients had intensive nystagmus lasting more than a minute regardless of canal involvement (62/263). 33% of patients required two or more maneuvers for the relief of symptoms (87/263). Conclusion: Symptoms are prone to recur in

  14. Pneumolabyrinth and positional vertigo after stapedectomy.

    PubMed

    Mandalà, Marco; Colletti, Liliana; Carner, Marco; Barillari, Marco; Cerini, Roberto; Mucelli, Roberto Pozzi; Colletti, Vittorio

    2011-08-01

    Pneumolabyrinth due to late complications of stapes surgery is a rare entity. Symptoms may include various degrees of hearing loss, tinnitus and dizziness. We report the case of a 67-year-old patient who developed a unique pneumolabyrinth variant affecting the vestibule, cochlea and semicircular canals 28 years after stapedectomy. The patient presented with intractable paroxysmal positional vertigo of the lateral semicircular canal. The pneumolabyrinth was visualized by means of high resolution computed tomography. Exploratory tympanotomy findings were consistent with a perilymphatic fistula. One year after surgical treatment the subject was free of vertigo spells. Pathogenetic mechanisms are discussed.

  15. Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable

    PubMed Central

    Bockisch, Christopher J; Straumann, Dominik; Weber, Konrad P

    2014-01-01

    Background Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV), is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult. Case presentation After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver. Conclusion Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely. PMID:24748776

  16. Benign paroxysmal positional vertigo after nonotologic surgery: case series.

    PubMed

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2015-03-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe three cases of benign paroxysmal positional vertigo attacks after non-otologic surgery (one patient after a nasal septoplasty and two patients after dental endodontic treatment) and discuss the pathophysiological mechanism of benign paroxysmal positional vertigo seen after non-otologic surgery, its diagnosis and treatment.

  17. Ocular VEMPs indicate repositioning of otoconia to the utricle after successful liberatory maneuvers in benign paroxysmal positioning vertigo

    PubMed Central

    BREMOVA, TATIANA; BAYER, OTMAR; AGRAWAL, YURI; KREMMYDA, OLYMPIA; BRANDT, THOMAS; TEUFEL, JULIAN; STRUPP, MICHAEL

    2014-01-01

    Conclusions This study showed a transient increase of ocular vestibular evoked myogenic potential (oVEMP) amplitudes in the affected ear after successful liberatory maneuvers and no changes in cervical VEMP (cVEMP) amplitudes. These findings support the hypothesis that successful liberatory maneuvers can lead to a repositioning of otoconia to the utricle. Objectives To evaluate whether oVEMP amplitudes increase after successful liberatory maneuvers in patients with posterior semicircular canal benign paroxysmal positioning vertigo (pc-BPPV), while cVEMP amplitudes do not change. These findings may indicate a successful repositioning of dislodged otoconia to the utricular macula, but not to the saccular macula. Methods Thirty patients with unilateral pc-BPPV were prospectively examined with bone-conducted oVEMP and air-conducted cVEMP at four time points: before, after, 1 week after, and 1 month after the liberatory maneuvers (Sémont maneuvers). Results At the 1-week follow-up, 20 of 30 patients were asymptomatic (responders); BPPV could still be induced in the other 10 (non-responders). In responders the mean n10 amplitude on the affected side increased from 12 ± 6.5 μV at baseline (before the treatment) to 15.9 ± 7.1 μV at 1 week after treatment; this increase was significantly (p = 0.001) higher in responders than in non-responders. cVEMP did not differ significantly. PMID:24245699

  18. The epidemiology of dizziness and vertigo.

    PubMed

    Neuhauser, H K

    2016-01-01

    This chapter gives an overview of the epidemiology of dizziness, vertigo, and imbalance, and of specific vestibular disorders. In the last decade, population-based epidemiologic studies have complemented previous publications from specialized settings and provided evidence for the high burden of dizziness and vertigo in the community. Dizziness (including vertigo) affects about 15% to over 20% of adults yearly in large population-based studies. Vestibular vertigo accounts for about a quarter of dizziness complaints and has a 12-month prevalence of 5% and an annual incidence of 1.4%. Its prevalence rises with age and is about two to three times higher in women than in men. Imbalance has been increasingly studied as a highly prevalent complaint particularly affecting healthy aging. Studies have documented the high prevalence of benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM), as well as of comorbid anxiety at the population level. BPPV and VM are largely underdiagnosed, while Menière's disease, which is about 10 times less frequent than BPPV, appears to be overdiagnosed. Risk factor research is only at its beginning, but has provided some interesting observations, such as the consistent association of vertigo and migraine, which has greatly contributed to the recognition of VM as a distinct vestibular syndrome. PMID:27638063

  19. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

    PubMed Central

    Socher, Dayra Dill; Socher, Jan Alessandro; Azzi, Viviane Jacintha Bolfe

    2012-01-01

    Summary Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD), which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR) is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05). Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender. PMID:25991970

  20. New Analyses of the Sensory Organization Test Compared to the Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo

    PubMed Central

    Mulavara, Ajitkumar P.; Cohen, Helen S.; Peters, Brian T.; Sangi-Haghpeykar, Haleh; Bloomberg, Jacob J.

    2013-01-01

    Objective To determine whether the Sensory Organization Test (SOT) of the computerized dynamic posturography battery or the Clinical Test of Sensory Integration and Balance (CTSIB) is more likely to indicate balance disorders in people with benign paroxysmal positional vertigo. Study design Normal controls were compared to patients with unilateral benign paroxysmal positional vertigo of the posterior semicircular canal (BPPV). Methods Subjects performed tests with eyes open or closed on stable and unstable surfaces, with head still or with head moving at 0.33 Hz in pitch or yaw. Dependent variables were the percent time of the standard duration each subject could perform the task, the number of head motions made, and kinematic variables measured with head- and torso-mounted inertial motion units. Results Because equilibrium scores of normals improved significantly over repeated trials on SOT patients were given only 1 trial per condition. For percent time between-group differences were found on CTSIB with eyes closed, on foam, head moving in yaw showing significantly reduced performance by BPPV subjects compared to controls. Compared to controls patients made significantly fewer head movements on CTSIB, eyes closed, on foam, head still, pitch and yaw. Kinematic data also differed between the groups on tests with eyes closed, unstable surfaces with different head movement combinations, indicating increased instability in BPPV patients. Conclusion For screening, CTSIB with head movements is more likely than SOT to indicate balance deficits, especially when dependent measures include percent time as well as head movement counts and kinematic measures. PMID:23553110

  1. Effectiveness of the Epley’s maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley’s maneuver performed by general practitioners (GPs) in the treatment of BPPV. Methods/Design This study is a randomized clinical trial conducted in the primary care setting. The study’s scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley’s maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients’ report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken. We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher’s exact test will be conducted to compare categorical measures and Student’s t-test or Mann–Whitney U-test will be used for intergroup comparison variables. Discussion Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and

  2. The effect of serum vitamin D normalization in preventing recurrences of benign paroxysmal positional vertigo: A case-control study

    PubMed Central

    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Bakhshi, Enyatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is a condition with recurrent attacks in a significant proportion of patients. The present case- control study was conducted to assess the influence of serum vitamin D normalization on recurrent attacks of vitamin D deficient patients. Methods: Diagnosis of BPPV was made based on history and clinical examination and exclusion of other conditions. Serum 25-hydroxy vitamin D (25-OHD) was measured using ELISA method and a levels of < 20 ng/ml was considered a deficiency of vitamin D. Inclusion criteria were as follows: history of recurrent attacks and serum 25-OHD<20.ng/ml. While the patients with history of trauma, surgery and chronic systemic diseases were excluded. The patients were classified into two groups: treatment and control, intermittently. Both groups received Epley rehabilitation therapy one session per week for 4 weeks but the treatment group received an additional supplement of 50.000 IU of vitamin D (cholecalciferol) weekly for two months to achieve serum 25-OHD ≥ 30 ng/ml and the study patients were followed-up for 6 months. Results: Twenty-seven patients were allocated to each group. At baseline, serum 25-OHD was similar (10.7±2.3 vs 11.41±1.9, P=0.23). At month 2, serum 25-OHD in the treatment group increased significantly to ≥ 30 ng/ ml, whereas serum 25-OHD in the control group remained unchanged (34.2±3.3 vs 10.6 10.6±2.2 ng/ml, P=0.001). During the follow-up period, attacks of BPPV in the treatment group decreased significantly compared with the control group (14.8% vs 96.3% OR= 0.18, P=0.001). Conclusion: The findings of this study indicate that the normalization of serum vitamin D significantly reduces BPPV recurrences.

  3. Double-blind randomized trial on short-term efficacy of the Semont maneuver for the treatment of posterior canal benign paroxysmal positional vertigo.

    PubMed

    Mandalà, Marco; Santoro, Giovanni Paolo; Asprella Libonati, Giacinto; Casani, Augusto Pietro; Faralli, Mario; Giannoni, Beatrice; Gufoni, Mauro; Marcelli, Vincenzo; Marchetti, Pierpaolo; Pepponi, Emanuela; Vannucchi, Paolo; Nuti, Daniele

    2012-05-01

    The need for Class I and II studies on the efficacy of Semont's liberatory maneuver (SLM) in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV) motivated the present double-blind randomized trial on the short-term efficacy of SLM. A total of 342 patients with unilateral PC-BPPV were recruited for a multicenter study. Patients were randomly assigned to treatment by SLM (n = 174) or sham treatment (n = 168). Subjects were followed up twice (1 and 24 h) with the Dix-Hallpike maneuver by blinded examiners. At the 1 and 24 h follow-up, 79.3 and 86.8%, respectively, of patients undergoing SLM had recovered from vertigo, compared to none of the patients undergoing the sham maneuver (p < 0.0001). Patients who manifested liberatory nystagmus at the end of SLM showed a significantly higher percentage of recovery (87.1 vs. 55.7%; p < 0.0001). To the best of our knowledge, this is the first Class I study on the efficacy of SLM. SLM proved highly effective with respect to the sham maneuver (p < 0.0001). Liberatory nystagmus was demonstrated to be a useful prognostic factor for the efficacy of treatment. The present Class I study of efficacy of SLM changes the level of recommendation of the maneuver for treating PC-BPPV from level C to level B.

  4. Benign paroxysmal positional vertigo following diagnostic transcranial magnetic stimulation.

    PubMed

    Strzelczyk, Adam; Kepenek, Yildiz; Rindock, Heike; Müller-Mazzotta, Jochen; Oertel, Wolfgang H; Mylius, Veit; Rosenow, Felix

    2011-06-01

    Benign paroxysmal positional vertigo is the most frequent cause of recurrent vertigo and according to the canalo- and cupulolithiasis theory it is caused by detached otoconia which accumulate in the semicircular canals. However, the mechanisms leading to detachment of otoconia from the matrix are still poorly understood. Head trauma, inner ear diseases, advanced age, migraine and bed rest are known predisposing factors. We report a case of a healthy 44-year-old female, who developed left sided benign paroxysmal positional vertigo 10 hours following standard bilateral diagnostic transcranial magnetic stimulation. As our patient did not innate any established predisposing factor and has a relatively young age, we conclude that diagnostic transcranial magnetic stimulation to elicit motor evoked potentials might be an iatrogenic cause of benign paroxysmal positional vertigo.

  5. Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

    PubMed Central

    Chang, Young-Soo; Choi, Jeesun

    2014-01-01

    The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam. PMID:24917912

  6. Vertigo syndromes associated with earthquake in Georgia.

    PubMed

    Tevzadze, N; Shakarishvili, R

    2007-01-01

    Georgia experienced strong earthquake, after this event the amount of patients with vestibular symptoms increased. Study evaluates 60 outpatients (51 females, 9 males) aged from 18 to 85 years old who applied at outpatient clinics with vestibular complaints in the initial weeks following the earthquake. BPPV and PPV are the most common causes of vertigo. "Idiopathic" BPPV is the cause of BPPV in 50-70% of cases. Head trauma, vestibular neuritis, Meniere disease, migraine are the most common causes of "secondary" BPPV. (PPV) syndrome characterized by dizziness, subjective disturbance of balance and by perception of illusory body perturbations, usually triggered by perceptual stimulus. PPV frequently associated with anxiety symptoms in patients with obsessive-compulsive type personality. The study revealed "Idiopathic" BPPV in 49 cases and "secondary" types BPPV in 11 cases. 37 previously documented histories of BPPV patients had features typical for posterior semisercircular canal BPPV and 23 patients experienced subjective disturbance symptoms like BPPV, but there were no abnormal responses in their vestibular testing. It is assumed that earthquake could manifest psychogenic vertigo with panic attacks, anxiety, agoraphobia, PPV and could provoke a transition from organic vertigo to PPV. It is concluded that psychological stress play an important role in occurring "secondary" BPPV, earthquake may trigger exacerbation of "secondary" BPPV and could be provoked factor to developing psychogenic vertigo, mostly PPV.

  7. New treatment strategy for cupulolithiasis associated with benign paroxysmal positional vertigo of the lateral canal: the head-tilt hopping exercise.

    PubMed

    Yamanaka, Toshiaki; Sawai, Yachiyo; Murai, Takayuki; Okamoto, Hideyuki; Fujita, Nobuya; Hosoi, Hiroshi

    2014-12-01

    This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period. Each session ended with a 20-hop trial. The HtH exercises were performed by 27 patients with intractable lateral canal BPPV who exhibited positional vertigo and persistent nystagmus beating toward the uppermost ear for more than 4 weeks, despite performing therapeutic head shaking in the horizontal plane maneuver. All the patients were subjected to the supine roll test before and immediately after the first trial as well as after 1 and 4 weeks of the program to evaluate the effect of the treatment on their apogeotropic nystagmus. Nystagmus of 9 (33.3 %) patients disappeared immediately after the first training session. After 1 and 4 weeks of the training, the number of patients that had experienced either of these improvements had increased to 15 (55.6 %) and 19 (70.4 %) subjects, respectively. These results suggest that HtH exercises aimed at releasing otoconial debris from the cupula are feasible as a new therapy for cupulolithiasis associated with intractable lateral canal BPPV. However, further studies for comparison with control are required to confirm these preliminary results.

  8. Residual dizziness after the first BPPV episode: role of otolithic function and of a delayed diagnosis.

    PubMed

    Faralli, Mario; Lapenna, Ruggero; Giommetti, Giorgia; Pellegrino, Cristina; Ricci, Giampietro

    2016-10-01

    Residual dizziness (RD) following the resolution of a benign paroxysmal positional vertigo (BBPV) episode is frequently reported by patients. Possible causes are still under debate in the literature. This study discusses the possible role of otolithic function and of elapsed time from onset of symptoms to diagnosis in the genesis of RD. In total, 116 patients younger than 65 years with their first episode of BPPV and without any other comorbidities were enrolled in the study. Before a bedside examination, subjective visual vertical (SVV) was determined in the case of a history suggestive of BPPV. SVV was tested 1 week later in those patients with BPPV of the posterior semicircular canal, and in whom positioning maneuvers showed resolution of BPPV. At 1 week control, reported RD and Dizziness Handicap Inventory (DHI) were recorded. Diagnosis and treatment of BPPV occurred within 4 days in 43 patients (group A), between 5 and 8 days in 38 patients (group B) and in more than 9 days in 35 patients (group C). Higher values of reported RD and DHI were recorded in group C, while higher values of SVV deviation were recorded in group A with an inverse relationship between SVV and DHI. Initial peripheral vestibular function asymmetry due to BPPV can induce a new central adaptation. This adaptation becomes better established the longer otoconia remain floating in the endolymph. Because of these changes, the brain is unable to quickly readapt to the old pattern after resolution resulting in more persistent RD.

  9. Residual dizziness after the first BPPV episode: role of otolithic function and of a delayed diagnosis.

    PubMed

    Faralli, Mario; Lapenna, Ruggero; Giommetti, Giorgia; Pellegrino, Cristina; Ricci, Giampietro

    2016-10-01

    Residual dizziness (RD) following the resolution of a benign paroxysmal positional vertigo (BBPV) episode is frequently reported by patients. Possible causes are still under debate in the literature. This study discusses the possible role of otolithic function and of elapsed time from onset of symptoms to diagnosis in the genesis of RD. In total, 116 patients younger than 65 years with their first episode of BPPV and without any other comorbidities were enrolled in the study. Before a bedside examination, subjective visual vertical (SVV) was determined in the case of a history suggestive of BPPV. SVV was tested 1 week later in those patients with BPPV of the posterior semicircular canal, and in whom positioning maneuvers showed resolution of BPPV. At 1 week control, reported RD and Dizziness Handicap Inventory (DHI) were recorded. Diagnosis and treatment of BPPV occurred within 4 days in 43 patients (group A), between 5 and 8 days in 38 patients (group B) and in more than 9 days in 35 patients (group C). Higher values of reported RD and DHI were recorded in group C, while higher values of SVV deviation were recorded in group A with an inverse relationship between SVV and DHI. Initial peripheral vestibular function asymmetry due to BPPV can induce a new central adaptation. This adaptation becomes better established the longer otoconia remain floating in the endolymph. Because of these changes, the brain is unable to quickly readapt to the old pattern after resolution resulting in more persistent RD. PMID:26926693

  10. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver

    PubMed Central

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O. B. de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2015-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p < 0.05 and p = 0.001, respectively). However, more than half of the elderly participants did not achieve negative Dix-Hallpike. Regarding static and dynamic balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p < 0.05). Conclusion Results reveal clinical and functional benefits in elderly people with Benign Paroxysmal Positional Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints. PMID:26722348

  11. Supine to prolonged lateral position: a novel therapeutic maneuver for posterior canal benign paroxysmal positional vertigo.

    PubMed

    Shih, Cheng-Ping; Wang, Chih-Hung

    2013-05-01

    The treatment of posterior canal benign paroxysmal positional vertigo often involves repositioning maneuvers and exercises; however, these procedures may not be suitable for patients with limb disabilities or back disorders, or for elder patients. We sought to develop a simple therapeutic maneuver as an alternative procedure, suitable for patients with a wide range of physical ability. A simple therapeutic maneuver, supine to prolonged lateral position, was developed based on the mechanism of canalolithiasis. Its efficacy in treating posterior canal benign paroxysmal positional vertigo was evaluated in a prospective study consisting of 81 objective and 13 subjective posterior canal benign paroxysmal positional vertigo patients. A successful outcome was defined as a negative Dix-Hallpike test within 2 weeks followed by the continued absence of symptoms of vertigo or dizziness for the next 4 weeks. Seventy-two patients with objective posterior canal benign paroxysmal positional vertigo and all 13 patients with subjective posterior canal benign paroxysmal positional vertigo were successfully treated: resolution rates were 88.9 and 100 %, respectively. In the objective group, negative Dix-Hallpike tests were obtained at 1 and 2 weeks in 66.7 and 88.9 % of patients, respectively. In the subjective group, the percentages of patients free of side-dependent vertigo illusions at 1 and 2 weeks were 84.6 and 100 %, respectively. These results suggest that the supine to prolonged lateral position maneuver, which is easy to perform and generally well tolerated, could be recommended as an alternative treatment modality for patients with posterior canal benign paroxysmal positional vertigo.

  12. THE USEFULNESS OF MONITORING THE NEUTROPHIL TO LYMPHOCYTE RATIO IN PATIENTS WITH PERIPHERAL VERTIGO.

    PubMed

    Sahin, C; Varim, C; Uyanik, M; Acar, B; Acar, T; Nalbant, A

    2016-07-01

    The purpose of this study was to evaluate the usefulness of the neutrophil to lymphocyte ratio (NLR) in a differential diagnosis and follow-up of patients with peripheral vertigo. Twenty patients with benign positional paroxysmal vertigo (BPPV) and 20 patients diagnosed with vestibular neuritis (VN) were included in the study. Serum samples were analysed at the initial presentation and on the seventh day of admission retrospectively. The WBC (white blood cell) count was 10500±2100 /mm3, the neutrophil count was 4700±1100/mm3, the lymphocyte count was 5000±1200/mm3 and the NLR was 0.9±0.2 in the VN group. In patients with BPPV, the WBC count was 9200±1300/mm3, the neutrophil count was 5200±1200/mm3, the lymphocyte count was 3100±1200/mm3 and the NLR was 1.9±0.9. The NLR was lower in patients with VN than in patients diagnosed with BPPV. The WBC and lymphocyte count was significantly higher in the patients with VN than in the patients diagnosed with BPPV. Within the first week of admission, the WBC and lymphocyte counts in patients with VN decreased, and the NLR was more elevated than at the admission. It is highly recommended that NLR is used in the diagnosis and follow-up of the most commonly observed aetiological factors of peripheral vertigo, BPPV and VN. PMID:27661276

  13. Benign paroxysmal positional vertigo after decompression sickness: a first case report and review of the literature.

    PubMed

    Dan-Goor, Eric; Eden, Julian C P; Wilson, Simon J; Dangoor, Joseph; Wilson, Benjamin R

    2010-01-01

    Benign paroxysmal positional vertigo is a common cause of vertigo. We describe a previously unreported case of this clinical entity in a young, fit recreational water diver, having experienced decompression illness. Full recovery occurred after hyperbaric recompression therapy, and he remained symptom free on 6-week follow-up. We review the literature and discuss the pathogenesis of benign paroxysmal positional vertigo, proposing that semicircular canal nitrogen bubble formation could have been the primary etiological event leading to this condition.

  14. Clinical Management of a Patient with Chronic Recurrent Vertigo Following a Mild Traumatic Brain Injury

    PubMed Central

    Johnson, Eric G.

    2009-01-01

    Vertigo, was provoked and right torsional up-beat nystagmus was observed in a 47-year-old patient when she was placed into the right Hallpike-Dix test position using infrared goggle technology. The clinical diagnosis was benign paroxysmal positional vertigo (BPPV), specifically right posterior canalithiasis, resulting from a mild traumatic brain injury (TBI) suffered approximately six-months earlier. Previous medical consultations did not include vestibular system examination, and Meclizine was prescribed to suppress her chief complaint of vertigo. Ultimately, the patient was successfully managed by performing two canalith repositioning maneuvers during a single clinical session. The patient reported 100% resolution of symptoms upon reexamination the following day, and the Hallpike-Dix test was negative. Continued symptom resolution was subjectively reported 10 days postintervention via telephone consultation. This case report supports previous publications concerning the presence of BPPV following TBI and the need for inclusion of vestibular system examination during medical consultation. PMID:19826635

  15. Clinical management of a patient with chronic recurrent vertigo following a mild traumatic brain injury.

    PubMed

    Johnson, Eric G

    2009-01-01

    Vertigo, was provoked and right torsional up-beat nystagmus was observed in a 47-year-old patient when she was placed into the right Hallpike-Dix test position using infrared goggle technology. The clinical diagnosis was benign paroxysmal positional vertigo (BPPV), specifically right posterior canalithiasis, resulting from a mild traumatic brain injury (TBI) suffered approximately six-months earlier. Previous medical consultations did not include vestibular system examination, and Meclizine was prescribed to suppress her chief complaint of vertigo. Ultimately, the patient was successfully managed by performing two canalith repositioning maneuvers during a single clinical session. The patient reported 100% resolution of symptoms upon reexamination the following day, and the Hallpike-Dix test was negative. Continued symptom resolution was subjectively reported 10 days postintervention via telephone consultation. This case report supports previous publications concerning the presence of BPPV following TBI and the need for inclusion of vestibular system examination during medical consultation. PMID:19826635

  16. Use of BPPV processes in Emergency Department Dizziness Presentations: A Population-Based Study

    PubMed Central

    Kerber, Kevin A.; Burke, James F.; Skolarus, Lesli E.; Meurer, William J.; Callaghan, Brian C.; Brown, Devin L.; Lisabeth, Lynda D.; McLaughlin, Thomas J.; Fendrick, A. Mark; Morgenstern, Lewis B.

    2013-01-01

    Objective A common cause of dizziness, benign paroxysmal positional vertigo (BPPV), is effectively diagnosed and cured with the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). We aimed to describe the use of these processes in Emergency Departments (ED), to assess for trends in use over time, and to determine provider level variability in use. Design Prospective population-based surveillance study Setting EDs in Nueces County, Texas, January 15, 2008 to January 14, 2011 Subjects and Methods Adult patients discharged from EDs with dizziness, vertigo, or imbalance documented at triage. Clinical information was abstracted from source documents. A hierarchical logistic regression model adjusting for patient and provider characteristics was used to estimate trends in DHT use and provider level variability. Results 3,522 visits for dizziness were identified. A DHT was documented in 137 visits (3.9%). A CRM was documented in 8 visits (0.2%). Among patients diagnosed with BPPV, a DHT was documented in only 21.8% (34 of 156) and a CRM in 3.9% (6 of 156). In the hierarchical model (c statistic = 0.93), DHT was less likely to be used over time (odds ratio, 0.97, 95% CI [0.95, 0.99]) and the provider level explained 50% (ICC, 0.50) of the variance in the probability of DHT use. Conclusion BPPV is seldom examined for, and when diagnosed, infrequently treated in this ED population. DHT use is decreasing over time, and varies substantially by provider. Implementation research focused on BPPV care may be an opportunity to optimize management in ED dizziness presentations. PMID:23264119

  17. Anxiety and depression among patients with different types of vestibular peripheral vertigo.

    PubMed

    Yuan, Qing; Yu, Lisheng; Shi, Dongmei; Ke, Xingxing; Zhang, Hua

    2015-02-01

    Numerous studies have been published on comorbid anxiety and depression in patients with vertigo. However, very few studies have separately described and analyzed anxiety or depression in patients with different types of vestibular peripheral vertigo. The present study investigated anxiety and depression among patients with 4 different types of peripheral vertigo. A total of 129 patients with 4 types of peripheral vertigo, namely, benign paroxysmal positional vertigo (BPPV, n = 49), migrainous vertigo (MV, n = 37), Menière disease (MD, n = 28), and vestibular neuritis (VN, n = 15), were included in the present study. Otological and neurootological examinations were carefully performed, and self-rating anxiety scale and self-rating depression scale were used to evaluate anxiety and depression. Patients were divided into 2 groups, according to the vestibular function: normal and abnormal vestibular function. There was no significant difference in the risk of anxiety/depression between these 2 groups. However, for patients with the 4 different vertigo types, the prevalence of anxiety (MV = 45.9%, MD = 50%) and depression (MV = 27%, MD = 28.6%) was significantly higher in the patients with MV or MD than those with BPPV or VN (P < 0.05). Vestibular function is not significantly associated with the risk of anxiety/depression. Anxiety/depression is more common in patients with MV or MD than those with BPPV or VN. This may be due to the different mechanisms involved in these 4 types of vertigo, as well as differences in the prevention and self-control of the patients against the vertigo.

  18. Causes and time-course of vertigo in an ear, nose, and throat clinic.

    PubMed

    Isaradisaikul, Suwicha; Navacharoen, Niramon; Hanprasertpong, Charuk; Kangsanarak, Jaran; Panyathong, Rapeepun

    2010-12-01

    The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere's disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere's disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.

  19. The fluid mechanics of the inner-ear disorder BPPV

    NASA Astrophysics Data System (ADS)

    Weidman, Michael; Squires, Todd; Stone, Howard

    2001-11-01

    The inner ear of mammals contains fluid-filled semi-circular canals with a flexible sensory membrane (called a cupula) which detects rotational acceleration. Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common disorders of this system diagnosed today, and is characterized by symptoms of dizziness and nausea brought on by sudden changes in head orientation. BPPV is believed to have a mechanical (rather than nervous) origin, in which dense particles called otoconia settle into the canals and trigger false sensations of rotational acceleration. Several qualitative mechanisms have been proposed by the medical community, which we examine from a fluid mechanical standpoint. Traditionally, the semicircular canal and the cupula are modeled as an over-damped torsional pendulum with a driving force provided by rotational acceleration. We extend this model to include the time-dependent mechanical response owing to sedimentation of the otoconia. We make qualitative and quantitative predictions associated with the proposed mechanisms, with an eye towards differentiating between them and perhaps towards more effective diagnostic and therapeutic methods.

  20. Paroxysmal positional vertigo in skeet shooters and hunters.

    PubMed

    Bruno, Ernesto; Napolitano, Bianca; Di Girolamo, Stefano; De Padova, Alessandro; Alessandrini, Marco

    2007-04-01

    Paroxysmal positional vertigo (PPV) is a high prevalence vestibular end organ disorder due to the detachment of the utricular otoconia floating in the posterior or lateral semicircular canal. In the majority of cases the etiology of PPV is unknown and it may follow viral infections, vascular disorders and head trauma. This report presents six cases (out of 520 diagnoses of PPV) of PPV following repeated training sessions of skeet shooting or gun shooting during animal hunting. The transmission of impulsive and vibratory energy from the shoulder to the cervical spine and the subsequent minimal whiplash injury ipsilateral to the side where the gun is placed on the shoulder may be considered to be responsible of the otoconia detachment. PMID:17242916

  1. A New Variant of Posterior Canal Benign Paroxysmal Positional Vertigo: A Nonampullary or Common Crus Canalolithiasis

    PubMed Central

    Yetiser, Sertac

    2015-01-01

    Clockwise or counterclockwise, rotational, upbeating nystagmus is seen in patients with posterior canal benign paroxysmal positional vertigo during left or right head-hanging test, respectively. Rotating of nystagmus in opposite direction to the ear tested or even reversal of initial positioning rotational nystagmus is not usual and has never been reported before. We propose a new variant of posterior canal benign paroxysmal positional vertigo due to unusual behavior and location of the otoliths inside the membranous labyrinth. Unexpected rotational direction may lead to confusion about the site. The examiner should be aware of this abnormal or atypical variant of posterior canal benign paroxysmal positional vertigo. PMID:26114003

  2. Dizziness and vertigo - aftercare

    MedlinePlus

    Meniere disease - aftercare; Benign positional vertigo - aftercare ... Dizziness can describe two different symptoms: lightheadedness and vertigo. Lightheadedness means you feel like you might faint. ...

  3. Anosmia associated with hearing loss and benign positional vertigo after head trauma.

    PubMed

    Ottaviano, G; Marioni, G; Marchese-Ragona, R; Trevisan, C P; De Filippis, C; Staffieri, A

    2009-10-01

    It is well known that head trauma may cause hearing loss, which can be either conductive or sensorineural. Benign paroxysmal positional vertigo and olfactory dysfunction due to head trauma are also well known. The association between sensorineural hearing loss and anosmia, following head trauma, is extremely rare. Two rare cases of post-traumatic occurrence of hearing loss, olfactory dysfunction and benign positional vertigo are reported and the pathophysiology of the association between sensorineural hearing loss, anosmia and benign paroxysmal positional vertigo, after head injury, are briefly discussed. ENT specialists should, in the authors' opinion, be aware of the possible association between anosmia, sensorineural hearing loss and benign paroxysmal positional vertigo after head injury, even in the absence of skull fracture.

  4. Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report.

    PubMed

    Kim, Yong Won; Shin, Jung Eun; Lee, Yong-Sik; Kim, Chang-Hee

    2015-09-01

    Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations.

  5. Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report

    PubMed Central

    Kim, Yong Won; Shin, Jung Eun; Lee, Yong-Sik

    2015-01-01

    Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations. PMID:26413578

  6. Particle sedimentation in curved tubes: A 3D simulation and optimization for treatment of vestibular vertigo

    NASA Astrophysics Data System (ADS)

    White, Brian; Squires, Todd M.; Hain, Timothy C.; Stone, Howard A.

    2003-11-01

    Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the vestibular system where micron-size crystals abnormally drift into the semicircular canals of the inner ear that sense angular motion of the head. Sedimentation of these crystals causes sensation of motion after true head motion has stopped: vertigo results. The usual clinical treatment is through a series of head maneuvers designed to move the particles into a less sensitive region of the canal system. We present a three-dimensional model to simulate treatment of BPPV by determining the complete hydrodynamic motion of the particles through the course of a therapeutic maneuver while using a realistic representation of the actual geometry. Analyses of clinical maneuvers show the parameter range for which they are effective, and indicate inefficiencies in current practice. In addition, an optimization process determines the most effective head maneuver, which significantly differs from those currently in practice.

  7. Insights into horizontal canal benign paroxysmal positional vertigo from a human case report.

    PubMed

    Aron, Margaret; Bance, Manohar

    2013-12-01

    For horizontal canal benign paroxysmal positional vertigo, determination of the pathologic side is difficult and based on many physiological assumptions. This article reports findings on a patient who had one dysfunctional inner ear and who presented with horizontal canal benign paroxysmal positional vertigo, giving us a relatively pure model for observing nystagmus arising in a subject in whom the affected side is known a priori. It is an interesting human model corroborating theories of nystagmus generation in this pathology and also serves to validate Ewald's second law in a living human subject.

  8. Efficacy of Epley's Maneuver in Treating BPPV Patients: A Prospective Observational Study

    PubMed Central

    Gaur, Sushil; Awasthi, Sanjeev Kumar; Bhadouriya, Sunil Kumar Singh; Saxena, Rohit; Pathak, Vivek Kumar; Bisht, Mamta

    2015-01-01

    Vertigo and balance disorders are among the most common symptoms encountered in patients who visit ENT outpatient department. This is associated with risk of falling and is compounded in elderly persons with other neurologic deficits and chronic medical problems. BPPV is the most common cause of peripheral vertigo. BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact, and medical costs. The objective of Epley's maneuver, which is noninvasive, inexpensive, and easily administered, is to move the canaliths out of the canal to the utricle where they no longer affect the canal dynamics. Our study aims to analyze the response to Epley's maneuver in a series of patients with posterior canal BPPV and compares the results with those treated exclusively by medical management alone. Even though many studies have been conducted to prove the efficacy of this maneuver, this study reinforces the validity of Epley's maneuver by comparison with the medical management. PMID:26495002

  9. Efficacy of Epley's Maneuver in Treating BPPV Patients: A Prospective Observational Study.

    PubMed

    Gaur, Sushil; Awasthi, Sanjeev Kumar; Bhadouriya, Sunil Kumar Singh; Saxena, Rohit; Pathak, Vivek Kumar; Bisht, Mamta

    2015-01-01

    Vertigo and balance disorders are among the most common symptoms encountered in patients who visit ENT outpatient department. This is associated with risk of falling and is compounded in elderly persons with other neurologic deficits and chronic medical problems. BPPV is the most common cause of peripheral vertigo. BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact, and medical costs. The objective of Epley's maneuver, which is noninvasive, inexpensive, and easily administered, is to move the canaliths out of the canal to the utricle where they no longer affect the canal dynamics. Our study aims to analyze the response to Epley's maneuver in a series of patients with posterior canal BPPV and compares the results with those treated exclusively by medical management alone. Even though many studies have been conducted to prove the efficacy of this maneuver, this study reinforces the validity of Epley's maneuver by comparison with the medical management. PMID:26495002

  10. Comparison of the canalith repositioning procedure and vestibular habituation training in forty patients with benign paroxysmal positional vertigo.

    PubMed

    Steenerson, R L; Cronin, G W

    1996-01-01

    Forty patients with benign paroxysmal positional vertigo were treated with either the canalith repositioning procedure or vestibular habituation exercises to determine which treatment approach would be most effective. Twenty additional patients with benign paroxysmal positional vertigo were not treated and served as a control group. The intensity and duration of symptoms were monitored during a 3-month period. All patients had symptomatic relief in the treated groups. The canalith repositioning procedure seemed to give resolution of symptoms with fewer treatments, but long-term results show either treatment approach is effective in relieving positional vertigo. A significant number of patients in the control group (75%) continued to have vertigo. Advantages and disadvantages of the canalith repositioning procedure and vestibular habituation exercises are discussed. PMID:8570252

  11. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    PubMed Central

    Riga, M.; Bibas, A.; Xenellis, J.; Korres, S.

    2011-01-01

    Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients. PMID:21837242

  12. [Therapeutic maneuvers in the treatment of paroxysmal positional vertigo: can they indicate a central genesis?].

    PubMed

    Casani, A P; Dallan, I; Berrettini, S; Raffi, G; Segnini, G

    2002-04-01

    Typical Paroxysmal Positional Nystagmus (PPNy) is a highly specific clinical finding that indicates the existence of a specific peripheral lesion: Paroxysmal Positional Vertigo (PPV). However, besides this typical nystagmus of high topodiagnostic significance, atypical PPNy's are also frequently found. Such atypical findings can lead one to suspect a central vestibular system pathology and often require additional diagnostic testing. Of 1805 patients with complaints of vertigo, 305 proved affected by PPV. The present study evaluated how patients affected by the posterior semicircular canal PPV (278/305, 91.2%) responded to canalith repositioning maneuvers. In 246 patients (88.5%) the Semont maneuver was performed as simplified by Toupet, while the remaining 32 subjects (11.5%) were treated with the Epley maneuver as modified by Herdman. The Semont maneuver provides the relief of symptoms in 96% of patients while the Epley maneuver resolved 78% of cases. The patients that did not respond to the maneuvers, even after several attempts, were subsequently treated using "habituation"-based rehabilitation techniques (the Brandt-Daroff technique and Vestibular Habituation Training). The presence of atypical PPNy was found in 57 subjects. Of these, the liberatory maneuver always resolved the PPV. In the present study, the choice to perform a neuroradiological study was based on the lack of response to physical therapy, whether performed with liberatory maneuvers or with habituation techniques. In 2 of the 3 cases of PPV which remained unchanged despite treatment, imaging revealed a severe expansive CNS pathology. In these patients the dizziness complaints disappeared after neurosurgery: this fact appears to confirm the central origin of these PPNy cases. These data clearly indicate that the results of PPV treatment must be carefully evaluated. In cases of PPV of the PSC, when either typical or atypical PPNy persists one month after diagnosis, with no appreciable period of

  13. Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo Presenting with Torsional Downbeating Nystagmus: An Apogeotropic Variant

    PubMed Central

    Vannucchi, Paolo; Pecci, Rudi; Giannoni, Beatrice

    2012-01-01

    The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC) so that assuming the Dix-Hallpike's positions, the clot could move towards the ampulla eliciting a inhibitory torsional-down beating paroxysmal positional nystagmus (PPNy), instead of typical excitatory torsional-up beating PPNy. Among 45 patients with vestibular signs suggesting anterior semicircular canal paroxysmal positional vertigo (PPV), collected from February 2003 to August 2006, we detected a group of 6 subjects whose clinical findings showed a singular behaviour during follow-up. At the first check-up, all patients were submitted to different types of physical manoeuvres for ASC canalolithiasis. Patients were controlled during the same session and after one week. When we found that nystagmus was qualitatively changed we adopted the appropriate physical therapies for that sign. At a next check-up, after having performed some physical therapies, all patients had a typical PSC PPNy of the opposite side, with respect to that of the ASC initially diagnosed. Basing on these observations we conclude that PSC PPV, similarly to lateral semicircular canal PPV, could manifests in a apogeotropic variant. PMID:22969807

  14. Posterior semicircular canal benign paroxysmal positional vertigo presenting with torsional downbeating nystagmus: an apogeotropic variant.

    PubMed

    Vannucchi, Paolo; Pecci, Rudi; Giannoni, Beatrice

    2012-01-01

    The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC) so that assuming the Dix-Hallpike's positions, the clot could move towards the ampulla eliciting a inhibitory torsional-down beating paroxysmal positional nystagmus (PPNy), instead of typical excitatory torsional-up beating PPNy. Among 45 patients with vestibular signs suggesting anterior semicircular canal paroxysmal positional vertigo (PPV), collected from February 2003 to August 2006, we detected a group of 6 subjects whose clinical findings showed a singular behaviour during follow-up. At the first check-up, all patients were submitted to different types of physical manoeuvres for ASC canalolithiasis. Patients were controlled during the same session and after one week. When we found that nystagmus was qualitatively changed we adopted the appropriate physical therapies for that sign. At a next check-up, after having performed some physical therapies, all patients had a typical PSC PPNy of the opposite side, with respect to that of the ASC initially diagnosed. Basing on these observations we conclude that PSC PPV, similarly to lateral semicircular canal PPV, could manifests in a apogeotropic variant.

  15. Treatment of vertigo.

    PubMed

    Swartz, Randy; Longwell, Paxton

    2005-03-15

    Vertigo is the illusion of motion, usually rotational motion. As patients age, vertigo becomes an increasingly common presenting complaint. The most common causes of this condition are benign paroxysmal positional vertigo, acute vestibular neuronitis or labyrinthitis, Ménière's disease, migraine, and anxiety disorders. Less common causes include vertebrobasilar ischemia and retrocochlear tumors. The distinction between peripheral and central vertigo usually can be made clinically and guides management decisions. Most patients with vertigo do not require extensive diagnostic testing and can be treated in the primary care setting. Benign paroxysmal positional vertigo usually improves with a canalith repositioning procedure. Acute vestibular neuronitis or labyrinthitis improves with initial stabilizing measures and a vestibular suppressant medication, followed by vestibular rehabilitation exercises. Meniere's disease often responds to the combination of a low-salt diet and diuretics. Vertiginous migraine headaches generally improve with dietary changes, a tricyclic antidepressant, and a beta blocker or calcium channel blocker. Vertigo associated with anxiety usually responds to a selective serotonin reuptake inhibitor. PMID:15791890

  16. Vertigo-associated disorders

    MedlinePlus

    Peripheral vertigo; Central vertigo; Dizziness ... There are two types of vertigo, peripheral and central vertigo. Peripheral vertigo is due to a problem in the part of the inner ear that controls balance. These areas ...

  17. Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation

    PubMed Central

    Ribeiro, Karyna M. O. B. de Figueiredo; Ferreira, Lidiane Maria de Brito Macedo; Freitas, Raysa Vanessa de Medeiros; Silva, Camila Nicácio da; Deshpande, Nandini; Guerra, Ricardo Oliveira

    2016-01-01

    Introduction Benign Paroxysmal Positional Vertigo is the most common cause of dizziness in elderly people. Recent studies have shown that the elderly present higher Benign Paroxysmal Positional Vertigo recurrence and that vertiginous symptomatology remission varies according to comorbidities and the therapeutic techniques applied. Objective To assess the short-term effectiveness of Vestibular Rehabilitation in addition to Canalith Repositioning Maneuver on positive to negative Dix-Hallpike test, on recurrence and number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo. Methods In this randomized controlled trial, 7 older adults (median age: 69 years, range 65–78) underwent Canalith Repositioning Maneuver and Vestibular Rehabilitation for thirteen weeks. Seven older adults (median age: 73 years, range 65–76) in the control group received only Canalith Repositioning Maneuver. The participants were assessed at baseline (T0), one (T1), five (T5), nine (T9), and thirteen weeks (T13). We assessed the differences between the groups by Mann-Whitney and Fisher exact tests, and used the Friedman and Wilcoxon tests to determine the intragroup differences. Results No significant differences were found between groups for the positive to negative Dix-Hallpike test, recurrence, and number of maneuvers to achieve a negative test. The number of maneuvers to achieve negative Dix-Hallpike test was lower in intragroup comparisons in the experimental group. Conclusion The findings suggest that additional Vestibular Rehabilitation did not influence the positive to negative Dix-Hallpike test, recurrence, or number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo. PMID:27746838

  18. [Peripheral vertigo classification. Consensus document. Otoneurology committee of the Spanish otorhinolaryngology society (2003-2006)].

    PubMed

    Morera, Constantino; Pérez, Herminio; Pérez, Nicolás; Soto, Andrés

    2008-02-01

    There are many different vertigo classifications and different denominations are frequently used for the same clinical processes. The Otoneurology Committee of the Spanish Society for Otorhinolaryngology and Head and Neck Pathology proposes an eminently practical classification of peripheral vertigo to facilitate a common terminology that can be easily used by the general ENT practitioners. The methodology used has been by consensus within our Society and especially among the most outstanding work groups in the area of otoneurology in Spain. Initially vertigo is divided into single-episode vertigo and recurring attacks of vertigo, and these are then sub-divided into 2 groups, depending on whether or not hearing loss is present. Acute vertigo without hearing loss corresponds to vestibular neuritis and if it is associated with hearing loss, it is due to labyrinthitis of different aetiologies and cochleo-vestibular neuritis. Recurrent vertigos without hearing loss are classified as induced, either by posture (BPPV) or pressure (perilymphatic fistula), or as spontaneous, including migraine-associated vertigo, metabolic vertigo, childhood paroxysmal vertigo and vertigo of vascular causes (AITs, vertebral-basilar failure). Finally, recurrent vertigo with hearing loss includes Ménière's disease and others such as vertigo-migraine (with hearing loss), autoimmune pathology of the inner ear, syphilitic infection, and perilymphatic fistula (with hearing loss).

  19. Vertigo (image)

    MedlinePlus

    ... cupula of the semicircular canal to "bend" the hair cells. The hair cells, in turn, send a signal to your brain ... are experiencing "motion". Vertigo can occur when these hair cells are still sending signals of motion, even though ...

  20. [Rehabilitation of the vertigo patient].

    PubMed

    Hassid, N

    2002-09-01

    Vestibular exercises are getting an increasing place in the different way to treat vertigo. Vestibular training can be an interesting alternative to drugs medication. We will limit this presentation to the principal peripheral vestibulopathy as benign paroxysmal positioning vertigo, vestibular neuritis and the dizziness of elderly. PMID:12422462

  1. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo.

    PubMed

    Li, Yongchao; Peng, Baogan

    2015-01-01

    Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients' subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with Barré-Liéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment.

  2. Posttraumatic vertigo and dizziness.

    PubMed

    Fife, Terry D; Giza, Christopher

    2013-07-01

    Dizziness and vertigo are common symptoms following minor head trauma. Although these symptoms resolve within a few weeks in many patients, in some the symptoms may last much longer and impede ability to return to work and full functioning. Causes of persisting or recurrent dizziness may include benign paroxysmal positional vertigo, so-called labyrinthine concussion, unilateral vestibular nerve injury or damage to the utricle or saccule, perilymphatic fistula, or less commonly traumatic endolymphatic hydrops. Some dizziness after head trauma is due to nonlabyrinthine causes that may be related to structural or microstructural central nervous system injury or to more complicated interactions between migraine, generalized anxiety, and issues related to patients self-perception, predisposing psychological states, and environmental and stress-related factors. In this article, the authors review both the inner ear causes of dizziness after concussion and also the current understanding of chronic postconcussive dizziness when no peripheral vestibular cause can be identified.

  3. Idiopathic benign paroxysmal vertigo in children, a migraine precursor.

    PubMed

    Ralli, G; Atturo, F; de Filippis, C

    2009-12-01

    Vertigo and dizziness are common conditions in the adult population that can be rarely seen during childhood; only a few articles describing vertigo in children can be found in literature. Although many causes of vertigo in adulthood occur also in childhood, their frequency may be different. A typical example is benign paroxysmal positional vertigo, the most common peripheral vestibular disorder in adults, which occurs quite uncommonly in children. Furthermore, many common diseases causing vertigo in children may be unique for this population, such as benign paroxysmal vertigo (BPV) of childhood. At present, BPV is defined as a migraine's equivalent, a precursor of migraine or a periodic syndrome of childhood. The International Headache Society also studied this form of vertigo and included the Benign Paroxysmal Vertigo in section 1.3.3. of the International Classification of Headaches (ICHD-2). The present review analyzes recent patho-physiological and clinical evidences regarding idiopathic BPV in children.

  4. [Medicolegal assessment of post-traumatic vertigo].

    PubMed

    Thömke, F; Dieterich, M

    2011-12-01

    Post-traumatic vertigo refers to a group of different disorders which occur following trauma, mainly closed head injury and whiplash injury of the cervical spine. Aside from headaches, vertigo is the most common symptom in this group of patients. In general, there are two main groups of patients with post-traumatic vertigo: those with documented vestibular dysfunctions and those without. The most common post-traumatic vestibular disorders are benign paroxysmal positioning vertigo, labyrinthine concussion, canal dehiscence and otolithic lesions. Some of these disorders are characterized by spontaneous improvement or recovery over weeks or months and some may also be treated effectively. A number of patients, however, develop phobic postural vertigo requiring psychiatric or psychosomatic exploration.

  5. Dizziness and Vertigo (Beyond the Basics)

    MedlinePlus

    ... and certain infections can cause problems in the vestibular system. The vestibular system includes parts of the inner ear and ... 1 ). Benign paroxysmal positional vertigo, Meniere disease, and vestibular neuritis are three of the most common types ...

  6. Light cupula: the pathophysiological basis of persistent geotropic positional nystagmus

    PubMed Central

    Imai, Takao; Matsuda, Kazunori; Takeda, Noriaki; Uno, Atsuhiko; Kitahara, Tadashi; Horii, Arata; Nishiike, Suetaka; Inohara, Hidenori

    2015-01-01

    Objective To clarify the pathophysiological basis of persistent geotropic positional nystagmus (PGN) in patients with the horizontal canal type of benign paroxysmal positional vertigo (H-BPPV), the time constant (TC) of nystagmus and the relationship between its slow phase eye velocity (SPV) and the angle of head rotation in supine were defined. Methods Geotropic or apogeotropic positional nystagmus was recorded by video-oculography and analysed three-dimensionally. Results Geotropic positional nystagmuses in patients with H-BPPV were classified as transient geotropic positional nystagmus with a TC of ≤35 s or PGN with a TC of >35 s. Alternatively, the TC of persistent apogeotropic positional nystagmus (AN) in patients with H-BPPV was >35 s. The direction of the SPV of patients with PGN was opposite to that of patients with AN at each head position across the range of neutral head positions. The relationship between the SPV of patients with PGN and the angle of head rotation was linearly symmetrical against that of patients with AN with respect to a line drawn on the neutral head position. Conclusions Since its TC was >35 s, it is suggested that PGN is induced by cupula deviation in response to gravity at each head position. It is also suggested that the direction of cupula deviation in patients with PGN is opposite to that of patients with AN across the neutral head positional range with no nystagmus where the long axis of cupula is in alignment with the axis of gravity. Since the pathophysiological basis of AN is considered a heavy cupula, it is suggested that PGN is conversely induced by a light cupula. PMID:25586370

  7. Dizziness and vertigo.

    PubMed

    Wipperman, Jennifer

    2014-03-01

    Dizziness is a common and challenging condition seen in the primary care office. Because dizziness is a vague term that can include a wide array of medical disorders, it is important to use a stepwise approach to differentiate between causes. This article focuses on vertigo and its four most common causes: benign paroxysmal peripheral vertigo, vestibular neuritis, vestibular migraine, and Meniere's disease.

  8. ["Zurich Vertigo Meeting"--phobic postural vertigo].

    PubMed

    Dieterich, M

    1997-10-01

    Phobic postural vertigo has been described as a syndrome that is distinguishable from agoraphobia, acrophobia, and "space phobia". Closely related to locomotion, it is characterized by a combination of nonrotational vertigo with subjective postural and gait instability mainly in patients with an obsessive-compulsive personality. The monosymptomatic disturbance of balance manifests with superimposed attacks that occur with and without recognizable provoking factors in the same patient and are experienced with and without accompanying excess anxiety, misleading both patient and physician to a false diagnosis of organic disease.

  9. Dizziness, Vertigo, and Disequilibrium

    MedlinePlus

    ... has a rotational, spinning component, and is the perception of movement, either of the self or surrounding ... to help maintain posture and balance. Vertigo: the perception of movement or whirling - either of the self ...

  10. [Vertigo and diving].

    PubMed

    Calvet, H; Serrano, E; Pessey, J J; Lacomme, Y

    1992-01-01

    The appearance of a vertigo during scuba-diving result from different pathophysiological mechanism at which oppose specific therapeutic. Whether it's during barotrauma or decompression accident, the vestibular reach can cause drowning. It is possible to make the difference between barotrauma and decompression accident, with the good study of the scuba-diving and the time when the vertigo has came. So, the therapeutic will use recompression in a multiplace hyperbaric chamber or only hyperbaric oxygen.

  11. The Role of Postural Restrictions after BPPV Treatment: Real Effect on Successful Treatment and BPPV's Recurrence Rates

    PubMed Central

    Papacharalampous, George X.; Vlastarakos, P. V.; Kotsis, G. P.; Davilis, D.; Manolopoulos, L.

    2012-01-01

    Background. Canalith repositioning techniques are adequately established in the literature, as the treatment of choice for benign paroxysmal positional vertigo. However, the role of the posttreatment instructions is still not clearly defined. Patients and Methods. A retrospective chart review of 82 patients was conducted in order to determine the efficacy of postural restrictions, when combined with the classic canalith repositioning techniques, in terms of successful treatment and recurrence rates. Follow-up period reached at least 12 months after the initial treatment. Results. In this study, postural restrictions did not appear to significantly affect the outcomes of repositioning maneuvers, as well as the recurrence rate. Conclusions. Although this study, as well as most recent control studies, states that there is no significant effect of postmaneuver postural restrictions on both treatment and recurrence rates, larger multicentric research projects, adopting improved methodology, are still necessary in order to determine the contribution of such restrictions to both the therapeutic results and the prevention of recurrence. Adequate followup, focusing on the first six months after the initially successful repositioning maneuver, is also of paramount importance. PMID:22518162

  12. [Sudden onset vertigo: imaging work-up].

    PubMed

    Craighero, F; Casselman, J W; Safronova, M M; De Foer, B; Delanote, J; Officiers, E F

    2011-11-01

    Vertigo and dysequilibrium are a frequent cause of medical consultation. Clinical evaluation is essential. Some cases of vertigo are diagnosed clinically while others require imaging, sometimes emergently (suspected stroke). MRI is the imaging modality of choice to assess the labyrinth (labyrinthitis? labyrinthine hemorrhage?), internal auditory canal (vestibular schwannoma? other tumor?…) and brain parenchyma including all structures of the auditory pathways: vestibular nuclei, vestibulocerebellar tract, tracts involved with ocular motricity, vestibular cortex… Multiple central etiologies exist: stroke, multiple sclerosis, tumor… However, some etiologies are best depicted with CT, especially lesions of the labyrinth: cholesteatoma, trauma, suspected dehiscence of the superior semicircular canal, suspected labyrinthine fistula… Finally, imaging may be negative (Benign Paroxysmal Positional Vertigo, Meniere's disease, vestibular neuritis, migraine…), merely reducing the differential diagnosis.

  13. Association between gout and vertigo in a Taiwanese population.

    PubMed

    Lin, Yu-Ting; Lin, Hui-Wen; Huang, Yu-Chen; Ho, Wen-Tsao; Li, Yu-Chuan; Chen, Ting-Jui

    2013-06-01

    There are reports of an association between benign paroxysmal positional vertigo and hyperuricemia. We sought to determine the risk of vertigo among patients with gout compared with the general population, using a nationwide Taiwanese population-based claims database. Our study cohort consisted of patients with a diagnosis of gout disorders in 2004 (N = 18773). Four age- and gender-matched controls for every patient in the study cohort were selected using random sampling as the comparison cohort (N = 75092). All subjects were followed from the date of cohort entry until they developed vertigo or to the end of 2006. Cox proportional hazard regressions were performed to evaluate the 3-year vertigo-free survival rates. Of the total sample, 2563 (incidence, 10.09 per 1000 person-years) had vertigo during the 3-year follow-up period: 570 (incidence, 11.78 per 1000 person-years) from the study cohort and 1993 (incidence, 9.69 per 1000 person-years) from the comparison cohort. The adjusted hazard ratios (HR) of peripheral and central vertigo in patients with gout compared with controls during the 2-3-year follow-up were 1.17 (95% confidence interval [CI] = 1.05-1.29, p = 0.003) and 1.08 (95% CI = 0.86-1.36, p = 0.53), respectively. This is the first population-based study performed to suggest that patients with gout may have an increased risk of peripheral vertigo but not central vertigo. Benign paroxysmal positional vertigo may be the reason for the observed association; however, future studies are required to further ascertain the relationship between gout and the various causes of peripheral vertigo.

  14. [Vertigo from the practitioner's standpoint].

    PubMed

    Kallela, Mikko; Kentala, Erna

    2014-01-01

    One third of the population suffer from vertigo at some stage of their life. Some of its causes are harmless, some life-threatening, some will resolve spontaneously and some never. Vertigo is divided into four main types: vertigo, syncope, disturbance of balance and nonspecific vertigo. Medical history is the most important method of examination and leads to diagnosis in two out of three cases. Attempts are always made to provoke the sensation of vertigo and the possible nystagmus during the consultation. The success of the specific treatment in accordance with the primary cause determines the patient's prognosis.

  15. The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics.

    PubMed

    Brandt, T; Arnold, F; Bles, W; Kapteyn, T S

    1980-01-01

    A theory is presented supporting a geometrical explanation of physiological height vertigo as a 'distance vertigo' created by visual destabilization of posture when the distance between the observer and visible stationary contrasts becomes critically large. Though height vertigo is generally regarded as a psychopathological process, we hypothesize that it might instead result from an intersensory mismatch when visual information is at variance with vestibular and proprioceptive inputs. Psychophysical experiments confirming the hypothesis revealed that: 1) height vertigo is clearly related to body position, being the greatest in the upright stance; 2) it is the eye-object distance rather than the direction of gaze which is critical; 3) there is a saturation of height vertigo magnitude. Subjective vertigo increases with increasing altitude only below 20 metres. Physiological 'distance vertigo' must be distinguished from psychological 'acrophobia'. Its postural consequences may be ameliorated by strategies gleaned from knowledge of its mechanism such as providing nearby stationary contrasts in the peripheral visual field.

  16. Benign paroxysmal vertigo of childhood: A review of the literature

    PubMed Central

    Batson, Glenna

    2004-01-01

    Childrens’ complaints of headache and dizziness merit careful evaluation to differentially diagnose a vestibular disorder. Children can manifest with a syndrome mimicking certain classic signs and symptoms of adult vestibular disorders, such as benign paroxysmal positional vertigo, usually associated with aging. Benign paroxysmal vertigo of childhood in which migraine is a key manifestation along with sudden onset of dizziness, is a rare peripheral vestibular disorder in children that is commonly overlooked or misdiagnosed. This review covers the historical development of the diagnosis, evaluation and treatment approaches of benign paroxysmal vertigo of childhood. PMID:19654978

  17. Vertigo and Dizziness in the Elderly

    PubMed Central

    Fernández, Lara; Breinbauer, Hayo A.; Delano, Paul Hinckley

    2015-01-01

    The prevalence of vertigo and dizziness in people aged more than 60 years reaches 30%, and due to aging of world population, the number of patients is rapidly increasing. The presence of dizziness in the elderly is a strong predictor of falls, which is the leading cause of accidental death in people older than 65 years. Balance disorders in the elderly constitute a major public health problem, and require an adequate diagnosis and management by trained physicians. In the elderly, common causes of vertigo may manifest differently, as patients tend to report less rotatory vertigo and more non-specific dizziness and instability than younger patients, making diagnosis more complex. In this mini review, age-related degenerative processes that affect balance are presented. Diagnostic and therapeutic approaches oriented to the specific impaired system, including visual, proprioceptive, and vestibular pathways, are proposed. In addition, presbystasis – the loss of vestibular and balance functions associated with aging – benign paroxysmal positional vertigo, and stroke (in acute syndromes) should always be considered. PMID:26167157

  18. Vertigo: few new spins on a common problem.

    PubMed

    Zanni, Guido R; Wick, Jeannette Y

    2006-09-01

    Vertigo is a common balance deregulation symptom among elders. Its etiology may be peripheral vestibular disease or a central vestibular disorder. Symptom onset, severity, and duration are distinguishing characteristics. The majority of peripheral vestibular disorders include benign paroxysmal positional vertigo, vestibular neuronitis, Meniere's disease, and perilymph fistula. Medication regimen review is necessary to identify possible drug-induced etiology. Treatment options include pharmacotherapy, canalith repositioning procedures, surgery, vestibular rehabilitation therapy, and dietary interventions. PMID:17069465

  19. A systematic review of vertigo in primary care.

    PubMed Central

    Hanley, K; O'Dowd, T; Considine, N

    2001-01-01

    The symptom of vertigo is usually managed in primary care without further referral. This review examines the evidence on which general practitioners can base clinical diagnosis and management of this relatively common complaint. Research in this area has in the main been from secondary and tertiary centres and has been of variable quality. Indications are that the conditions that present in general practice are most likely to be benign positional vertigo, acute vestibular neuronitis, and Ménière's disease; however, vascular incidents and neurological causes, such as multiple sclerosis, must be kept in mind. An important practice point is that vestibular sedatives are not recommended on a prolonged basis for any type of vertigo. There is a need for basic epidemiological and clinical management research of vertigo in general practice. PMID:11510399

  20. [Vertigo in children and adolescents. Part 1: Epidemiology and diagnosis of peripheral vestibular disorders].

    PubMed

    Langhagen, T; Lehnen, N; Krause, E; Jahn, K

    2013-09-01

    Migraine equivalents are the most common cause of vertigo in children and adolescents. Vertigo and balance disorders occur frequently in children during the course of otitis media, middle ear effusion and viral infections. If otitis media is associated with reduced hearing and vertigo, labyrinthitis must be considered. Craniocerebral injury is another important cause of vertigo in children. In contrast, spontaneous benign paroxysmal positional vertigo is rare among children. The isolated cases of endolymphatic hydrops that occur in children are usually secondary. Perilymph fistula can have congenital, infectious or trauma-related causes. The following characteristics are useful for differentiating between different vertiginous syndromes: type and duration of vertigo, triggering/aggravating/alleviating factors and accompanying symptoms. A neuro-ophthalmologic examination is essential to rule out central vestibular disorders.

  1. Associations between peripheral vertigo and gastroesophageal reflux disease.

    PubMed

    Viliušytė, Edita; Macaitytė, Raminta; Vaitkus, Antanas; Rastenytė, Daiva

    2015-09-01

    We hypothesize that peripheral vertigo is associated with gastroesophageal reflux disease (GERD). Two mechanisms could be considered – gastric acids may directly irritate the respiratory mucosa and cause inflammation, or Helicobacter pylori (H. pylori) could be present and cause local infection. Reflux material (Hydrochloric acid (HCl) and pepsin) could get into the middle ear via Eustachian tube and affect osseous structures directly. Disturbance of ossicles could cause tinnitus, which is more common for peripheral vertigo. H. pylori could also get in the esophagus and in the upper respiratory tract via gastroesophageal reflux, and could cause tympanosclerosis and fixation of ossicles. In our study group, 120 of 153 (78.4%) patients had gastroesophageal reflux disease (GERD). Diagnostic tests of H. pylori (rapid urease test or blood antibody test) were performed for 96 of 120 (80%) patients with GERD and were found positive for 32 of 96 (33.3%) patients. Peripheral vertigo was present in 93 of 120 (77.6%) patients with GERD compared to 33 of 126 (26%) patients without GERD (χ(2)=9.016, p=0.003). H. pylori and peripheral vertigo coexisted in 26 of 126 patients (20.6%) (OR 1.36; 95% CI 0.49-3.74, p=0.55). Our study demonstrated statistically significant association between peripheral vertigo and GERD but not between peripheral vertigo and H. pylori. Further more extensive investigations are needed in order to explore our hypothesis.

  2. Vertigo and hearing loss.

    PubMed

    Newman-Toker, David E; Della Santina, Charles C; Blitz, Ari M

    2016-01-01

    Symptoms referable to disorders affecting the inner ear and vestibulocochlear nerve (eighth cranial nerve) include dizziness, vertigo, tinnitus, and hearing loss, in various combinations. Similar symptoms may occur with involvement of the central nervous system, principally the brainstem and cerebellum, to which the vestibular and auditory systems are connected. Imaging choices should be tailored to patient symptoms and the clinical context. Computed tomography (CT) should be used primarily to assess bony structures. Magnetic resonance imaging (MRI) should be used primarily to assess soft-tissue structures. Vascular imaging by angiography or venography should be obtained when vascular lesions are suspected. No imaging should be obtained in patients with typical presentations of common peripheral vestibular or auditory disorders. In current clinical practice, neuroimaging is often overused, especially CT in the assessment of acute dizziness and vertigo in the emergency department. Despite low sensitivity for ischemic strokes, CT is often used to rule out neurologic causes. When ischemic stroke is the principal concern in acute vestibular presentations, imaging should almost always be by MRI with diffusion-weighted images, rather than CT. In this chapter, we describe recommended strategies for audiovestibular imaging based on patient symptoms and signs. PMID:27430449

  3. Post-traumatic vertigo.

    PubMed

    Friedman, Jules M

    2004-10-01

    The vestibular-like symptoms that commonly follow head injury are most often due to one of a number of specific pathologies affecting vestibular, CNS or cervical structures. These pathologies can be readily identified in the majority of cases by appropriate testing in the examining room, and in vestibular function or neurodiagnosic laboratories. Whereas vestibular suppressants have a roll, they often delay recovery and have been supplanted as the mainstay of treatment in most cases by vestibular rehabilitation techniques. Given the large number of patients requiring outpatient management following head injury, it is appropriate that most generalists and many subspecialists should be aware of the differential diagnosis, workup and treatment options for post-traumatic vertigo.

  4. Stop the spinning: diagnosing and managing vertigo.

    PubMed

    Sandhaus, Sonia

    2002-08-01

    Differentiating vertigo from other forms of dizziness presents a diagnostic challenge. Extensive investigation, however, can help reveal vertigo's true etiology: life-threatening central lesions or debilitating, but benign, peripheral causes. Here, learn to assess vertigo using physical examination, history, and diagnostic procedures. Also, manage symptoms of common vestibular disorders, such as benign paroxysmal peripheral vertigo, labyrinthitis, and Ménière's disease. PMID:12352769

  5. Seasonality of dizziness and vertigo in a tropical region.

    PubMed

    Pereira, Alcione Botelho; Almeida, Leonardo Alves Ferreira; Pereira, Nayara Gorette; Menezes, Patrícia Andrade Freitas de; Felipe, Lilian; Volpe, Fernando Madalena

    2015-06-01

    Vertigo and dizziness are among the most common medical complaints in the emergency room, and are associated with a considerable personal and health care burden. Scarce and conflicting reports indicate those symptoms may present a seasonal distribution. This study aimed at investigating the existence of a seasonal distribution of vertigo/dizziness in a tropical region, and the correlations of these findings with climatic variables. The charts of all patients consecutively admitted between 2009 and 2012 in the emergency room of a Brazilian general hospital were reviewed. A total of 4920 cases containing these terms were sorted from a sample of 276,076 emergency records. Seasonality was assessed using Cosinor Analysis. Pearson's correlations were performed between the incidence of consultations, considering separately dizziness and vertigo and each of the predictor climatic variables of that index month. Significant seasonal patterns were observed for dizziness and vertigo in the emergency room. Vertigo was more frequent in late winter-spring, negatively correlating to humidity (r = -0.374; p = 0.013) and rainfall (r = -0.334; p = 0.020). Dizziness peaked on summer months, and positively correlated to average temperatures (r = 0.520; p < 0.001) and rainfall (r = 0.297; p = 0.040), but negatively to atmospheric pressure (r = -0.424; p = 0.003). The different seasonal patterns evidenced for dizziness and vertigo indicate possible distinct underlying mechanisms of how seasons may influence the occurrence of those symptoms.

  6. Vertigo and dizziness in children.

    PubMed

    Jahn, K

    2016-01-01

    Vertigo and dizziness of at least moderate severity occur in >5% of school-aged children and cause considerable restrictions in participation in school and leisure activity. More than 50% of dizzy children also have headache. Vestibular migraine and benign paroxysmal vertigo as a migraine precursor are the most common diagnoses in dizziness clinics for children and adolescents. They account for 30-60% of diagnoses. Other common causes are somatoform, orthostatic, or posttraumatic dizziness. All other disorders that are known to cause vertigo and dizziness in adults also occur in children, but incidence rates are usually lower. The vestibular and balance systems are largely developed after 1 year of age. Therefore, clinical and laboratory testing is reliable. Brain magnetic resonance imaging to exclude severe conditions, such as a brainstem tumor, is necessary only if clinical - in particular, ocular motor - testing is abnormal. Most conditions causing vertigo and dizziness in childhood and adolescence are treatable. Nonpharmacologic prophylaxis should always be recommended in vestibular migraine. Behavioral support is useful in somatization. Evidence for the effectiveness of drug therapy is largely based on experience in adult populations. High-quality controlled studies in childhood cohorts are sparse. It is important to make a correct diagnosis early on, as counseling and appropriate treatment may avoid chronic illness. PMID:27638083

  7. Clinical characteristics of cervicogenic-related dizziness and vertigo.

    PubMed

    Yacovino, Dario A; Hain, Timothy C

    2013-07-01

    Cervical vertigo has long been a controversial entity and its very existence as a medical entity has advocates and opponents. Supporters of cervical vertigo claim that its actual prevalence is underestimated due to the overestimation of other diagnostic categories in clinics. Furthermore, different pathophysiological mechanisms have been attributed to cervical vertigo. Here the authors discuss the clinical characteristics of rotational vertebral artery vertigo, postwhiplash vertigo, proprioceptive cervical vertigo, and cervicogenic vertigo of old age. A clinical entity named subclinical vertebrobasilar insufficiency appears in the context of cervical osteoarticular changes. Migraine-associated vertigo may explain why some patients suffering from cervical pain have vertigo while others do not.

  8. Epigone migraine vertigo (EMV): a late migraine equivalent.

    PubMed

    Pagnini, P; Vannucchi, P; Giannoni, B; Pecci, R

    2014-02-01

    Migrainous headache is determined by pathogenetic mechanisms that are also able to affect the peripheral and/or central vestibular system, so that vestibular symptoms may substitute and/or present with headache. We are convinced that there can be many different manifestations of vestibular disorders in migrainous patients, representing true different clinical entities due to their different characteristics and temporal relashionship with headache. Based on such considerations, we proposed a classification of vertigo and other vestibular disorders related to migraine, and believe that a particular variant of migraine-related vertigo should be introduced, namely "epigone migraine vertigo" (EMV): this could be a kind of late migraine equivalent, i.e. a kind of vertigo, migrainous in origin, starting late in the lifetime that substitutes, as an equivalent, pre-existing migraine headache. To clarify this particular clinical picture, we report three illustrative clinical cases among 28 patients collected during an observation period of 13 years (November 1991 - November 2004). For all patients, we collected complete personal clinical history. All patients underwent standard neurotological examination, looking for spontaneous-positional, gaze-evoked and caloric induced nystagmus, using an infrared video camera. We also performed a head shaking test (HST) and an head thrust test (HTT). Ocular motility was tested looking at saccades and smooth pursuit. To exclude other significant neurological pathologies, a brain magnetic resonance imaging (MRI) with gadolinium was performed. During the three months after the first visit, patients were invited to keep a diary noting frequency, intensity and duration of vertigo attacks. After that period, we suggested that they use prophylactic treatment with flunarizine (5 mg per day) and/or acetylsalicylic acid (100 mg per day), or propranolol (40 mg twice a day). All patients were again recommended to note in their diary the frequency

  9. [Peripheral vertigo versus central vertigo. Application of the HINTS protocol].

    PubMed

    Batuecas-Caletrío, Ángel; Yáñez-González, Raquel; Sánchez-Blanco, Carmen; González-Sánchez, Enrique; Benito, José; Gómez, José Carlos; Santa Cruz-Ruiz, Santiago

    2014-10-16

    Introduccion. Uno de los dilemas mas importantes concernientes al vertigo en urgencias es su diagnostico diferencial. Existen signos de alarma de gran sensibilidad en la exploracion que pueden ponernos en la pista de encontrarnos ante un vertigo central. Objetivo. Determinar la eficacia de la aplicacion del protocolo HINTS en el diagnostico del accidente cerebrovascular que simula un vertigo periferico. Pacientes y metodos. Estudio observacional descriptivo sobre pacientes ingresados con diagnostico de sindrome vestibular agudo en urgencias. Todos los pacientes fueron objeto de un seguimiento diario hasta la mejoria de sus sintomas con informacion del nistagmo, la maniobra de impulso oculocefalico y el test de skew. Se comparan los resultados del estudio de resonancia magnetica con la alteracion en alguno de esos tres signos a lo largo del ingreso del enfermo. Resultados. Se reunio a 91 pacientes, con una edad media de 55,8 años. Se objetivo un accidente cerebrovascular en ocho de ellos. De estos (edad media: 71 años), en siete existia una alteracion en alguno de los signos HINTS y en uno el estudio fue normal (sensibilidad: 0,88; especificidad: 0,96). Todos ellos tenian algun factor de riesgo vascular. Conclusiones. Una exploracion adecuada y dirigida ante un paciente que acude a urgencias con un sindrome vestibular agudo resulta de vital importancia para establecer el diagnostico diferencial entre la patologia periferica y la central, ya que algunos accidentes cerebrovasculares se pueden presentar bajo la apariencia de un vertigo agudo. Aplicar un protocolo como HINTS permite sospechar la patologia central con una gran sensibilidad y especificidad.

  10. Vision and vertigo: some visual aspects of vestibular disorders.

    PubMed

    Bronstein, Adolfo M

    2004-04-01

    This review deals with two syndromes, oscillopsia and visual vertigo. Oscillopsia is the illusion of oscillation of the visual surroundings. For diagnosis purposes one should ask, when does the oscillopsia occur? If oscillopsia is only present during head (or whole body) movements, the likely underlying cause is a bilateral defect in the vestibulo-ocular reflex (VOR). The more common causes are post meningitic vestibular damage, gentamicin ototoxicity or bilateral idiopathic vestibular failure. When oscillopsia develops after specific head positions, it is usually due to a positional nystagmus, usually the result of brainstem-cerebellar disease. When the oscillopsia is largely unrelated to head movements, one should ask, is it fairly constant or is it in attacks (paroxysmal)? If the oscillopsia is constant it is usually due to the presence of a clinically observable nystagmus; the most common is downbeat nystagmus but the most visually disabling is pendular nystagmus. If the oscillopsia comes in brief attacks it is usually due to a paroxysmal nystagmus as observed in irritative VIII nerve and brainstem lesions. However, the most common cause of paroxysmal oscillopsia is a non organic condition called voluntary nystagmus. Treatment of oscillopsia is often pharmacological but disappointing; the best chance of success is carbamazepine for paroxysmal disorders secondary to structural vestibular nerve/nuclear lesions.Visual vertigo should not be confused with oscillopsia. It can be defined as dizziness provoked by visual environments with large size (full field) repetitive or moving visual patterns. Patients with visual vertigo report discomfort in supermarkets and when viewing movement of large visual objects, eg crowds, traffic, clouds or foliage. Visual vertigo is present in many patients with a history of a peripheral vestibular disorder, particularly those who are visually dependent (ie subjects who use vision preferentially for postural and space orientation

  11. Ischemic syndromes causing dizziness and vertigo.

    PubMed

    Choi, K-D; Lee, H; Kim, J-S

    2016-01-01

    Dizziness/vertigo and imbalance are the most common symptoms of vertebrobasilar ischemia. Even though dizziness/vertigo usually accompanies other neurologic symptoms and signs in cerebrovascular disorders, a diagnosis of isolated vascular vertigo is increasing markedly by virtue of recent developments in clinical neurotology and neuroimaging. It is important to differentiate isolated vertigo of a vascular cause from more benign disorders involving the inner ear, since therapeutic strategies and prognosis differ between these two conditions. Over the last decade, we have achieved a marked development in the understanding and diagnosis of vascular dizziness/vertigo. Introduction of diffusion-weighted magnetic resonance imaging (MRI) has greatly enhanced detection of infarctions in patients with vascular dizziness/vertigo, especially in the posterior-circulation territories. However, well-organized bedside neurotologic evaluation is even more sensitive than MRI in detecting acute infarction as a cause of spontaneous prolonged vertigo. Furthermore, detailed evaluation of strategic infarctions has elucidated the function of various vestibular structures of the brainstem and cerebellum. In contrast, diagnosis of isolated labyrinthine infarction still remains a challenge. This diagnostic difficulty also applies to isolated transient dizziness/vertigo of vascular origin. Regarding the common nonlacunar mechanisms in the acute vestibular syndrome from small infarctions, individual strategies may be indicated to prevent recurrences of stroke in patients with vascular vertigo. PMID:27638081

  12. Point prevalence of vertigo and dizziness in a sample of 2672 subjects and correlation with headaches.

    PubMed

    Teggi, R; Manfrin, M; Balzanelli, C; Gatti, O; Mura, F; Quaglieri, S; Pilolli, F; Redaelli de Zinis, L O; Benazzo, M; Bussi, M

    2016-06-01

    Vertigo and dizziness are common symptoms in the general population, with an estimated prevalence between 20% and 56%. The aim of our work was to assess the point prevalence of these symptoms in a population of 2672 subjects. Patients were asked to answer a questionnaire; in the first part they were asked about demographic data and previous vertigo and or dizziness. Mean age of the sample was 48.3 ± 15 years, and 46.7% were males. A total of 1077 (40.3%) subjects referred vertigo/dizziness during their lifetime, and the mean age of the first vertigo attack was 39.2 ± 15.4 years; in the second part they were asked about the characteristics of vertigo (age of first episode, rotational vertigo, relapsing episodes, positional exacerbation, presence of cochlear symptoms) and lifetime presence of moderate to severe headache and its clinical features (hemicranial, pulsatile, associated with phono and photophobia, worse on effort). An age and sex effect was demonstrated, with symptoms 4.4 times more elevated in females and 1.8 times in people over 50 years. In the total sample of 2672 responders, 13.7% referred a sensation of spinning, 26.3% relapsing episodes, 12.9% positional exacerbation and 4.8% cochlear symptoms; 34.8% referred headache during their lifetime. Subjects suffering from headache presented an increased rate of relapsing episodes, positional exacerbation, cochlear symptoms and a lower age of occurrence of the first vertigo/dizziness episode. In the discussion, our data are compared with those of previous studies, and we underline the relationship between vertigo/dizziness from one side and headache with migrainous features on the other.

  13. Symptoms of vertigo in general practice: a prospective study of diagnosis.

    PubMed Central

    Hanley, K; O' Dowd, T

    2002-01-01

    BACKGROUND: There is little published evidence of the general practice experience of the diagnostic outcomes when symptoms of vertigo present. What research there is has been dominated by specialist centres. This gives a skewed view of the prevalence of the causes of such symptoms. AIM: To describe the likely diagnosis of symptoms of vertigo. DESIGN OF STUDY: Prospective cohort study METHODS: Thirteen GPs were recruited and trained to clinically assess and follow up all patients presenting with symptoms of vertigo over a six-month period Age-sex data were simultaneously gathered on those who consulted with non-vertiginous dizziness. RESULTS: The main diagnoses assigned by the GPs in 70 patients were benign positional vertigo, acute vestibular neuronitis and Ménière's disease, which together accounted for 93% (95% confidence interval = 71% to 100%) of patients' symptoms. Ninety-one per cent of patients were managed in general practice and 60% received a prescription for a vestibular sedative. CONCLUSION: This study suggests that presentations of symptoms of vertigo can be clinically diagnosed in most cases. The diagnoses recorded by GPs differ in proportion to those in specialist centres, with a larger number of patients suffering from benign positional vertigo and acute vestibular neuronitis in general practice, in contrast with specialist centres, which see more patients with Ménière's disease. PMID:12392120

  14. HINTS for differentiating peripheral from central causes of vertigo.

    PubMed

    Jaynstein, Dayna

    2016-10-01

    Dizziness and vertigo are common and difficult complaints encountered by providers. The differential diagnosis is large and varies from benign to life-threatening disorders. The true challenge becomes differentiating benign peripheral vertigo from central vertigo. The HINTS examination can help differentiate peripheral from central causes of dizziness and vertigo. PMID:27685517

  15. Evaluation and Treatment of the Patient with Vertigo.

    ERIC Educational Resources Information Center

    Glasscock, Michael E. III; Haynes, David S.

    1997-01-01

    The sensation of vertigo is a complex symptom that patients find difficult to describe, and physicians often find evaluating and treating patients with the vertigo a difficult task. This article outlines types and causes of vertigo and the work up, evaluation, and treatment of a patient with vertigo. (Contains references.) (Author/CR)

  16. [Comparative efficacy of betaserc and cinnarizine of vertigo in patients with migraine].

    PubMed

    Amelin, A V; Skoromets, A A; Gonchar, M A; Tumelevich, B Ch; Nikitin, K A

    2003-01-01

    Headache and vertigo often emerge simultaneously. Fifty six (40%) out of 140 patients complaining of vertigo were studied. Emerging in the aura and/or in headache phases, vertigo was more frequently registered in patients suffered from migraine with aura (57%). Vertigo associated with migraine was diagnosed in 25% of the cases. The patients were randomized into 2 equal identical groups, one of which was treated by betaserc (16 mg, 3 times daily before meal) and the other one was given cinnarizine (25 mg, 3 times daily). Treatment duration was 12 weeks. Reduction of vertigo attacks frequency and headache by 50% and over, in comparison to the baseline period, was considered as beneficial. Fifty three (95%) patients completed the treatment course. Decrease of a risk for negative results and a frequency of positive effect of vertigo therapy were significantly higher in the group receiving betaserc. Reduction of monthly relapses by 50% and over was detected in 79% of the patients of betaserc group and in 52% of those of cinnarizine one. Migraine attacks monthly frequency was diminished by 43% and 64%, respectively. Therefore, betaserc is considered for using as vertigolytic medication and for migraine attacks prevention. PMID:12789824

  17. Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo.

    PubMed

    Pavlin-Premrl, Davor; Waterston, John; McGuigan, Sean; Infeld, Bernard; Sultana, Ron; O'Sullivan, Richard; Gerraty, Richard P

    2015-03-01

    Vertigo is a common cause of emergency department attendance. Detection of spontaneous nystagmus may be a useful sign in distinguishing vestibular neuritis from other vestibular diagnoses. We aimed to assess the contribution of spontaneous nystagmus in the diagnosis of acute vertigo. We enrolled consecutive consenting patients arriving at a single emergency department with acute vertigo. There was no declared protocol for the emergency department staff. A standardized history and examination was conducted by the investigators. Observation for spontaneous nystagmus, its response to visual fixation, and testing the vestibulo-ocular reflex with the horizontal head impulse test were the chief examination components. MRI was obtained within 24 hours. Clinical criteria and MRI were used to reach the final diagnosis. The investigators' physical findings and final neurological diagnosis were compared with the initial emergency department examination findings and the referral diagnosis. There were 28 patients, 15 with vestibular neuritis, six with benign paroxysmal positional vertigo, one with stroke, suspected clinically, and three with migraine. In three the diagnosis remained uncertain. Spontaneous nystagmus was seen in all 15 patients with vestibular neuritis, fixation-suppressed in eight of 11 tested for this. The head impulse test was positive in 12 of 15 with vestibular neuritis. The emergency department referral diagnosis was correct in six of 23 patients. The ability to detect spontaneous nystagmus is useful in vestibular diagnosis, both in support of a diagnosis of vestibular neuritis and in avoiding false positive diagnoses of benign paroxysmal positional vertigo.

  18. Mastication-induced vertigo and nystagmus.

    PubMed

    Park, Seong-Ho; Kim, Hyo-Jung; Kim, Ji-Soo; Koo, Ja-Won; Oh, Seo Won; Kim, Dong-Uk; Kim, Joon-Tae; Welgampola, Miriam; Deriu, Franca

    2014-03-01

    Even though trigeminovestibular connections are well established in animals, mastication-induced dizziness has been described only as a vascular steal phenomenon in humans. We determined induction or modulation of nystagmus in two index patients with mastication-induced vertigo, 12 normal controls, and 52 additional patients with peripheral (n = 38, 26 with vestibular neuritis/labyrinthitis and 12 with Meniere's disease) or central (n = 14, 11 with Wallenberg syndrome, two with cerebellar infarction, and one with pontine infarction) vestibulopathy during their acute or compensated phase. Both index patients developed mastication-induced vertigo after near complete resolution of the spontaneous vertigo from presumed acute unilateral peripheral vestibulopathy. The nystagmus and vertigo gradually built up during mastication and dissipated slowly after cessation of mastication. Brain MRI and cerebral angiography were normal in these patients. Mastication did not induce nystagmus in normal controls. However, mastication induced nystagmus in five (24 %) of the 21 patients without spontaneous nystagmus (SN) but with a previous history of a vestibular syndrome, and either increased (21/31, 68 %) or decreased (7/31, 23 %) the SN in almost all the patients (28/31, 90 %) with SN. Mastication may induce significant vertigo and nystagmus in patients with a prior history of acute vestibulopathy. The induction or modulation of nystagmus by mastication in both peripheral and central vestibulopathies supports trigeminal modulation of the vestibular system in human. The gradual build-up and dissipation suggest a role of the velocity storage mechanism in the generation of mastication-induced vertigo and nystagmus.

  19. Vertigo due to posterior circulation stroke.

    PubMed

    Kim, Ji Soo; Lee, Hyung

    2013-07-01

    Stroke in the distribution of the posterior circulation may present as acute onset spontaneous vertigo and imbalance. Although vertigo due to posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts in the cerebellum or brainstem can present with vertigo without other localizing symptoms. Approximately 17% of patients with isolated posterior inferior cerebellar artery territory infarction presented with isolated vertigo, nystagmus, and postural unsteadiness. A head impulse test can differentiate acute isolated vertigo associated with cerebellar stroke from more benign disorders involving the inner ear. Sometimes acute isolated audiovestibular loss can be the initial symptom of impending posterior circulation ischemic stroke (particularly within the territory of the anterior inferior cerebellar artery). In this case, evaluation of isolated audiovestibular loss may prevent the progression of acute vertigo and hearing loss into more widespread areas of infarction in the posterior circulation. In this article, the clinical syndromes and signs of acute vestibular syndrome due to posterior circulation stroke involving the brainstem and cerebellum are summarized.

  20. Sound-induced vertigo due to bone dehiscence of the lateral semicircular canal.

    PubMed

    Zhang, Yi-Bo; Dai, Chun-Fu; Sha, Yan

    2010-08-01

    Dehiscence of the lateral semicircular canal (LSCD) has been reported much but mainly in association with cholesteatoma and canal wall down mastoidectomy, while idiopathic LSCD was rarely reported. Bassim reported one case with lateral semicircular canal dehiscence, but presented no vestibular or auditory symptoms. The patient in this study complained significant sound-induced vertigo and autophony in his right ear. The axis of nystagmus was orthogonal to the lateral semicircular canal, and no torsional or vertical motions were observed, so pathology of the lateral semicircular canal was preferentially considered. Benign paroxysmal positional vertigo was excluded since vertigo attacks had no relation to the change of head position. The dehiscence of the right lateral semicircular canal was then confirmed through the high-resolution temporal bone computer tomography scan and the reconstructed images. The cause of the LSCD is poorly understood, since no history of head trauma, otological infection or surgery was documented.

  1. [Migraine-associated vertigo with hearing loss and recurrent vertigo attack].

    PubMed

    Goto, Fumiyuki; Tsutsumi, Tomoko; Ogawa, Kaoru

    2013-05-01

    The clinical features of Ménière's disease and migraine-associated vertigo are quite similar. Both disorders are characterized by repeated vertigo spells. Several diagnostic criteria are used to diagnose migraine-associated vertigo. None of these criteria has been internationally defined, although the criteria proposed by Neuhauser are wieldy accepted. Hearing impairment is believed to be a key factor for diagnosing Ménière's disease. We report herein on a case of repeated vertigo spells with sensorineural hearing loss in the right ear. Initially, the condition was diagnosed as Ménière's disease. Treatment for improving endolymphatic hydrops did not have an effect on the vertigo spells. On careful questioning, we noted the coexistence of migraines without any aura. Treatment with Ca antagonists to prevent the migraine attacks successfully stopped the patient's vertigo spells. On the basis of this clinical course, it is safe to assume that the patient had migraine-associated vertigo with sensorineural hearing loss rather than Ménière's disease. For a patient experiencing migraines together with sensorineural hearing loss, an accurate diagnosis requires careful evaluation. The coexistence of migraines should be carefully ruled out, even if Ménière's disease with hearing loss is strongly suspected.

  2. La Mettrie's soul: vertigo, fever, massacre, and The Natural History.

    PubMed

    Hacking, Ian

    2009-01-01

    La Mettrie's materialist and monistic philosophy is that of a military doctor, knowing what dysentery did to his own mind, watching his regiment destroyed at Fontenoy, running French field hospitals in Flanders. He learned brain science in the injuries of his fellows. He knew pain and that man's main positive drive was sex. He despised the prudish hypocrisies of feeble materialists like Diderot and Voltaire. His brutal military life and his hedonism made him the most coherent monist against Cartesian dualism. His study of vertigo is sound clinical medicine, which well accords with one trend in today's medical practice. PMID:19831303

  3. La Mettrie's soul: vertigo, fever, massacre, and The Natural History.

    PubMed

    Hacking, Ian

    2009-01-01

    La Mettrie's materialist and monistic philosophy is that of a military doctor, knowing what dysentery did to his own mind, watching his regiment destroyed at Fontenoy, running French field hospitals in Flanders. He learned brain science in the injuries of his fellows. He knew pain and that man's main positive drive was sex. He despised the prudish hypocrisies of feeble materialists like Diderot and Voltaire. His brutal military life and his hedonism made him the most coherent monist against Cartesian dualism. His study of vertigo is sound clinical medicine, which well accords with one trend in today's medical practice.

  4. Surgery for vertigo (you don't have to live with it).

    PubMed

    Silverstein, H

    1981-10-01

    Surgery for vertigo is recommended where there is objective evidence of a unilateral inner ear disorder, when medical therapy fails, and when the patient demands definitive therapy. Common surgical procedures are the endolymphatic subarachnoid shunt, retrolabyrinthine vestibular neurectomy, cochleovestibular neurectomy, and the post ampullary nerve section (singular neurectomy). Vertiginous disorders which can be surgically cured are Ménière's disease, vestibular neuronitis, chronic labyrinthitis, and benign positional vertigo. Due to the recent advances in microsurgery and the development of new surgical procedures in the past 20 years, it is possible to help the vertiginous patient who has been told he must live forever with his problem. PMID:7328719

  5. Vertigo and dizziness from environmental motion: visual vertigo, motion sickness, and drivers' disorientation.

    PubMed

    Bronstein, Adolfo M; Golding, John F; Gresty, Michael A

    2013-07-01

    The normal vestibular system may be adversely affected by environmental challenges which have characteristics that are unfamiliar or ambiguous in the patterns of sensory stimulation they provide. A disordered vestibular system lends susceptibility even to quotidian environmental experiences as the sufferer becomes dependent on potentially misleading, nonvestibular sensory stimuli. In both cases, the sequelae may be vertigo, incoordination, imbalance, and unpleasant autonomic responses. Common environmental motion conditions include visual vertigo, motion sickness, and motorists' disorientation. The core therapy for visual vertigo, motion sickness, and drivers' disorientation is progressive desensitization within a cognitive framework of reassurance and explanation, plus anxiolytic tactics and autogenic control of autonomic symptoms.

  6. Cervical vertigo and dizziness after whiplash injury.

    PubMed

    Endo, Kenji; Ichimaru, Katsuji; Komagata, Mashashi; Yamamoto, Kengo

    2006-06-01

    Whiplash injury is not only limited to neck injury but also brainstem injury that does not involve direct damage to the neck or head. The symptoms of whiplash injury are polymorphous, with the most common complaints being cervical pain, headache and scapulodynia. Vertigo and dizziness are also reported in 25-50% of the cases. In otoneurologic studies, magnetic resonance angiography (MRA) is used for the evaluation of vertebrobasilar hemodynamics in patients who complain of dizziness and vertigo. It is reported that vertebrobasilar artery insufficiency (VBI) leads to brainstem and cerebellar ischemia and infarction following cervical manipulation. Here we examined the correlation between vertigo or dizziness and the right and left side difference in vertebral arteries after whiplash injury using MRA. We studied 20 patients who complained of neck pain with vertigo or dizziness after whiplash injury and 13 healthy volunteers as a control. In the control group, abnormal MRA findings in the vertebral arteries such as occlusion, stenosis or slow blood flow were seen in 77% of the cases. In the patient group, abnormal MRA findings were seen in 60%. The side difference in blood flow was 3.5+/-2.5 cm/s in the control group and 6.1+/-3.0 cm/s in the patient group. Our findings suggest that some subjects with persistent vertigo or dizziness after whiplash injury are more likely to have VBI on MRA. VBI might be an important background factor to evoke cervical vertigo or dizziness after whiplash injury. The side difference between the two vertebral arteries could cause a circulation disorder in the vertebrobasilar system after whiplash injury. However, the VBI on MRA itself was also seen in the control group, and thus it is not clear whether it is due to whiplash injury in the patient group.

  7. Migraine-related vertigo and somatoform vertigo frequently occur in children and are often associated.

    PubMed

    Langhagen, Thyra; Schroeder, A Sebastian; Rettinger, Nicole; Borggraefe, Ingo; Jahn, Klaus

    2013-02-01

    Migraine-related syndromes are a common cause of episodic vertigo and dizziness in children. Somatoform vertigo (SV) is an important cause of chronic dizziness, especially in adolescents. Our aim was to elucidate the comorbidity of migraine and SV. Three diagnostic groups were defined: migraine-related vertigo (MRV), SV, and combined migraine-related and SV (MSV). A retrospective analysis was performed on patient data (demographics, diagnosis, neuro-orthoptic and neurologic status, and results of vestibular and balance testing) from 168 patients who were presented to the German Center for Vertigo and Balance Disorders (IFB) over a 2.5-year period. Mean age of patients was 12 ± 4 years (range: 1.4 to 18 years). The most frequent diagnosis was MRV (28%), followed by MSV (19%) and SV (14%). MSV occurred most frequently in adolescent girls (25%). MRV was the most common cause of dizziness in our cohort. MSV ranked second overall but ranked first in adolescent girls, followed by isolated SV. SV was most prevalent in adolescent girls. MRV, MSV, and SV account for about 60% of diagnoses established in our tertiary referral center. Competent care of childhood migraine should include skill in detecting both the clinical symptoms of vertigo and overlapping somatoform symptoms.

  8. Vertigo in downhill mountain biking and road cycling.

    PubMed

    Lion, Alexis; Vibert, Dominique; Bosser, Gilles; Gauchard, Gérome C; Perrin, Philippe P

    2016-01-01

    Vertigo has been described after the practice of mountain bike. This study aimed to investigate the prevalence of vertigo following competitions or training sessions of downhill mountain biking (DMB) or road cycling (RC). One hundred and two DMB riders, 79 road cyclists and 73 control participants filled in a survey intended to evaluate the prevalence of vertigo in daily living activities and following competitions or training sessions. Vertigo causal factors (crashes, head trauma, fatigue, characteristics of the path/road ridden) were recorded. DMB riders and road cyclists did not report more vertigo during daily living activities than controls. But DMB riders older than 30 had more risk to report vertigo than age-matched road cyclists (OR: 5.06, 95% CI: 1.23-20.62). Road cyclists aged between 20 and 29 were 2.59-fold (95% CI: 1.06-6.27) more likely to report vertigo than controls. After competitions and training sessions, DMB riders were 2.33-fold (95% CI: 1.22-4.41) more likely to report vertigo than road cyclists. Vertigo causal factors were crash with head trauma in DMB riders and fatigue in road cyclists. Vertigo during daily living activities may be of concern for cyclists, particularly older DMB riders. The accumulation of impacts (crashes, vibrations) during the career of a DMB rider may generate micro-traumatisms of the central nervous system and/or peripheral vestibular structures, particularly the otolith organs. In RC, the pathophysiological mechanisms generating vertigo might be effort-related disturbance of homeostasis. To avoid injuries, DMB riders should be aware that vertigo may occur at the end of training sessions or competitions. PMID:25495238

  9. Vertigo in downhill mountain biking and road cycling.

    PubMed

    Lion, Alexis; Vibert, Dominique; Bosser, Gilles; Gauchard, Gérome C; Perrin, Philippe P

    2016-01-01

    Vertigo has been described after the practice of mountain bike. This study aimed to investigate the prevalence of vertigo following competitions or training sessions of downhill mountain biking (DMB) or road cycling (RC). One hundred and two DMB riders, 79 road cyclists and 73 control participants filled in a survey intended to evaluate the prevalence of vertigo in daily living activities and following competitions or training sessions. Vertigo causal factors (crashes, head trauma, fatigue, characteristics of the path/road ridden) were recorded. DMB riders and road cyclists did not report more vertigo during daily living activities than controls. But DMB riders older than 30 had more risk to report vertigo than age-matched road cyclists (OR: 5.06, 95% CI: 1.23-20.62). Road cyclists aged between 20 and 29 were 2.59-fold (95% CI: 1.06-6.27) more likely to report vertigo than controls. After competitions and training sessions, DMB riders were 2.33-fold (95% CI: 1.22-4.41) more likely to report vertigo than road cyclists. Vertigo causal factors were crash with head trauma in DMB riders and fatigue in road cyclists. Vertigo during daily living activities may be of concern for cyclists, particularly older DMB riders. The accumulation of impacts (crashes, vibrations) during the career of a DMB rider may generate micro-traumatisms of the central nervous system and/or peripheral vestibular structures, particularly the otolith organs. In RC, the pathophysiological mechanisms generating vertigo might be effort-related disturbance of homeostasis. To avoid injuries, DMB riders should be aware that vertigo may occur at the end of training sessions or competitions.

  10. [Height vertigo, fear of heights, acrophobia].

    PubMed

    Rennert, H

    1990-06-01

    Height vertigo (acrophobia) is a very frequent phenomenon being of interest for its physiological and psychological background, though usually only of limited significance in neuropsychiatry and otology. The different aspects as to its nature and origin are discussed. If acrophobia has developed into a conditioned reaction of avoidance with pressure of suffering, or acrophobia in persons, who have to work at heights, behavior therapeutic measures with systematic desensibilisation, starting from an imaginative training, are indicated.

  11. Bilateral subclavian steal syndrome with vertigo.

    PubMed

    Yamanaka, Toshiaki; Sawai, Yachiyo; Hosoi, Hiroshi

    2014-06-01

    Subclavian steal syndrome (SSS) is usually caused by unilateral subclavian artery (SA) occlusion, and bilateral SSS is very rare. Takayasu's arteritis (TA) is a chronic granulomatous form of vasculitis that affects the SA, most commonly in women aged 15-40 years. We report a rare case of bilateral SSS due to TA in a 52-year-old woman, who exhibited severe vertigo. Although her blood pressure was within the normal range and did not differ between her arms, Doppler ultrasonography revealed low antegrade blood flow in the right SA and retrograde flow in the left SA. Computed tomography angiography demonstrated complete obstruction of the bilateral SA proximal to the vertebral artery origin. The more marked decrease in the blood flow of the vertebrobasilar artery experienced in bilateral SSS compared with unilateral SSS is considered to have caused the severe rotatory vertigo in the present patient. Since the vascular conditions of TA progressively deteriorate, delayed diagnosis and treatment could result in poor outcomes and unfavorable prognosis. We suggest that SSS with TA might require an early detection and treatment as well as careful follow-up for preventing vertigo and other neurological deficits in the vertebrobasilar arterial region.

  12. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans

    PubMed Central

    Alsalman, Ola; Ost, Jan; Vanspauwen, Robby; Blaivie, Catherine; De Ridder, Dirk; Vanneste, Sven

    2016-01-01

    Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic symptoms of vertigo

  13. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans.

    PubMed

    Alsalman, Ola; Ost, Jan; Vanspauwen, Robby; Blaivie, Catherine; De Ridder, Dirk; Vanneste, Sven

    2016-01-01

    Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic symptoms of vertigo

  14. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans.

    PubMed

    Alsalman, Ola; Ost, Jan; Vanspauwen, Robby; Blaivie, Catherine; De Ridder, Dirk; Vanneste, Sven

    2016-01-01

    Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic symptoms of vertigo

  15. Probable Correlation between Temporomandibular Dysfunction and Vertigo in the Elderly

    PubMed Central

    Marchiori, Luciana Lozza de Moraes; Oltramari-Navarro, Paula Vanessa Pedron; Meneses-Barrivieira, Caroline Luiz; Melo, Juliana Jandre; Macedo, Julya; Bruniera, Juliana Ribeiro Zuculin; Gorres, Vanessa Cristina; Navarro, Ricardo de Lima

    2013-01-01

    Introduction Temporomandibular disorder (TMD) covers a variety of clinical problems, and some epidemiologic studies have tried to indicate mechanisms of interaction and association between vertigo and TMD, but this topic still is controversial. Objective To assess the presence of vertigo in elderly patients associated with TMD. Methods A cross-sectional study was conducted with the inclusion of elderly individuals who lived independently. TMD was assessed by dental evaluation and vertigo was verified by medical history. Statistical analysis was performed using the chi-square and relative risk. Results There was a significant association (p = 0.0256) between the TMD and vertigo (odds ratio = 2.3793). Conclusion These results highlighted the importance of identifying risk factors for vertigo that can be modified through specific interventions, which is essential to prevent future episodes, as well as managing the process of rehabilitation of elderly patients in general. PMID:25992063

  16. Did Vertigo Kill America's Forgotten Astronaut?

    NASA Technical Reports Server (NTRS)

    Bendrick, Gregg A.; Merlin, Peter W.

    2007-01-01

    On November 15, 1967, U.S. Air Force test pilot Major Michael J. Adams was killed while flying the X-15 rocket-propelled research vehicle in a parabolic spaceflight profile. This flight was part of a joint effort with NASA. An electrical short in one of the experiments aboard the vehicle caused electrical transients, resulting in excessive workload by the pilot. At altitude Major Adams inappropriately initiated a flat spin that led to a series of unusual aircraft attitudes upon atmospheric re-entry, ultimately causing structural failure of the airframe. Major Adams was known to experience vertigo (i.e. spatial disorientation) while flying the X-15, but all X-15 pilots most likely experienced vertigo (i.e. somatogravic, or "Pitch-Up", illusion) as a normal physiologic response to the accelerative forces involved. Major Adams probably experienced vertigo to a greater degree than did others, since prior aeromedical testing for astronaut selection at Brooks AFB revealed that he had an unusually high degree of labyrinthine sensitivity. Subsequent analysis reveals that after engine burnout, and through the zenith of the flight profile, he likely experienced the oculoagravic ("Elevator") illusion. Nonetheless, painstaking investigation after the mishap revealed that spatial disorientation (Type II, Recognized) was NOT the cause, but rather, a contributing factor. The cause was in fact the misinterpretation of a dual-use flight instrument (i.e. Loss of Mode Awareness), resulting in confusion between yaw and roll indications, with subsequent flight control input that was inappropriate. Because of the altitude achieved on this flight, Major Adams was awarded Astronaut wings posthumously. Understanding the potential for spatial disorientation, particularly the oculoagravic illusion, associated with parabolic spaceflight profiles, and understanding the importance of maintaining mode awareness in the context of automated cockpit design, are two lessons that have direct

  17. Vertigo of cerebrovascular origin proven by CT scan or MRI: pitfalls in clinical differentiation from vertigo of aural origin.

    PubMed

    Kim, G W; Heo, J H

    1996-02-01

    To get a better insight into the clinical differentiation between vertigo of cerebrovascular origin and of aural origin, we investigated radiologically proven stroke patients who presented with vertigo as an initial clinical manifestation. Of 154 stroke patients, 30 patients with vertigo (20%) had the relevant lesion, demonstrated with the initial computerized tomographic scan (13 patients) or the follow-up magnetic resonance imaging (MRI) study (17 patients) of the brain. Every lesion was in the vertebrobasilar arterial territory; 19 in the cerebellum, 8 in the pons, and 3 in the medulla oblongata. Although 12 of the 30 patients (40%) presented with vertigo in isolation at the onset of stroke, eight patients (27%) developed additional neurologic abnormalities from four hours to seven days later. Patients with isolated vertigo (13%) had the small lesion exclusively in the cerebellum of the PICA medial branch territory. The most frequent accompanying neurological sign was swaying in the cerebellar and medullary lesion, and dysarthria in the pontine lesion. The direction of nystagmus or swaying did not match the lesion side in some patients. Our findings suggest that cerebellar stroke may commonly manifest isolated vertigo or vertigo with swaying mimicking labyrinthine disorder, particularly at the onset of the disease. MRI study and tests for truncal ataxia and lateropulsion may be crucial for the detection of vertigo of cerebrovascular origin.

  18. Vertigo after sailing a nineteenth century ship.

    PubMed

    Cohen, H

    1996-01-01

    Few papers describe illusions of motion after sailing for which subjects do not seek medical assistance. After sailing on a square-rigged ship for five-hour periods subjects were surveyed about the incidence, intensity, and quality of such illusions. Even on a calm day, 20% to 41% of the crew experienced post-sailing vertigo, but it only occurred among the nonprofessional sailors. This phenomenon is characterized by extinction with repeated exposure, a lag time to onset of about two hours, brief duration, and occurrence in enclosed visual surrounds. These data are similar to vestibular habituation and suggest that some central vestibular mechanisms may be involved.

  19. [Thinking about vertigo effectiveness evaluation methods in clinical research of Chinese medicine].

    PubMed

    Liu, Hong-mei; Li, Tao

    2014-10-01

    Vertigo is a kind of patients' subjective feelings. The severity of vertigo is closely related to many factors. But we are short of a well accepted quantitative evaluation method capable of accurately and comprehensively evaluating vertigo in clinics. Reducing the onset of vertigo, enhancing the re- covery of equilibrium function, and improving the quality of life of vertigo patients should be taken as the focus of evaluating therapeutic effects. As for establishing a Chinese medical effectiveness evaluation system for vertigo, we believe we should distinguish different "diseases". We could roughly identify it as systemic vertigo and non-systemic vertigo. For systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by UCLA vertigo questionnaire or dizziness handicap inventory combined with equilibrium function testing indices. But for non-systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by taking UCLA vertigo questionnaire or dizziness handicap inventory as main efficacy indices. Secondly, we should analyze different reasons for vertigo, choose symptoms and signs in line with vertigo features as well as with Chinese medical theories, and formulate corresponding syndrome effectiveness standards according to different diseases. We should not simply take syndrome diagnosis standards as efficacy evaluation standards.

  20. Jugulotympanic Paraganglioma: A Rare Cause of Vertigo

    PubMed Central

    Jehangir, Asad; Pathak, Ranjan; Shaikh, Bilal; Salman, Ahmed; Fareedy, Shoaib Bilal; Qureshi, Anam; Jehangir, Qasim; Alweis, Richard

    2015-01-01

    Patient: Female, 83 Final Diagnosis: Jugulotympanic paraganglioma Symptoms: Dizziness • tinnitus Medication: — Clinical Procedure: — Specialty: Oncology Objective: Rare disease Background: Jugulotympanic paraganglioma generally presents in the 5th or 6th decades of life with tinnitus and hearing loss. In this manuscript, we present a rare case of jugulotympanic paraganglioma presenting in the 9th decade with vertigo as the most bothersome symptom. Case Report: An 83-year-old woman presented with worsening episodes of dizziness of a few months duration. She also complained of tinnitus and hearing loss, more severe on the left side. Examination revealed a red bulging left-sided tympanic membrane, conductive hearing loss, and a bruit at the base of the skull. Dix-Hallpike test was negative. CT head and MRI brain revealed findings consistent with a large left-sided jugulotympanic paraganglioma, which was found to be hormonally inactive on laboratory tests. The patient underwent treatment with radiotherapy, which resulted in partial improvement of symptoms. Conclusions: Jugulotympanic paraganglioma may manifest in the elderly with the chief complaint of intermittent vertigo, as in our case. A red bulging mass on otoscopy raises the suspicion, necessitating further investigations, including CT and MRI. PMID:25889842

  1. Vertigo with a Vestibular Dysfunction in Children During Respiratory Tract Infections.

    PubMed

    Dzięciołowska-Baran, E A; Gawlikowska-Sroka, A

    2015-01-01

    Sudden balance disorders with violent vegetative symptoms (nausea and vomiting) pose a diagnostic and therapeutic problem. In children vertigo/dizziness with symptoms of vestibular dysfunction is rare, but as vascular etiology is unlikely in children such symptoms arouse concern. This article presents two cases of this type of vertigo. The patients were two boys (6 and 9 years old). They came down with similar symptoms: sudden dizziness, disabled walking, nausea and vomiting, spontaneous nystagmus, and a positive Romberg test. The onset of the balance disorder was preceded by respiratory infection: common cold with symptoms of inflammation of the mucous membrane in the nose and throat. Laboratory tests revealed increased levels of C-reactive protein only in the older boy. Neuroinfection and a displacement process were ruled out. Videonystagmography revealed vestibular dysfunction and vestibular neuronitis on the left side.

  2. Acute Diagnosis and Management of Stroke Presenting Dizziness or Vertigo.

    PubMed

    Lee, Seung-Han; Kim, Ji-Soo

    2015-08-01

    Stroke involving the brainstem and cerebellum frequently presents acute vestibular syndrome. Although vascular vertigo is known to usually accompany other neurologic symptoms and signs, isolated vertigo from small infarcts involving the cerebellum or brainstem has been increasingly recognized. Bedside neuro-otologic examination can reliably differentiate acute vestibular syndrome due to stroke from more benign inner ear disease. Sometimes acute isolated audiovestibular loss may herald impending infarction in the territory of the anterior inferior cerebellar artery. Accurate identification of isolated vascular vertigo is very important because misdiagnosis of acute stroke may result in significant morbidity and mortality.

  3. Isolated rotational vertigo due to internal capsular infarction.

    PubMed

    Park, Kang Min; Shin, Kyong Jin; Ha, Sam Yeol; Park, Jinse; Kim, Sung Eun

    2014-03-01

    Isolated rotational vertigo is most often associated with disorders of the semicircular canals, vestibular nerve, brainstem, or cerebellum but rarely observed following a supratentorial stroke. A 64-year-old man developed sudden onset of vertigo and horizontal right-beating nystagmus with a torsional component in primary and eccentric gazes, unsteady gait, and axial lateropulsion to the right side. Magnetic resonance imaging demonstrated an infarction in the posterior limb of left internal capsule, an unusual cause of the patient's signs and symptoms.

  4. [The clinical features of migraine-associated vertigo].

    PubMed

    Goto, Fumiyuki; Tsutsumi, Tomoko; Ogawa, Kaoru

    2013-08-01

    Migraine-associated vertigo (MAV) is proposed as a new clinical entity on the basis of the assumption that the typical migraine and vertigo or dizziness have a common pathophysiology. Some of the patients with recurrent vertigo syndromes with unknown pathology may have MAV. We performed a retrospective study to clarify the clinical characteristics of MAV in the Japanese population. The following were considered as diagnostic criteria: (1) recurrent vestibular symptoms, (2) migraine headache as defined by the International Headache Society (IHS) criteria, (3) at least one instance of synchronization of a vertiginous attack with a migraine headache, (4) no associated unilateral hearing loss, and (5) absence of other diseases that may have caused vertiginous attacks. Of 552 patients with dizziness or vertigo, 46 (8.3%) were diagnosed as having MAV. A typical feature of this clinical entity is that migraine occurs before the onset of vertigo in women aged 30-40 years. Usually the attacks occur once in a year for 1 to 10 years. An attack lasts for 1-24 h and presents as vertigo and unsteadiness with simultaneous headache. The presence of hearing loss presents an important clinical dilemma. Whether the condition in patients experiencing hearing loss should be defined as MAV or not is still a matter for discussion.

  5. PubMed Central

    CALIFANO, L.; SALAFIA, F.; MAZZONE, S.; MELILLO, M.G.; CALIFANO, M.

    2014-01-01

    SUMMARY Posterior canal benign paroxysmal positional vertigo (BPPV) is the most frequent form of BPPV. It is characterized by a paroxysmal positioning nystagmus evoked through Dix-Hallpike and Semont positioning tests. Anterior canal BPPV (AC) is more rare than posterior canal BPPV; it presents a prevalent down beating positioning nystagmus, with a torsional component clockwise for the left canal, counterclockwise for the right canal. Due to the possible lack of the torsional component, it is sometimes difficult to identify the affected ear. An apogeotropic variant of posterior BPPV (APC) has recently been described, characterised by a paroxysmal positional nystagmus in the opposite direction to the one evoked in posterior canal BPPV: the linear component is down-beating, the torsional component is clockwise for the right canal, counter-clockwise for the left canal, so that a contra-lateral anterior canal BPPV could be simulated. During a 16 month period, of 934 BPPV patients observed, the authors identified 23 (2.5%) cases of apogeotropic posterior canal BPPV and 11 (1.2%) cases of anterior canal BPPV, diagnosed using the specific oculomotor patterns described in the literature. Anterior canal BPPV was treated with the repositioning manoeuvre proposed by Yacovino, which does not require identification of the affected side, whereas apogeotropic posterior canal BPPV was treated with the Quick Liberatory Rotation manoeuvre for the typical posterior canal BPPV, since in the Dix-Hallpike position otoliths are in the same position if they come either from the ampullary arm or from the non-ampullary arm. The direct resolution of BPPV (one step therapy) was obtained in 12/34 patients, 8/23 patients with APC and 4/11 patients with AC; canalar conversion into typical posterior canal BPPV, later treated through Quick Liberatory Rotation (two-step therapy), was obtained in 19 patients,14/23 with APC and 5/11 with AC. Three patients were lost to follow-up. Considering the

  6. "Light cupula" involving all three semicircular canals: A frequently misdiagnosed disorder.

    PubMed

    Kim, Chang-Hee; Shin, Jung Eun; Shin, Dong Hyuk; Kim, Yong Won; Ban, Jae Ho

    2014-11-01

    Though benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder causing positional vertigo, patients with typical positional vertigo in which the findings of positional nystagmus do not meet the diagnostic criteria for BPPV are often encountered in the clinic. Recently a concept of the light cupula was introduced, which accounts for some of positional vertigo. Under a normal condition in which the specific gravity of the cupula is same as that of the surrounding endolymph, semicircular canals (SCCs) are not influenced by the gravity. The light cupula, which indicates cupula with lower specific gravity than the surrounding endolymph, is characterized by persistent geotropic direction-changing positional nystagmus (DCPN) without latency on the supine head-roll test and the presence of a null plane. Unless the duration and pattern of positional nystagmus are carefully examined, the light cupula can be misdiagnosed as other types of BPPV. We present a patient with light cupula on the right side who reported recurrent episodes of positional vertigo and had been diagnosed as BPPV with multiple canal involvement (posterior and lateral SCCs) on the opposite side. In this study, we present the mechanism of typical positional nystagmus patterns in patients with light cupula involving all of the unilateral SCCs, and discuss the possible causes of misdiagnosis of the light cupula.

  7. Lateral medullary ischemia presenting with persistent hiccups and vertigo.

    PubMed

    Mandalà, Marco; Rufa, Alessandra; Cerase, Alfonso; Bracco, Sandra; Galluzzi, Paolo; Venturi, Carlo; Nuti, Daniele

    2010-03-01

    This study describes a patient with lateral medullary ischemia (LMI) presenting with persistent hiccups followed by vertigo with horizontal head-shaking-induced contralesional nystagmus (HSN) and discusses pertinent pathophysiology. A 65-year-old man presented with persistent hiccups and disabling spells of vertigo, lasting 30 seconds that became much more frequent and associated with lateropulsion to the right. A strong left beating HSN was evident. Magnetic resonance imaging and angiography, and intra-arterial cerebral digital subtracted angiography showed subacute ischemic lesions in the right lateral medulla and ipsilateral inferior cerebellar hemisphere, and two tight stenoses of the V1 and V4 segments of the right vertebral artery. Patient was treated by intravenous heparin and oral clopidogrel. After 48 hours, hiccups disappeared. One month later, vertigo spells were less frequent but still disabling. Endovascular stenting of the right vertebral artery stenoses was then performed. In the subsequent four years, the patient had no further episodes of hiccups or vertigo. Less intense HSN persisted. Hiccups followed by vertigo, lateropulsion, and HSN had been the clinical presentation of LMI and cerebellar ischemia, without other major neurologic or ocular motor findings. This unusual clinical variant of LMI could mimic a more benign labyrinthine lesion, and possibly leading to a dangerously delayed treatment.

  8. The migraine: benign paroxysmal vertigo of childhood complex.

    PubMed

    Herraiz, C; Calvin, F J; Tapia, M C; de Lucas, P; Arroyo, R

    1999-01-01

    The migraine--a benign paroxysmal vertigo of childhood complex is the most frequent etiology of pediatric dizziness, with an incidence of 34.7%. We present a series of 34 children in whom this entity was diagnosed. We describe the most important characteristics and discuss the possible etiological factors. We review the theories about a common pathophysiological origin for migraine, benign paroxysmal vertigo of childhood, and paroxysmal torticollis. Evolution of these entities confirms the idea of a common origin and a different vestibular symptomatology, depending on the age of the child experiencing dizziness.

  9. Wallenberg Syndrome: An Exceptional Cause of Acute Vertigo in Children.

    PubMed

    Ehresmann, Aude Ménétrey; Van, Hélène Cao; Merlini, Laura; Fluss, Joel

    2016-01-01

    The assessment of acute vertigo in childhood is often challenging, but fortunately a central cause is rarely identified. We present the case of a 7-year-old boy who developed, after a mild head trauma, a rotary vertigo associated with nausea and vomiting. A posttraumatic peripheral vestibular dysfunction was first suspected but not confirmed by an otoneurological evaluation. When subtle neurological signs were elicited, a brain magnetic resonance imaging was promptly requested. This showed a small infarct on the lateral posterior left part of the medulla oblongata of the brainstem, typical of Wallenberg syndrome. Vascular imaging was normal and no defined etiology was found. The child was started on prophylactic acetylsalicylic acid. The rapid disappearance of vertigo was noted. On follow-up at 6 months, there has been no recurrence and neurological examination was fully normal. Our case extends the differential diagnosis of acute vertigo in childhood that rarely includes the possibility of a brainstem infarct whose recognition through appropriate clinical examination is nevertheless capital for appropriate investigations and management.

  10. Sound induced vertigo: superior canal dehiscence resulting from blast exposure.

    PubMed

    Mehlenbacher, Adam; Capehart, Bruce; Bass, Dale; Burke, James R

    2012-04-01

    Barotrauma is common in modern warfare. We present the first description of sound induced vertigo caused by superior canal dehiscence (SCD) precipitated by blast exposure. Patients who complain of balance or visual changes after military or terrorist blast exposure should be evaluated for SCD.

  11. Clinical and electrographic findings in epileptic vertigo and dizziness

    PubMed Central

    Lee, Seung-Han; Robinson, Karen A.; Kaplan, Peter W.; Newman-Toker, David E.

    2015-01-01

    Objective: Seizures can cause vestibular symptoms, even without obvious epileptic features. We sought to characterize epileptic vertigo or dizziness (EVD) to improve differentiation from nonepileptic causes, particularly when vestibular symptoms are the sole manifestation. Methods: We conducted a systematic review with electronic (Medline) and manual search for English-language studies (1955–2014). Two independent reviewers selected studies. Study/patient characteristics were abstracted. We defined 3 study population types: (1) seizures, some experiencing vertigo/dizziness (disease cohort); (2) vertigo/dizziness, some due to seizures (symptom cohort); (3) vertigo/dizziness due to seizures in all patients (EVD-only cohort). Results: We identified 84 studies describing 11,354 patients (disease cohort = 8,129; symptom cohort = 2,965; EVD-only cohort = 260). Among 1,055 EVD patients in whom a distinction could be made, non-isolated EVD was present in 8.5%, isolated EVD in 0.8%. Thorough diagnostic workups (ictal EEG, vestibular testing, and brain MRI to exclude other causes) were rare (<0.1%). Ictal EEG was reported in 487 (4.3%), formal neuro-otologic assessment in 1,107 (9.7%). Localized EEG abnormalities (n = 350) were most frequently temporal (79.8%) and uncommonly parietal (11.8%). Duration of episodic vestibular symptoms varied, but was very brief (<30 seconds) in 69.6% of isolated EVD and 6.9% of non-isolated EVD. Conclusions: Non-isolated EVD is much more prevalent than isolated EVD, which appears to be rare. Diagnostic evaluations for EVD are often incomplete. EVD is primarily associated with temporal lobe seizures; whether this reflects greater epidemiologic prevalence of temporal lobe seizures or a tighter association with dizziness/vertigo presentations than with other brain regions remains unknown. Consistent with clinical wisdom, isolated EVD spells often last just seconds, although many patients experience longer spells. PMID:25795644

  12. Dizziness Handicap Inventory and Visual Vertigo Analog Scale in Vestibular Dysfunction

    PubMed Central

    Grigol, Thaís Alvares de Abreu e Silva; Silva, Adriana Marques; Ferreira, Maristela Mian; Manso, Andrea; Ganança, Maurício Malavasi; Caovilla, Heloisa Helena

    2015-01-01

    Introduction  Dizziness is one of the most common symptoms among the population, producing numerous consequences for individual's quality of life. There are some questionnaires that can trace the patient's profile and quality of life impairment from dizziness, including the Dizziness Handicap Inventory (DHI) and the Visual Vertigo Analogue Scale (VVAS). Objective  This study aims to correlate the results of the DHI and VVAS in patients with vestibular dysfunction. Methods  This is a retrospective study of medical records of patients treated in a medical school between 2006 and 2012. Results of the DHI and EVA were collected and subjected to statistical analysis using Pearson's correlation test with p < 0.001. The significance level adopted for the statistical tests was p ≤ 0.05. Results  A total of 91 records were included in this study, 72 (79.1%) from female and 19 (20.9%) from male patients, aged 23 to 86 years, with a mean age of 52.5 years. The mean score on the DHI total was 43.9 and 5.2 points for the EVA. The result of Pearson's correlation test was 0.54. Conclusion  Self-perceived dizziness measured with the Dizziness Handicap Inventory has a regular and positive correlation with the Visual Vertigo Analog Scale in patients with vestibular dysfunction. The clinical trial is registered under number UTN U1111–1170–5065. PMID:27413406

  13. Acute vertigo due to hemispheric stroke: a case report and comprehensive review of the literature.

    PubMed

    von Brevern, Michael; Süßmilch, Sina; Zeise, Daniel

    2014-04-15

    Acute cortical lesions rarely cause vertigo. We report a 51-year-old patient presenting with an acute vestibular syndrome including spontaneous vertigo and nystagmus, lateropulsion and nausea due to middle cerebral artery infarction. The central origin of the acute vestibular syndrome was revealed by a normal head impulse test. A comprehensive literature review on patients with hemispheric stroke manifesting with acute vertigo is provided. Typically, patients with an acute vestibular syndrome due to cortical stroke have involvement of the temporoparietal junction.

  14. [Severe vertigo after a scuba-dive to 29 meters].

    PubMed

    Frigg, C; Stepanek, J; Gmür, A

    2004-04-28

    A 27-year-old flight instructor experienced 5 to 10 minutes after a scuba-dive to 29 m, which lasted totally 50 minutes, dizziness, nausea and severe vertigo. The symptoms lasted about an hour. The patient vomited several times and noted sudden onset headache and vertigo lasting the following three days. Hyperbaric oxygen therapy was started 30 hours after the event because decompression sickness was suspected. Transthoracic echocardiographic evaluation showed a patent foramen ovale. Diving accidents may be caused by decompression sickness, the formation of a free intravascular gas phase (bubbles) may result in transatrial shunting in the presence of a patent foramen ovale and may lead to neurological signs and symptoms. In this context the diver was advised to undergo closure of the atrial septal defect. Five months after the incident the patient underwent successful transcatheter occlusion of the PFO.

  15. [Vertigo in the Emergency Department: new bedside tests].

    PubMed

    Tamás, T László; Garai, Tibor; Tompos, Tamás; Szirmai, Ágnes

    2016-03-13

    According to international statistics, the first examination of 25% of patients with vertigo is carried out in Emergency Departments. The most important task of the examining physician is to diagnose life threatening pathologic processes. One of the most difficult otoneurological diagnostic challange in Emergency Departments is to differentiate between dangerous posterior scale stroke presenting with isolated vertigo and the benign vestibular neuritis.These two disorders can be safely differentiated using fast, non-invasive, evidence based bedside tests which have been introduced in the past few years. 35% of stroke cases mimicking vestibular neuritis (pseudoneuritis) are misdiagnosed at the Emergency Department, and 40% of these cases develop complications. During the first 48 hours, sensitivity for stroke of the new test that is based on the malfunction of the oculomotor system is better than the diffusion-weighted cranial magnetic resonance imaging. Using special test glasses each component of the new test can be made objective and repeatable.

  16. Persistent vertigo and dizziness after mild traumatic brain injury.

    PubMed

    Fife, Terry D; Kalra, Deepak

    2015-04-01

    Vertigo, dizziness, and disequilibrium are common symptoms following concussion or mild traumatic brain injury (mTBI). Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner-ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine-preventative medications. This paper reviews the nonotogenic causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

  17. Vertigo in virtual reality with haptics: case report.

    PubMed

    Viirre, Erik; Ellisman, Mark

    2003-08-01

    A researcher was working with a desktop virtual environment system. The system was displaying vector fields of a cyclonic weather system, and the system incorporated a haptic display of the forces in the cyclonic field. As the subject viewed the rotating cyclone field, they would move a handle "through" the representation of the moving winds and "feel" the forces buffeting the handle as it moved. Stopping after using the system for about 10 min, the user experienced an immediate sensation of postural instability for several minutes. Several hours later, there was the onset of vertigo with head turns. This vertigo lasted several hours and was accompanied with nausea and motion illusions that exacerbated by head movements. Symptoms persisted mildly the next day and were still present the third and fourth day, but by then were only provoked by head movements. There were no accompanying symptoms or history to suggest an inner ear disorder. Physical examination of inner ear and associated neurologic function was normal. No other users of this system have reported similar symptoms. This case suggests that some individuals may be susceptible to the interaction of displays with motion and movement forces and as a result experience motion illusions. Operators of such systems should be aware of this potential and minimize exposure if vertigo occurs. PMID:14511456

  18. Betahistine treatment in managing vertigo and improving vestibular compensation: clarification.

    PubMed

    Lacour, Michel

    2013-01-01

    Betahistine dihydrochloride (betahistine) is currently used in the management of vertigo and vestibular pathologies with different aetiologies. The main goal of this review is to clarify the mechanisms of action of this drug, responsible for the symptomatic relief of vertigo and the improvement of vestibular compensation. The review starts with a brief summary recalling the role of histamine as a neuromodulator/neurotransmitter in the control of the vestibular functions, and the role of the histaminergic system in vestibular compensation. Then are presented data recorded in animal models demonstrating that betahistine efficacy can be explained by mechanisms targeting the histamine receptors (HRs) at three different levels: the vascular tree, with an increase of cochlear and vestibular blood flow involving the H1R; the central nervous system, with an increase of histamine turnover implicating the H3R, and the peripheral labyrinth, with a decrease of vestibular input implying the H3R/H4R. Clinical data from vestibular loss patients show the impact of betahistine treatment for the long-term control of vertigo, improvement of balance and quality of life that can be explained by these mechanisms of action. However, two conditions, at least, are required for reaching the betahistine therapeutic effect: the dose and the duration of treatment. Experimental and clinical data supporting these requirements are exposed in the last part of this review.

  19. Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

    PubMed

    Kim, Hyun-Ah; Yi, Hyon-Ah; Lee, Hyung

    2015-11-01

    Orthostatic hypotension (OH), a proxy for sympathetic adrenergic failure, is the most incapacitating sign of autonomic failure. Orthostatic dizziness (OD) is known to be the most common symptom of OH. However, recent studies have demonstrated that 30-39 % of patients with OH experienced rotatory vertigo during upright posture (i.e., orthostatic vertigo, OV), which challenges the dogma that OH induces dizziness and not vertigo. A recent population-based study on spontaneously occurring OD across a wide age range showed that the one-year and lifetime prevalence of OD was 10.9 and 12.5 %, respectively. Approximately 83 % of patients with OD had at least one abnormal autonomic function test result. So far, 11 subtypes of OD have been proposed according to the pattern of autonomic dysfunction, and generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions was the most common type. Four different patterns of OH, such as classic, delayed, early, and transient type have been found in patients with OD. The head-up tilt test and Valsalva maneuver should be performed for a comprehensive evaluation of sympathetic adrenergic failure in patients with OD/OV. This review summarizes current advances in OH presenting OD/OV, with a particular focus on the autonomic dysfunction associated with OD.

  20. [Vertigo/dizziness and syncope from a neurological perspective].

    PubMed

    Machetanz, J

    2015-01-01

    Vertigo/dizziness and syncope are among the most frequent clinical entities encountered in neurology. In patients with presumed syncope, it is important to distinguish it from neurological and psychiatric diseases causing a transient loss of consciousness due to another etiology. Moreover, central nervous disorders of autonomic blood pressure regulation as well as affections of the peripheral autonomic nerves can be responsible for the onset of real syncope. This is particularly relevant in recurrent syncope. Vertigo occurs in the context of temporary disorders, relatively harmless diseases associated with chronic impairment, as well as in acute life-threatening states. Patient history and clinical examination play an important role in classifying these symptoms. It is of crucial importance in this context, e.g., to establish whether the patient is experiencing an initial manifestation or whether such episodes have been known to occur recurrently over a longer period of time, as well as how long the episodes last. Clinical investigations include a differential examination of the oculomotor system with particular regard to nystagmus. The present article outlines the main underlying neurological diseases associated with syncope and vertigo, their relevant differential diagnoses as well as practical approaches to their treatment.

  1. Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

    PubMed

    Kim, Hyun-Ah; Yi, Hyon-Ah; Lee, Hyung

    2015-11-01

    Orthostatic hypotension (OH), a proxy for sympathetic adrenergic failure, is the most incapacitating sign of autonomic failure. Orthostatic dizziness (OD) is known to be the most common symptom of OH. However, recent studies have demonstrated that 30-39 % of patients with OH experienced rotatory vertigo during upright posture (i.e., orthostatic vertigo, OV), which challenges the dogma that OH induces dizziness and not vertigo. A recent population-based study on spontaneously occurring OD across a wide age range showed that the one-year and lifetime prevalence of OD was 10.9 and 12.5 %, respectively. Approximately 83 % of patients with OD had at least one abnormal autonomic function test result. So far, 11 subtypes of OD have been proposed according to the pattern of autonomic dysfunction, and generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions was the most common type. Four different patterns of OH, such as classic, delayed, early, and transient type have been found in patients with OD. The head-up tilt test and Valsalva maneuver should be performed for a comprehensive evaluation of sympathetic adrenergic failure in patients with OD/OV. This review summarizes current advances in OH presenting OD/OV, with a particular focus on the autonomic dysfunction associated with OD. PMID:26292788

  2. Neutrophil-to-lymphocyte ratio in patients with peripheral vertigo: a prospective controlled clinical study.

    PubMed

    Ozbay, Isa; Kahraman, Cuneyt; Balikci, Hasan Huseyin; Kucur, Cuneyt; Kahraman, Nilufer Kuzeyli; Ozkaya, Derya Pınar; Oghan, Fatih

    2014-01-01

    We aimed to investigate the relationship between peripheral vertigo and inflammation by using the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker. We recruited 103 patients with peripheral vertigo (71 women, 32 men; mean age, 39.8 ± 14.7 years) who presented to the Otolaryngology Department of Dumlupinar University Hospital. Vertigo patients with systemic diseases, neurological disorders, malignancy or any inflammatory disease that could alter the NLR were excluded from the study. We also enrolled 103 age- and sex-matched healthy subjects (controls; 82 women, 21 men; mean age, 36.7 ± 13.5 years) who underwent routine checkups in our hospital. The vertigo patients underwent full otolaryngologic and neurologic examinations and audiometric tests to rule out any other pathology causing the peripheral vertigo. NLR was calculated in all subjects and was compared between the patient and control groups. There were no significant differences between the study and control groups in terms of lipid profiles, liver-function tests, white blood cell (WBC) count, hemoglobin level, mean platelet volume, and vitamin B12 and folate levels. The mean NLR was significantly higher in the patients than in the controls (P<0.05). In conclusion, this study, which was the first to investigate the relationship between the NLR and peripheral vertigo, found that the NLR is significantly higher among peripheral vertigo patients than among healthy controls. This result suggests that the NLR is a novel potential marker of stress in peripheral vertigo patients.

  3. The predominant forms of vertigo in children and their associated findings on balance function testing.

    PubMed

    McCaslin, Devin L; Jacobson, Gary P; Gruenwald, Jill M

    2011-04-01

    This article reports vestibular laboratory findings from the most common disorders known to cause dizziness and vertigo in children. Specific information regarding migraine, trauma, benign paroxysmal vertigo of childhood, vestibular neuritis, and otitis media is reviewed, along with indications for balance function testing in children.

  4. Early Diagnosis and Management of Acute Vertigo from Vestibular Migraine and Ménière's Disease.

    PubMed

    Seemungal, Barry; Kaski, Diego; Lopez-Escamez, Jose Antonio

    2015-08-01

    Vestibular migraine is the most common cause of acute episodic vestibular symptoms after benign paroxysmal positional vertigo. In contrast, Ménière's disease is an uncommon disorder. For both conditions, early and accurate diagnosis (or its exclusion) enables the correct management of patients with acute episodic vestibular symptoms. Long-term management of migraine requires changes in lifestyle to avoid triggers of migraine and/or prophylactic drugs if attacks become too frequent. The long-term management of Ménière's disease also involves lifestyle changes (low salt diet), medications (betahistine, steroids), and ablative therapy applied to the diseased ear (eg, intratympanic gentamicin).

  5. Cervicogenic vertigo treated by c1 transverse foramen decompression : a case report.

    PubMed

    Park, Junhee; Lee, Chulkyu; You, Namkyu; Kim, Sanghyun; Cho, Kihong

    2014-09-01

    Cervicogenic vertigo was known as Bow hunter's syndrome. Occlusion of vertebral artery causes vertebrobasilar insufficiency and we reported cervicogenic vertigo case which was treated by simple decompression of transverse foramen of C1. The patient was 48 years old female who had left side dominant vertebral artery and vertigo was provoked when she rotated her head to right side. Angiography showed complete obliteration of blood flow of left vertebral artery when her head was rotated to right side. The operation was decompression of left vertebral artery at C1 level. Posterior wall of transverse foramen was resected and vertebral artery was exposed and decompressed. After surgery, vertigo of the patient was disappeared, and angiography showed patent left vertebral artery when her head was rotated to right side. Vertigo caused by compression of cervical vertebral artery could be treated by decompression without fusion or instrumentation, especially in C1 transverse foramen. PMID:25346772

  6. The RAVE/VERTIGO vertex reconstruction toolkit and framework

    NASA Astrophysics Data System (ADS)

    Waltenberger, W.; Mitaroff, W.; Moser, F.; Pflugfelder, B.; Riedel, H. V.

    2008-07-01

    A detector-independent toolkit for vertex reconstruction (RAVE1) is being developed, along with a standalone framework (VERTIGO2) for testing, analyzing and debugging. The core algorithms represent state-of-the-art for geometric vertex finding and fitting by both linear (Kalman filter) and robust estimation methods. Main design goals are ease of use, flexibility for embedding into existing software frameworks, extensibility, and openness. The implementation is based on modern object-oriented techniques, is coded in C++ with interfaces for Java and Python, and follows an open-source approach. A beta release is available.

  7. Psychometric properties of the Vertigo symptom scale – Short form

    PubMed Central

    Wilhelmsen, Kjersti; Strand, Liv Inger; Nordahl, Stein Helge G; Eide, Geir Egil; Ljunggren, Anne Elisabeth

    2008-01-01

    Background The aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian. Methods A cross-sectional survey design was used to examine the factor structure, internal consistency and discriminative ability (sample I, n = 503). A cross-sectional pre-intervention design was used to examine the construct validity (sample II, n = 36) of the measure and a test-retest design was used to examine reliability (sub-sample of sample II, n = 28). Results The scree plot indicated a two factor structure accounting respectively for 41% and 12% of the variance prior to rotation. The factors were related to vertigo-balance (VSS-V) and autonomic-anxiety (VSS-A). Twelve of the items loaded clearly on either of the two dimensions, while three items cross-loaded. Internal consistency of the VSS-SF was high (alpha = 0.90). Construct validity was indicated by correlation between path length registered by platform posturography and the VSS-V (r = 0.52), but not with the VSS-A. The ability to discriminate between dizzy and not dizzy patients was excellent for the VSS-SF and sub-dimension VSS-V (area under the curve 0.87 and 0.91, respectively), and acceptable for the sub-dimension VSS-A (area under the curve 0.77). High test-retest reliability was demonstrated (ICC VSS-SF: 0.88, VSS-V: 0.90, VSS-A: 0.90) and no systematic change was observed in the scores from test to retest after 2 days. Conclusion Using a Norwegian translated version of the VSS-SF, this is the first study to provide evidence of the construct validity of this instrument demonstrating a stable two factor structure of the scale, and the identified sub-dimensions of dizziness were related to vertigo-balance and autonomic-anxiety, respectively. Evidence regarding a physical construct underlying the vertigo-balance sub-scale was provided. Satisfactory internal consistency was

  8. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    PubMed Central

    Greco, A.; Macri, G. F.; Gallo, A.; Fusconi, M.; De Virgilio, A.; Pagliuca, G.; Marinelli, C.; de Vincentiis, M.

    2014-01-01

    Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes. PMID:24741601

  9. Evaluation of vertigo by auditory brain stem response.

    PubMed

    Welsh, Louis W; Welsh, John J; Rosen, Laurie G

    2002-08-01

    The authors examined the hypothesis that abnormal patterns of the auditory brain stem response (ABR) could supplement the neuro-otological evaluation and assist in localizing the site of vestibulocerebellar dysfunction. This project is based upon the fact that the sources of waves I through V have been regionally identified. Absent or delayed patterns can be referenced to the normal data, and the site of a lesion generating vertigo can be established. We found absence of waves or prolonged interpeak latencies in 25% of the vertiginous subjects with normal hearing and magnetic resonance images of the brain. We conclude that in selected cases, lesions affecting the vestibular system can influence the ABR, and the electrophysiological tests of audition may suggest regionalization of the dysfunction in the hindbrain and midbrain. PMID:12184596

  10. Acute vertigo in an anesthesia provider during exposure to a 3T MRI scanner.

    PubMed

    Gorlin, Andrew; Hoxworth, Joseph M; Pavlicek, William; Thunberg, Christopher A; Seamans, David

    2015-01-01

    Vertigo induced by exposure to the magnetic field of a magnetic resonance imaging (MRI) scanner is a well-known phenomenon within the radiology community but is not widely appreciated by other clinical specialists. Here, we describe a case of an anesthetist experiencing acute vertigo while providing sedation to a patient undergoing a 3 Tesla MRI scan. After discussing previous reports, and the evidence surrounding MRI-induced vertigo, we review potential etiologies that include the effects of both static and time-varying magnetic fields on the vestibular apparatus. We conclude our review by discussing the occupational standards that exist for MRI exposure and methods to minimize the risks of MRI-induced vertigo for clinicians working in the MRI environment. PMID:25792858

  11. Vestibular Migraine (a.k.a.Migraine Associated Vertigo or [MAV])

    MedlinePlus

    ... is a Top Rated Nonprofit! Volunteer. Donate. Review. Vestibular Migraine (a.k.a. Migraine Associated Vertigo or ... Wackym on his You Tube Channel. Migraine and vestibular dysfunction Approximately 40% of migraine patients have some ...

  12. Acute vertigo in an anesthesia provider during exposure to a 3T MRI scanner

    PubMed Central

    Gorlin, Andrew; Hoxworth, Joseph M; Pavlicek, William; Thunberg, Christopher A; Seamans, David

    2015-01-01

    Vertigo induced by exposure to the magnetic field of a magnetic resonance imaging (MRI) scanner is a well-known phenomenon within the radiology community but is not widely appreciated by other clinical specialists. Here, we describe a case of an anesthetist experiencing acute vertigo while providing sedation to a patient undergoing a 3 Tesla MRI scan. After discussing previous reports, and the evidence surrounding MRI-induced vertigo, we review potential etiologies that include the effects of both static and time-varying magnetic fields on the vestibular apparatus. We conclude our review by discussing the occupational standards that exist for MRI exposure and methods to minimize the risks of MRI-induced vertigo for clinicians working in the MRI environment. PMID:25792858

  13. Anterior and posterior inferior cerebellar artery infarction with sudden deafness and vertigo.

    PubMed

    Murakami, Takenobu; Nakayasu, Hiroyuki; Doi, Mitsuru; Fukada, Yasuyo; Hayashi, Miwa; Suzuki, Takeo; Takeuchi, Yuichi; Nakashima, Kenji

    2006-12-01

    We report a patient with anterior and posterior inferior cerebellar artery infarction, which manifested as profound deafness, transient vertigo, and minimal cerebellar signs. We suspect that ischaemia of the left internal auditory artery, which originates from the anterior inferior cerebellar artery, caused the deafness and transient vertigo. A small lesion in the middle cerebellar peduncle in the anterior inferior cerebellar artery territory and no lesion in the dentate nucleus in the posterior inferior cerebellar artery territory are thought to explain the minimal cerebellar signs despite the relatively large size of the infarction. Thus a relatively large infarction of the vertebral-basilar territory can manifest as sudden deafness with vertigo. Neuroimaging, including magnetic resonance imaging, is strongly recommended for patients with sudden deafness and vertigo to exclude infarction of the vertebral-basilar artery territory.

  14. Consumer Demand for Online Dizziness Information: If You Build it, They may Come

    PubMed Central

    Kerber, Kevin A.; Skolarus, Lesli E.; Callaghan, Brian C.; Zheng, Kai; Zhang, Yuhao; An, Lawrence C.; Burke, James F.

    2014-01-01

    Objective: Dizziness is a common reason patients present to doctors, but effective diagnostic tests and treatments for dizziness are underused. The internet is a way to disseminate medical information and is emerging as an intervention platform. The objective of this study was to describe internet searches for dizziness terms to assess the possible consumer demand for internet-based dizziness diagnostic and treatment tools. Study Design/Methods: Google AdWords and Google Insights for Search were used for keyword search data on the following generic terms: vertigo, dizzy, dizziness, lightheaded, and lightheadedness. Data collected included keyword ideas (i.e., additional keywords identified by Google as being related search terms), global and US only monthly search frequencies, as well as trends in top searches related to dizziness terms from 2004 to 2012. Keywords suggestive of benign paroxysmal positional vertigo (BPPV) or BPPV processes were identified. Results: Of the five generic dizziness terms, vertigo had the most global searches per month (1.83 million) and lightheadedness had the least (90,500). Four BPPV-specific terms had more than 100,000 global searches per month. Three BPPV terms (“positional vertigo,” “benign vertigo,” and “benign positional vertigo”) have been in the list of top searches related to vertigo every quarter since 2004. Conclusion: Substantial demand exists for dizziness information via the internet. Future studies should seek to better characterize the population seeking this information. The magnitude of this potential demand suggests that validated and tested diagnostic and treatment tools could contribute to healthcare efficiencies and patient outcomes. PMID:24795690

  15. Effect of edaravone on acute brainstem-cerebellar infarction with vertigo and sudden hearing loss.

    PubMed

    Inoue, Yuta; Yabe, Takao; Okada, Kazunari; Nakamura, Yuka

    2014-06-01

    We report 2 cases with acute brainstem and brainstem-cerebellar infarction showed improvement of their signs and symptoms after administration of edaravone. Case 1, a 74-year-old woman who experienced sudden vertigo, also had dysarthria and left hemiplegia. Magnetic resonance imaging (MRI) showed an abnormal region in the right ventrolateral medulla oblongata. The patient's vertigo and hemiplegia improved completely after treatment. Case 2, a 50-year-old man who experienced sudden vertigo and sensorineural hearing loss (SNHL), developed dysarthria after admission. MRI revealed acute infarction in the right cerebellar hemisphere. Magnetic resonance angiography revealed dissection of the basilar artery and occlusion of the right anterior inferior cerebellar artery. The patient's vertigo and hearing remarkably improved. We have described 2 patients whose early symptoms were vertigo and sudden SNHL, but who were later shown to have ischemic lesions of the central nervous system. Edaravone is neuroprotective drug with free radical-scavenging actions. Free radicals in the ear are responsible for ischemic damage. Edaravone, a free radical scavenger, may be useful in the treatment of vertigo and SNHL.

  16. DIZZYNET--a European network initiative for vertigo and balance research: visions and aims.

    PubMed

    Zwergal, Andreas; Brandt, Thomas; Magnusson, Mans; Kennard, Christopher

    2016-04-01

    Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo often receive either inappropriate or inadequate treatment. The most important reasons for this deplorable situation are insufficient interdisciplinary cooperation, nonexistent standards in diagnostics and therapy, the relatively rare translations of basic science findings to clinical applications, and the scarcity of prospective controlled multicenter clinical trials. To overcome these problems, the German Center for Vertigo and Balance Disorders (DSGZ) started an initiative to establish a European Network for Vertigo and Balance Research called DIZZYNET. The central aim is to create a platform for collaboration and exchange among scientists, physicians, technicians, and physiotherapists in the fields of basic and translational research, clinical management, clinical trials, rehabilitation, and epidemiology. The network will also promote public awareness and help establish educational standards in the field. The DIZZYNET has the following objectives as regards structure and content: to focus on multidisciplinary translational research in vertigo and balance disorders, to develop interdisciplinary longitudinal and transversal networks for patient care by standardizing and personalizing the management of patients, to increase methodological competence by implementing common standards of practice and quality management, to internationalize the infrastructure for prospective multicenter clinical trials, to increase recruitment capacity for clinical trials, to create a common data base for patients with vertigo and balance disorders, to offer and promote attractive educational and career paths in a network of cooperating institutions. In the long term, the DIZZYNET should serve as an internationally visible network for interdisciplinary and multiprofessional research on vertigo and balance disorders. It ideally should equally attract the afflicted patients and

  17. Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study.

    PubMed

    Obermann, Mark; Bock, Eva; Sabev, Nikolay; Lehmann, Nils; Weber, Ralph; Gerwig, Marcus; Frings, Markus; Arweiler-Harbeck, Diana; Lang, Stephan; Diener, Hans-Christoph

    2015-09-01

    To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23%), benign peripheral paroxysmal vertigo (14.4%), unilateral vestibulopathy (10.5%), central vestibular disorders (8%), Menière's disease (9.8%), vestibular migraine (6.9%), bilateral vestibulopathy (5.5%), and vestibular paroxysmia (3.1%). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1% of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably. PMID:26092518

  18. Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study.

    PubMed

    Obermann, Mark; Bock, Eva; Sabev, Nikolay; Lehmann, Nils; Weber, Ralph; Gerwig, Marcus; Frings, Markus; Arweiler-Harbeck, Diana; Lang, Stephan; Diener, Hans-Christoph

    2015-09-01

    To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23%), benign peripheral paroxysmal vertigo (14.4%), unilateral vestibulopathy (10.5%), central vestibular disorders (8%), Menière's disease (9.8%), vestibular migraine (6.9%), bilateral vestibulopathy (5.5%), and vestibular paroxysmia (3.1%). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1% of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.

  19. Alternobaric vertigo in sport SCUBA divers and the risk factors.

    PubMed

    Uzun, Cem; Yagiz, Recep; Tas, Abdullah; Adali, Mustafa K; Inan, Nurkan; Koten, Muhsin; Karasalihoglu, Ahmet R

    2003-11-01

    We investigated the eustachian tube function and the incidence of alternobaric vertigo (AV) in 29 sport self-contained underwater breathing apparatus (SCUBA) divers with, or without, some possible risk factors for AV. The divers had normal audiological and otoscopic findings at the pre-dive examination. We used the nine-step inflation/deflation tympanometric test and Toynbee test for evaluation of eustachian tube function, and the Valsalva manoeuvre for patency. Information on divers, their history, and their otolaryngologic examination were obtained in the pre-dive examination. Divers performed 1086 dives (mean 37, range: 3-100) during the observation period. Four divers (14 per cent) experienced AV during five dives (0.46 per cent), (one diver experienced AV two times). It was found that having an otitis media history or eustachian tube dysfunction determined with the nine-step inflation/deflation tympanometric test before diving, or difficulty in clearing ears during diving could be important risk factors for AV in sport SCUBA divers (p <.05). Divers with such findings seem to be more prone to AV and should pay rigorous attention to the precautions for prevention of AV.

  20. Cinnarizine and dimenhydrinate in the treatment of vertigo in medical practice.

    PubMed

    Scholtz, Arne-Wulf; Ilgner, Justus; Loader, Benjamin; Pritschow, Bernd W; Weisshaar, Gerhard

    2016-05-01

    The efficacy and safety of the fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in the treatment of vertigo of various origins have been investigated in a prospective, noninterventional study involving private practices throughout Germany. A total of 1275 patients with an average age of 61.2 years participated in the study. The vertigo symptoms, measured by a validated mean vertigo score (primary efficacy endpoint) improved by 61 % in the course of the observational period (median: 6 weeks). Concomitant symptoms frequently associated with vertigo such as nausea, vomiting and tinnitus were also markedly reduced by 84, 85 and 51 %, respectively. Overall efficacy has been rated by the physicians as 'very much improved' or 'much improved' in 95 % of the patients. A total of 47 patients (3.7 %) reported 51 adverse drug reactions (all nonserious). The results indicate a good tolerability and efficacy of the fixed combination of cinnarizine and dimenhydrinate in the treatment of vertigo in daily medical practice, which is in line with previous findings of numerous interventional, randomised, double-blind, controlled clinical trials. PMID:26659910

  1. Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial.

    PubMed

    Lepcha, Anjali; Amalanathan, Sophia; Augustine, Ann Mary; Tyagi, Amit Kumar; Balraj, Achamma

    2014-11-01

    Migrainous vertigo is a common cause of dizziness presenting to an otorhinolaryngology/otoneurology clinic. Although it causes a substantial burden to the individual and society there are no randomized controlled trails on prophylactic medication for this condition. Flunarizine, a calcium channel blocker has been used effectively in both migraine and vestibular conditions. This randomized control trial was undertaken in a tertiary academic referral center to evaluate the efficacy of flunarizine in patients with migrainous vertigo when compared to non-specific vestibular treatment of betahistine and vestibular exercises. The effect of flunarizine on two particularly disabling symptoms of vertigo and headache was studied. A total of 48 patients who were diagnosed with definitive migrainous vertigo completed the study of 12 weeks duration. Patients in arm A received 10-mg flunarizine daily along with betahistine 16 mg and paracetamol 1 gm during episodes, and arm B received only betahistine and paracetamol during episodes. Symptom scores were noted at the start of the study and at the end of 12 weeks. Analysis of the frequency of vertiginous episodes showed a significant difference between arm A and arm B (p = 0.010) and improvement in severity of vertigo between the two groups (p = 0.046). Headache frequency and severity did not improve to a significant degree in arm A as compared to arm B. The main side effects were weight gain and somnolence and this was not significantly different between the two groups. Flunarizine (10 mg) is effective in patients with migrainous vertigo who suffer from considerable vestibular symptoms.

  2. Cervicogenic dizziness as a cause of vertigo while swimming: an unusual case report.

    PubMed

    Heidenreich, Katherine D; Beaudoin, Kelly; White, Judith A

    2008-01-01

    We present the unusual case of a competitive swimmer with cervicogenic dizziness manifesting as vertigo while she was surface swimming. This patient complained of brief and episodic room-spinning vertigo consistently associated with swimming the freestyle stroke and was referred to an otolaryngology clinic for evaluation. She did not have significant complaints of neck pain while swimming. Her history, examination findings, laboratory study results, differential diagnoses, and treatment are discussed in detail. A succinct overview of cervicogenic dizziness--a controversial diagnosis often overlooked by otolaryngologists-is also provided. PMID:19144307

  3. [Characteristics and drug analysis associated with vertigo disease in real world].

    PubMed

    Xie, Qian; Li, Yuan-Yuan; Xie, Yan-Ming; Yang, Wei; Zhao, Wei; Zhuang, Yan; Wang, Yong-Yan

    2014-09-01

    To explore the characteristics and influenced factors associated with the onset of vertigo disease, analysis of 3 719 cases of hospitalized patients with vertigo disease from the real world. Analysis the date of patients diagnosed with vertigo disease from the hospital information system of 19 grade-III class-A hospital from 2004 to 2011, include general information, the doctor's advice, other diseases combined, diagnostic information and the relationship with the onset of 24 solar terms, and the treatment drugs. The median age of hospitalized patients with vertigo disease was 59, the number of women (65.91%) was more than men (34.09%), manual workers (85.32%) were the majority career, most patients (81.63%) condition were general by the time they were hospital admission, patients more like admitted to neurologist (70.34%) when they first time to outpatient serves, hospitalization days were in 8-14 days (46.65%), 46.04% of the patients in the hospital total cost is in 5 000 RMB to 10 000 RMB, 73.86% of patients paid by National Health Medical Insurance. Hypertension (20.79%) was the most common underlying health problems, The most common syndromes was deficiency of liver-Yin and kidney-Yin(44. 21%) , followed by hyperactivity of liver-yang, disease of phlegm turbidity in mongolia and deficiency of Qi and blood. There were more deficiency syndrome and less excess syndrome. The highest rate of hospital admission solar terms in 2009 was the insects awaken throttle (5.21%), In 2010, the highest rate solar terms of hospital admission was the rain throttle (6.14%). The most frequently used traditional Chinese medicine was gastrodine injection (20.55%), the most frequently used western medicine for betahistine (10.19%), gastrodine injection was the most traditional Chinese medicine that combination with other western medicine. Hypertension was the most underlying health problems in the patients with vertigo disease in the real world, although the mental factors should

  4. [Characteristics and drug analysis associated with vertigo disease in real world].

    PubMed

    Xie, Qian; Li, Yuan-Yuan; Xie, Yan-Ming; Yang, Wei; Zhao, Wei; Zhuang, Yan; Wang, Yong-Yan

    2014-09-01

    To explore the characteristics and influenced factors associated with the onset of vertigo disease, analysis of 3 719 cases of hospitalized patients with vertigo disease from the real world. Analysis the date of patients diagnosed with vertigo disease from the hospital information system of 19 grade-III class-A hospital from 2004 to 2011, include general information, the doctor's advice, other diseases combined, diagnostic information and the relationship with the onset of 24 solar terms, and the treatment drugs. The median age of hospitalized patients with vertigo disease was 59, the number of women (65.91%) was more than men (34.09%), manual workers (85.32%) were the majority career, most patients (81.63%) condition were general by the time they were hospital admission, patients more like admitted to neurologist (70.34%) when they first time to outpatient serves, hospitalization days were in 8-14 days (46.65%), 46.04% of the patients in the hospital total cost is in 5 000 RMB to 10 000 RMB, 73.86% of patients paid by National Health Medical Insurance. Hypertension (20.79%) was the most common underlying health problems, The most common syndromes was deficiency of liver-Yin and kidney-Yin(44. 21%) , followed by hyperactivity of liver-yang, disease of phlegm turbidity in mongolia and deficiency of Qi and blood. There were more deficiency syndrome and less excess syndrome. The highest rate of hospital admission solar terms in 2009 was the insects awaken throttle (5.21%), In 2010, the highest rate solar terms of hospital admission was the rain throttle (6.14%). The most frequently used traditional Chinese medicine was gastrodine injection (20.55%), the most frequently used western medicine for betahistine (10.19%), gastrodine injection was the most traditional Chinese medicine that combination with other western medicine. Hypertension was the most underlying health problems in the patients with vertigo disease in the real world, although the mental factors should

  5. Vertebral artery dissection: an unusual cause of transient ataxia, vertigo, and sensorineural hearing loss.

    PubMed

    Touil, Leila L; Watson, Glen James; Small, Michael

    2013-12-01

    We present the case of a 33-year-old man who was admitted with intermittent ataxia, vertigo, and sensorineural hearing loss as a result of a vertebral artery dissection following minor neck trauma. Our aim is to highlight the importance of obtaining magnetic resonance imaging, magnetic resonance angiography, and/or duplex color-flow imaging when presented with a case of fluctuating vertigo and sensorineural hearing loss with side-specific ataxia. Likewise, it is important to obtain the input of neurologists to optimize a patient's prognosis and minimize long-term sequelae.

  6. Incidence and localizing value of vertigo and dizziness in patients with epilepsy: Video-EEG monitoring study.

    PubMed

    Kim, Dong Wook; Sunwoo, Jun-Sang; Lee, Sang Kun

    2016-10-01

    Vertigo and dizziness are common neurological complaints that have long been associated with epilepsy. However, studies of patients with epileptic vertigo or dizziness with concurrent EEG monitoring are scarce. We performed the present study to investigate the incidence and localizing value of vertigo and dizziness in patients with epilepsy who had confirmation of EEG changes via video-EEG monitoring. Data of aura and clinical seizure episodes of 831 consecutive patients who underwent video-EEG monitoring were analyzed retrospectively. Out of 831 patients, 40 patients (4.8%) experienced vertigo or dizziness as aura (mean age, 32.8±11.8years), all of whom had partial seizures. Eight had mesial temporal, 20 had lateral temporal, four had frontal, one had parietal, and seven had occipital lobe onset seizures. An intracranial EEG with cortical stimulation study was performed in seven patients, and the area of stimulation-induced vertigo or dizziness coincided with the ictal onset area in only one patient. Our study showed that vertigo or dizziness is a common aura in patients with epilepsy, and that the temporal lobe is the most frequent ictal onset area in these patients. However, it can be suggested that the symptomatogenic area in patients with epileptic vertigo and dizziness may not coincide with the ictal onset area. PMID:27454529

  7. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

    PubMed Central

    Ceylan, Emin Mehmet; Evrensel, Alper

    2016-01-01

    Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient's vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient. PMID:27651969

  8. Treatment of vertebrobasilar insufficiency--associated vertigo with a fixed combination of cinnarizine and dimenhydrinate.

    PubMed

    Otto, Volker; Fischer, Bernhard; Schwarz, Mario; Baumann, Wolfgang; Preibisch-Effenberger, Rudolf

    2008-01-01

    Thirty-seven patients suffering from vertigo associated with vertebrobasilar insufficiency participated in our prospective, single-center, double-blind, comparative study. Patients were randomly allocated to treatment with placebo; betahistine (12 mg betahistine dimesylate, one tablet three times daily); or the fixed combination of 20 mg cinnarizine and 40 mg dimenhydrinate (one tablet three times daily) for 4 weeks. The primary efficacy end point was the decrease of the mean vertigo score (S(M)), which was based on the patients' assessments of 12 individual vertigo symptoms after 4 weeks of treatment. Patients treated with the fixed combination showed significantly greater reductions of S(M) as compared to patients receiving placebo (p < .001) or the reference therapy betahistine (p < .01). The vestibulospinal parameter lateral sway (Unterberger's test) improved to a significantly greater extent in patients taking the fixed combination as compared to those receiving placebo (p < .001). No serious adverse event was reported in any therapy group. The tolerability of the fixed combination was judged as very good or good by 91% (betahistine, 73%; placebo, 82%). In conclusion, the fixed combination proved to be statistically more effective than the common antivertiginous drug betahistine in reducing vertebrobasilar insufficiency-associated vertigo symptoms. PMID:18616088

  9. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo.

    PubMed

    Ceylan, Emin Mehmet; Önen Ünsalver, Bariş; Evrensel, Alper

    2016-01-01

    Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient's vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient. PMID:27651969

  10. Two case reports of bilateral vertebral artery tortuosity and spiral twisting in vascular vertigo

    PubMed Central

    2014-01-01

    Background Tortuous blood vessels are commonly seen in the cerebral arteries. The association between vertebrobasilar artery tortuosity and vascular vertigo remains obscure. Case presentation We describe two patients with vascular vertigo who had bilateral curving and spiral looping in multiple segments of the vertebral arteries and also exhibited basilar artery tortuosity. Both patients had cerebrovascular risk factors and exhibited clinical features of vertigo with high severity, slow recovery, and recurrent tendencies. Contrast enhanced magnetic resonance angiography of the neck showed bilateral tortuosity in the V2 segments and spiral twisting in the V4 segments of the vertebral arteries, and basilar artery curving. No obvious sign of atherosclerotic stenosis was found in the vertebrobasilar arteries and no abnormalities were observed in the internal carotid arteries. Transcranial Doppler ultrasound showed decreased blood flow in tortuous vertebrobasilar arteries. Brainstem auditory evoked potentials showed that the interpeak latencies (IPL) of waves III-IV were prolonged, with a ratio of IPL III-V/IPL I-III > 1. Conclusions Vertebrobasilar tortuosity in combination with cerebrovascular risk factors may lead to vascular vertigo in these patients. PMID:24428889

  11. Vertigo in childhood: proposal for a diagnostic algorithm based upon clinical experience.

    PubMed

    Casani, A P; Dallan, I; Navari, E; Sellari Franceschini, S; Cerchiai, N

    2015-06-01

    The aim of this paper is to analyse, after clinical experience with a series of patients with established diagnoses and review of the literature, all relevant anamnestic features in order to build a simple diagnostic algorithm for vertigo in childhood. This study is a retrospective chart review. A series of 37 children underwent complete clinical and instrumental vestibular examination. Only neurological disorders or genetic diseases represented exclusion criteria. All diagnoses were reviewed after applying the most recent diagnostic guidelines. In our experience, the most common aetiology for dizziness is vestibular migraine (38%), followed by acute labyrinthitis/neuritis (16%) and somatoform vertigo (16%). Benign paroxysmal vertigo was diagnosed in 4 patients (11%) and paroxysmal torticollis was diagnosed in a 1-year-old child. In 8% (3 patients) of cases, the dizziness had a post-traumatic origin: 1 canalolithiasis of the posterior semicircular canal and 2 labyrinthine concussions, respectively. Menière's disease was diagnosed in 2 cases. A bilateral vestibular failure of unknown origin caused chronic dizziness in 1 patient. In conclusion, this algorithm could represent a good tool for guiding clinical suspicion to correct diagnostic assessment in dizzy children where no neurological findings are detectable. The algorithm has just a few simple steps, based mainly on two aspects to be investigated early: temporal features of vertigo and presence of hearing impairment. A different algorithm has been proposed for cases in which a traumatic origin is suspected.

  12. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

    PubMed Central

    Ceylan, Emin Mehmet; Evrensel, Alper

    2016-01-01

    Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient's vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.

  13. The methodology of Dynamic Uncertain Causality Graph for intelligent diagnosis of vertigo.

    PubMed

    Dong, Chunling; Wang, Yanjun; Zhang, Qin; Wang, Ningyu

    2014-01-01

    Vertigo is a common complaint with many potential causes involving otology, neurology and general medicine, and it is fairly difficult to distinguish the vertiginous disorders from each other accurately even for experienced physicians. Based on comprehensive investigations to relevant characteristics of vertigo, we propose a diagnostic modeling and reasoning methodology using Dynamic Uncertain Causality Graph. The symptoms, signs, findings of examinations, medical histories, etiology and pathogenesis, and so on, are incorporated in the diagnostic model. A modularized modeling scheme is presented to reduce the difficulty in model construction, providing multiple perspectives and arbitrary granularity for disease causality representations. We resort to the "chaining" inference algorithm and weighted logic operation mechanism, which guarantee the exactness and efficiency of diagnostic reasoning under situations of incomplete and uncertain information. Moreover, the causal insights into underlying interactions among diseases and symptoms intuitively demonstrate the reasoning process in a graphical manner. These solutions make the conclusions and advices more explicable and convincing, further increasing the objectivity of clinical decision-making. Verification experiments and empirical evaluations are performed with clinical vertigo cases. The results reveal that, even with incomplete observations, this methodology achieves encouraging diagnostic accuracy and effectiveness. This study provides a promising assistance tool for physicians in diagnosis of vertigo.

  14. [A Retrospective Series of 77 Pediatric Patients with Vertigo at a National Center for Child Health and Development].

    PubMed

    Goto, Fumiyuki; Suzuki, Noriomi; Hara, Mariko; Tsuchihashi, Nana; Morimoto, Noriko

    2015-07-01

    The evaluation and management of vertigo in children varies among institutional and medical specialties. The aim of this study was to describe the characteristics of vertigo in children presenting at a national pediatric center. Patients < 16 years old presenting with vertigo to the department of otolaryngology at a national center for child health and development from April 2004 to October 2009 were included (N = 77; 42 males and 35 females; average age, 8.7 ± 3.4 years) in this study. The most common diagnoses were vestibular migraine (VM; N = 21), benign paroxysmal vertigo (BPV; N =16), unilateral vestibulopathy (N = 12), and psychogenic vertigo (N = 8). Significant differences were observed in the frequency of the diagnoses between children aged older and younger than 7 years: BPV was most common in children < 7 years of age (p < 0.01) and VM was most common in ≥ 27 years of age (p < 0.05). Because obtaining adequate information from children for making a correct diagnosis is sometimes difficult, acquiring sufficient information from the parents is important. In addition, getting the parents to record the nystagmus during a vertigo attack with a digital camera or cellular phone can be useful because observing the nystagmus recorded on the video is helpful for making a diagnosis. Furthermore, the parents are participating in their child's care by attempting to record the attack, strengthening the relationship between the parents and the child. The incidence of psychogenic vertigo is low (less than 10%). Therefore, although physicians have recently tended to define the disorder as psychogenic when no objective abnormality is found in a patient, making a diagnosis of psychogenic vertigo is not recommended. Because vertigo can sometimes make a child anxious, delivering the correct diagnosis and treatment at the early stage is important for preventing anxiety in affected children.

  15. [Height-induced vertigo and its medical interpretation: Goethe and the Strassburger Münster].

    PubMed

    Jagella, C

    2000-02-19

    An analysis combining medicine and literature challenges the methodology of both disciplines. This essay on the vertigo Goethe suffered on the tower of the Strasbourg Minster attempts to trace the vicissitudes of interpreting an emblem, like vertigo, burdened by cultural meaning and implications. Thus, Goethe's own report of this event 40 years after the fact, in his "Dichtung und Wahrheit", has to be related to another, hidden chronology of vertigo and fear in his account which, at first glance, conveys quite different implications. The first part of this paper refers to a medical interpretation of Goethe's dread of high places and his way of coping with it which, today, could be defined as a typical example of a behaviourist approach. In the second part, Goethe's vertigo is linked to psychoanalytic, literary, and historical reflections on the meanings of symptoms we connect today with medical terms like anxiety, phobia, and vertigo. Goethe's vertigo is shown as a complex problem--not only for himself but also for its interpreters: on the one hand, it tells its own story-within-a-story; on the other, it depends on the tools it was written with. Traditional approaches of medical history try to find symptoms and traces of diseases known to us today in literary texts, an approach which is as dubious as taking today's tools of medical analysis, such as psychoanalytic terms and concepts, to explain specific phenomena in literature without first carefully analysing these methods themselves, and only then subjecting the text to an analysis based on them. Nevertheless, this essay does not contest the justification of interpreting literary texts in the light of today's medical knowledge, but postulates that it should be clear which type of medical knowledge is applied. It is quite possible to read Goethe's account only as an old tale of acrophobia, but how will this help us? It seems more interesting to look at the link between the feeling of dizziness he experienced on

  16. [Height-induced vertigo and its medical interpretation: Goethe and the Strassburger Münster].

    PubMed

    Jagella, C

    2000-02-19

    An analysis combining medicine and literature challenges the methodology of both disciplines. This essay on the vertigo Goethe suffered on the tower of the Strasbourg Minster attempts to trace the vicissitudes of interpreting an emblem, like vertigo, burdened by cultural meaning and implications. Thus, Goethe's own report of this event 40 years after the fact, in his "Dichtung und Wahrheit", has to be related to another, hidden chronology of vertigo and fear in his account which, at first glance, conveys quite different implications. The first part of this paper refers to a medical interpretation of Goethe's dread of high places and his way of coping with it which, today, could be defined as a typical example of a behaviourist approach. In the second part, Goethe's vertigo is linked to psychoanalytic, literary, and historical reflections on the meanings of symptoms we connect today with medical terms like anxiety, phobia, and vertigo. Goethe's vertigo is shown as a complex problem--not only for himself but also for its interpreters: on the one hand, it tells its own story-within-a-story; on the other, it depends on the tools it was written with. Traditional approaches of medical history try to find symptoms and traces of diseases known to us today in literary texts, an approach which is as dubious as taking today's tools of medical analysis, such as psychoanalytic terms and concepts, to explain specific phenomena in literature without first carefully analysing these methods themselves, and only then subjecting the text to an analysis based on them. Nevertheless, this essay does not contest the justification of interpreting literary texts in the light of today's medical knowledge, but postulates that it should be clear which type of medical knowledge is applied. It is quite possible to read Goethe's account only as an old tale of acrophobia, but how will this help us? It seems more interesting to look at the link between the feeling of dizziness he experienced on

  17. TiTrATE: A Novel Approach to Diagnosing Acute Dizziness and Vertigo

    PubMed Central

    Newman-Toker, David E.; Edlow, Jonathan A.

    2015-01-01

    Diagnosing dizziness can be challenging, and the consequences of missing dangerous causes such as stroke can be substantial. Most physicians use a diagnostic paradigm developed over 40 years ago that focuses on the type of dizziness (e.g., vertigo vs. non-vertigo), but this approach is flawed. In this article we propose a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (‘TiTrATE’). Using timing and triggers, patients with recent-onset dizziness will fall into one of four major ‘syndrome’ categories (triggered episodic, spontaneous episodic, post-exposure acute, and spontaneous acute), each with its own differential diagnosis and set of targeted examination techniques that help clinicians make a specific diagnosis. Following an evidence-based approach such as this could help reduce the frequency of misdiagnosis of serious causes of dizziness. PMID:26231273

  18. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo.

    PubMed

    Wen, Yan; Zhang, Chao; Zhao, Xiao-Feng; Deng, Shi-Zhe; He, Si; Huang, Ling-Hui; Tian, Guang; Meng, Zhi-Hong

    2016-08-01

    Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea) and different needle twisting frequencies (60 or 120 times/minute) at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]). The patients received 14 treatments over 3-4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the first treatment session and after the final session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo. PMID:27651774

  19. [Study on rules of acupoints selection for vertigo in ancient acupuncture].

    PubMed

    Zhan, Qiana; Chen, Hua-De

    2014-04-01

    The characteristics of selection and matching acupoint and application rules of meridians in ancient acupuncture literature for vertigo were explored. The data were collected from literature regarding acupuncture for vertigo from the pre-Qin period to Qing dynasty and then database was established. Frequency statistics method and comparison of support degree were applied to analyze and explore application rules of acupoints and meridians, while association rules in data mining was used to extract combinations of acupoints. As a result, for treatment of vertigo, according to frequency of use and support degree, generally the most selected acupoints, in turn, were Fengchi (GB 20), Shangxing (GV 23), Yanggu (SI 5), Jiexi (ST 41), Zulinqi (GB 41) and Shenting (GV 24), etc.; the most methods for matching acupoint were combination of adjacent acupoints, combination of same-meridian acupoints, combination of the superior-inferior acupoints, combination of yang-meridian and yang-meridian acupoints and combination of child-mother meridians acupoints; the most selected meridians were bladder meridian of foot-taiyang, gallbladder meridian of foot-shaoyang and governor vessel. Compared between the ancient and modern literature, it was found out that the ancient and modern clinic has same points in selection of acupoint-meridian and matching acupoints methods. However, the use of Yanggu (SI 5), Jiexi (ST 41) and Feiyang (BL 58) as well as combination of child-mother meridians acupoints were less seen in modern clinic, which could provide new reference.

  20. [Cervicogenic proprioceptive vertigo: etiopathogenesis, clinical manifestations, diagnosis and therapy with special emphasis on manual therapy].

    PubMed

    Grgić, Vjekoslav

    2006-01-01

    Cervical proprioceptive system (CPS) consisting of mechanoreceptors of cervical intervertebral joints, mechanoreceptors of neck muscles and ligament's insertions, muscle spindles located in deep short muscles of cervical spine and sensitive fibers connecting neck's proprioceptors with neurons of cornu posteriori of spinal cord, plays an essential part in maintaining bodily balance. CPS, via tractus spinovestibularis, is connected to vestibular nuclei. Clinical and neurophysiological studies have shown that functional disorders and/or organic lesions of CPS cause identical symptoms as vestibular diseases: vertigo, nystagmus and balance disorders. Dysfunction (functional blockade) of craniocervical joints is the most frequent cause of cervicogenic proprioceptive vertigo (CPV). The constant tension of the capsule of a blocked joint irritates mechanoreceptors protecting the joint's capsules. The increased activity of mechanoreceptors results in confusion of vestibular system. That is, the impulses from the blocked craniocervical joints do not correspond to the impulses from the vestibular organ and other sensory systems that take part in maintaining bodily balance. The disharmony of impulses results in an inadequate vestibulo-spinal and vestibulo-ocular reaction manifesting as vertigo and nystagmus. Hyperactivity of craniocervical mechanoreceptors also causes disturbances in reflex regulation of postural muscle tonus manifesting as "general instability". Knowledge of CPV as a separate clinical entity is important from diagnostical and therapeutical aspect. As it concerns a peripheral vestibular disorder still unknown to a wider circle of physicians, the article describes etiopathogenesis, clinical manifestations, diagnosis and therapy of CPV with special emphasis on manual therapy.

  1. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

    PubMed Central

    Wen, Yan; Zhang, Chao; Zhao, Xiao-feng; Deng, Shi-zhe; He, Si; Huang, Ling-hui; Tian, Guang; Meng, Zhi-hong

    2016-01-01

    Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea) and different needle twisting frequencies (60 or 120 times/minute) at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]). The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the first treatment session and after the final session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo. PMID:27651774

  2. A Case of Linear Scleroderma Involving Cerebellum with Vertigo

    PubMed Central

    Choi, Eui Je; Lee, Dong Won; Park, Chul Won

    2012-01-01

    Linear scleroderma is a kind of disease that can cause complication of the central nervous system. Sometimes, ipsilateral intracerebral or white matter lesions in the brain magnetic resonance imaging are noted. Nystagmus is important for the differential diagnosis of dizziness. Positional nystagmus was classified into regular direction nystagmus, direction changing positional nystagmus (DCPN) and irregular nystagmus by their character. DCPN is defined as a nystagmus that changes its direction with different head and body positions, and it can be the sign of lesion in the central vestibular system. Recently, we experienced a 17-year-old woman who had a scalp linear scleroderma, treated for about 10 years and showed DCPN induced by positional nystagmus test. We report a case of linear scleroderma accompanied by cerebellar lesion with a brief review of literature. PMID:24653878

  3. Doubling of water intake increases daytime blood pressure and reduces vertigo in healthy subjects.

    PubMed

    Jormeus, Anders; Karlsson, Samuel; Dahlgren, Christina; Lindström, Torbjörn; Nystrom, Fredrik H

    2010-01-01

    We studied the effect of increased water intake on ambulatory blood pressure (BP) in healthy individuals. Blood pressure was recorded after 2 weeks of either regular (RWI) or extra water intake (EWI, an additional 30 ml water/kg body weight per day) in 20 healthy subjects (10 males, 10 females). The extra water intake (RWI: 1.7 ± 0.59 l, EWI: 3.7 ± 0.84 l, respectively, p < 0.0001, i.e., an increase of 2 liters) induced an increase in mean arterial daytime BP from 89.0 ± 5.5 mmHg during RWI to 91.4 ± 6.4 mmHg during the EWI phase (p = 0.005), while night-time BP was unchanged by the intervention. The visual-analogue-scale (VAS, maximum score of 10) score corresponding to the statement "I often experience vertigo" was 3.1 ± 2.6 during RWI and decreased to 2.1 ± 2. 1 during EWI phase (p = 0.008). In conclusion,two liters of extra water intake for 2 weeks significantly increased daytime blood pressure and reduced a sense of vertigo in healthy individuals.

  4. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

    PubMed Central

    Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

    2015-01-01

    Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (QH/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: QH/V = 0.31 versus controls: QH/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

  5. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness.

    PubMed

    Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E; Eckhardt-Henn, Annegret; Dieterich, Marianne

    2015-01-01

    Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V ), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

  6. [Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders].

    PubMed

    Brandt, T; Zwergal, A; Jahn, K; Strupp, M

    2009-08-01

    The German BMBF (German Ministry of Education and Research) has decided to establish an Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFB(LMU)) in Munich in 2010. After funding over a 10-year period, the long-term continuation of the IFB(LMU) by the medical faculty and the hospital is envisioned. Vertigo is one of the most common complaints in medicine. Despite its high prevalence patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications and the scarcity of clinical multicenter studies. The IFB(LMU) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neuroscience "Brain and Mind". The IFB(LMU) has the following objectives with regard to structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomic administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations, to establish a standardized interdisciplinary longitudinal and transversal network at one site for the management of patients. This should

  7. Institutional profile: integrated center for research and treatment of vertigo, balance and ocular motor disorders.

    PubMed

    Brandt, Thomas; Zwergal, Andreas; Jahn, Klaus; Strupp, Michael

    2010-01-01

    In 2009 the German BMBF (German Ministry of Education and Research) established an Integrated Center for Research and Treatment (IFB(LMU)) of Vertigo, Balance and Ocular Motor Disorders in Munich. After the 10-year period of funding by the BMBF, it is envisioned that the (IFB(LMU)) will continue over the long term with the joint support of the University Hospital, the Medical Faculty, and the Bavarian State. Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications, and the scarcity of clinical multicenter studies. The (IFB(LMU)) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in Neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neurosciences - Brain and Mind. The (IFB(LMU)) has the following objectives as regards structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomous administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations; to establish a standardized interdisciplinary longitudinal and

  8. [Vertigo and falls in the elderly: Part 2: Fall diagnostics, prophylaxis and therapy].

    PubMed

    Walther, L E; Nikolaus, T; Schaaf, H; Hörmann, K

    2008-09-01

    In many acute or chronic vestibular diseases in old age, the risk of falling is increased. A fear of falling often develops together with further limitations to physical activity and subsequent physical and psychological consequences. Falls represent a substantial health-related risk factor. A regular balance, walking and muscle training is an effective prophylaxis. Components of the treatment of vestibular diseases in old age are counselling and encouragement (psychotherapy), treatment of the specific organic disease, specific vestibular rehabilitation and a symptomatic medication therapy. Vertigo in old age is a multifactorial process. The differential diagnosis of disorders of the equilibrium function in old age represents a challenge which can only be overcome by interdisciplinary cooperation. PMID:18712512

  9. [Vertigo and falls in the elderly: Part 2: Fall diagnostics, prophylaxis and therapy].

    PubMed

    Walther, L E; Nikolaus, T; Schaaf, H; Hörmann, K

    2008-09-01

    In many acute or chronic vestibular diseases in old age, the risk of falling is increased. A fear of falling often develops together with further limitations to physical activity and subsequent physical and psychological consequences. Falls represent a substantial health-related risk factor. A regular balance, walking and muscle training is an effective prophylaxis. Components of the treatment of vestibular diseases in old age are counselling and encouragement (psychotherapy), treatment of the specific organic disease, specific vestibular rehabilitation and a symptomatic medication therapy. Vertigo in old age is a multifactorial process. The differential diagnosis of disorders of the equilibrium function in old age represents a challenge which can only be overcome by interdisciplinary cooperation.

  10. Persistent Down-Beating Torsional Positional Nystagmus: Posterior Semicircular Canal Light Cupula?

    PubMed

    Ichimura, Akihide; Otsuka, Koji

    2016-01-01

    A 16-year-old boy with rotatory positional vertigo and nausea, particularly when lying down, visited our clinic. Initially, we observed vertical/torsional (downward/leftward) nystagmus in the supine position, and it did not diminish. In the sitting position, nystagmus was not provoked. Neurological examinations were normal. We speculated that persistent torsional down-beating nystagmus was caused by the light cupula of the posterior semicircular canal. This case provides novel insights into the light cupula pathophysiology.

  11. Persistent Down-Beating Torsional Positional Nystagmus: Posterior Semicircular Canal Light Cupula?

    PubMed Central

    Otsuka, Koji

    2016-01-01

    A 16-year-old boy with rotatory positional vertigo and nausea, particularly when lying down, visited our clinic. Initially, we observed vertical/torsional (downward/leftward) nystagmus in the supine position, and it did not diminish. In the sitting position, nystagmus was not provoked. Neurological examinations were normal. We speculated that persistent torsional down-beating nystagmus was caused by the light cupula of the posterior semicircular canal. This case provides novel insights into the light cupula pathophysiology. PMID:27668113

  12. Sudden hearing loss and vertigo after tooth extraction successfully treated with combined therapy including HBO2: a case report.

    PubMed

    Yilmaz, Huseyin Baki; Erdogan, Raziye Banu Atalay; Paksoy, Mustafa; Sanli, Arif

    2015-01-01

    Sudden sensorineural hearing loss (SSNHL) is a decrease in hearing of at least 30 dB that occurs within three days and which affects at least three consecutive frequencies in either ear or both ears. This case report describes a woman who had sudden hearing loss and vertigo in the right ear after tooth extraction. As the first-line therapy, systemic and intratympanic steroid injections were used this led to a slight improvement; however, the majority of improvement in hearing was not observed until hyperbaric oxygen (HBO2) therapy was instituted on the 20th day of hearing loss. Sudden hearing loss and vertigo after tooth extraction is an otologic emergency and early evaluation and treatment are effective. HBO2, although employed beyond the Undersea and Hyperbaric Medical Society's recommended initial 14 days of symptom onset, very was effective for this particular case.

  13. Behavior of the Posterior Semicircular Canal After Dix-Hallpike Maneuver

    PubMed Central

    e Maia, Francisco Carlos Zuma; Albernaz, Pedro Luiz Mangabeira; Cal, Renato Valério

    2016-01-01

    The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix-Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients’ age. PMID:27588161

  14. Behavior of the Posterior Semicircular Canal After Dix-Hallpike Maneuver.

    PubMed

    Zuma e Maia, Francisco Carlos; Albernaz, Pedro Luiz Mangabeira; Cal, Renato Valério

    2016-04-20

    The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix-Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients' age. PMID:27588161

  15. An attempt to understand flicker vertigo: changes in pupil size and choroidal blood flow under flickering conditions

    NASA Astrophysics Data System (ADS)

    Masi, Maria Gabriella; Peretto, Lorenzo; Rovati, Luigi; Ansari, Rafat R.

    2010-02-01

    Light flickering at a rate of 4- 20 cycles per second can produce unpleasant reactions such as nausea and vertigo. In this paper, the possibility of achieving an objective evaluation/prediction of the physiological effects induced by flicker is investigated using a new imaging method based on the pupil size determination. This method is also compared with the blood flow analysis in the choroid.

  16. Can low frequency sound stimulation during posturography help diagnosing possible perilymphatic fistula in patients with sensorineural hearing loss and/or vertigo?

    PubMed

    Selmani, Z; Ishizaki, H; Pyykkö, I

    2004-03-01

    Perilymphatic fistula (PLF) is often difficult to diagnose because of the similar symptomatology, such as vertigo, tinnitus and hearing loss, which is found in several inner ear diseases. We attempted to correlate a positive result of low frequency sound (LFS) stimulation tests in posturography with the presence or absence of a PLF confirmed by transtympanic endoscopy in 209 patients with various inner ear diseases (Meniere's disease ( n=128), vestibulopathy ( n=41), cochleopathy ( n=28) and sudden deafness ( n=12). LFS provoked unsteadiness in posturography without PLF in 24 patients with Meniere's disease, in 5 patients with vestibulopathy, in 3 patients with cochleopathy and in 2 patients with sudden deafness. In one patient, tympanoscopy revealed fistula in the round window membrane that was covered with a fibrinous layer. In four cases there was abnormal light reflex in the round window but without PLF. In eight cases, Hennebert's sign was present with nystagmus, without PLF. We conclude that pathological responses to the LFS test in posturography can also be encountered in other inner ear diseases without PLF.

  17. Predictive value of vertebral artery extracranial color-coded duplex sonography for ischemic stroke-related vertigo.

    PubMed

    Liou, Li-Min; Lin, Hsiu-Fen; Huang, I-Fang; Chang, Yang-Pei; Lin, Ruey-Tay; Lai, Chiou-Lian

    2013-12-01

    Vertigo can be a major presentation of posterior circulation stroke and can be easily misdiagnosed because of its complicated presentation. We thus prospectively assessed the predictive value of vertebral artery extracranial color-coded duplex sonography (ECCS) for the prediction of ischemic stroke-related vertigo. The inclusion criteria were: (1) a sensation of whirling (vertigo); (2) intractable vertigo for more than 1 hour despite appropriate treatment; and (3) those who could complete cranial magnetic resonance imaging (MRI) and vertebral artery (V2 segment) ECCS studies. Eventually, 76 consecutive participants with vertigo were enrolled from Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan between August 2010 and August 2011. Demographic data, neurological symptoms, neurologic examinations, and V2 ECCS were assessed. We chose the parameters of peak systolic velocity (PSV), end diastolic velocity (EDV), PSV/EDV, mean velocity (MV), resistance index (RI), and pulsatility index (PI) to represent the hemodynamics. Values from both sides of V2 segments were averaged. We then calculated the average RI (aRI), average PI (aPI), average PSV (aPSV)/EDV, and average (aMV). Axial and coronal diffusion-weighted MRI findings determined the existence of acute ischemic stroke. We grouped and analyzed participants in two ways (way I and way II analyses) based on the diffusion-weighted MRI findings (to determine whether there was acute stroke) and neurological examinations. Using way I analysis, the "MRI (+)" group had significantly higher impedance (aRI, aPI, and aPSV/EDV ratio) and lower velocity (aPSV, aEDV, and aMV(PSV + EDV/2)), compared to the "MRI (-)" group. The cutoff value/sensitivity/specificity of aPSV, aEDV, aMV, aPI, aRI, and aPSV/EDV between the MRI (+) and MRI (-) groups were 41.15/61.5/66.0 (p = 0.0101), 14.55/69.2/72.0 (p = 0.0003), 29.10/92.1/38.0 (p = 0.0013), 1.07/76.9/64.0 (p = 0.0066), 0.62/76.9/64.0 (p = 0.0076), and 2.69/80.8/66.0 (p = 0

  18. Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health

    PubMed Central

    2012-01-01

    Purpose Aims of this study were to identify aspects of functioning and health relevant to patients with vertigo expressed by ICF categories and to explore the potential of the ICF to describe the patient perspective in vertigo. Methods We conducted a series of qualitative semi-structured face-to-face interviews using a descriptive approach. Data was analyzed using the meaning condensation procedure and then linked to categories of the International Classification of Functioning, Disability and Health (ICF). Results From May to July 2010 12 interviews were carried out until saturation was reached. Four hundred and seventy-one single concepts were extracted which were linked to 142 different ICF categories. 40 of those belonged to the component body functions, 62 to the component activity and participation, and 40 to the component environmental factors. Besides the most prominent aspect “dizziness” most participants reported problems within “Emotional functions (b152), problems related to mobility and carrying out the daily routine. Almost all participants reported “Immediate family (e310)” as a relevant modifying environmental factor. Conclusions From the patients’ perspective, vertigo has impact on multifaceted aspects of functioning and disability, mainly body functions and activities and participation. Modifying contextual factors have to be taken into account to cover the complex interaction between the health condition of vertigo on the individuals’ daily life. The results of this study will contribute to developing standards for the measurement of functioning, disability and health relevant for patients suffering from vertigo. PMID:22738067

  19. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness

    PubMed Central

    Chau, Allan T.; Menant, Jasmine C.; Hübner, Patrick P.; Lord, Stephen R.; Migliaccio, Americo A.

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51–92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1–2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s2 to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5–1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  20. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness.

    PubMed

    Chau, Allan T; Menant, Jasmine C; Hübner, Patrick P; Lord, Stephen R; Migliaccio, Americo A

    2015-01-01

    Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people, it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological, and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim is to accurately identify the prevalence of benign paroxysmal positional vertigo (BPPV), peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy-six participants aged 51-92 (mean ± SD = 69 ± 9.5 years) were tested using the head thrust dynamic visual acuity (htDVA) test, dizziness handicap inventory (DHI), as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for htDVA score, DHI score, sinusoidal (whole-body, 0.1-2 Hz with peak velocity at 30°/s) vestibulo-ocular reflex (VOR) gain and phase, transient (whole-body, acceleration at 150°/s(2) to a constant velocity rotation of 50°/s) VOR gain and time constant (TC), optokinetic nystagmus (OKN) gain, and TC (whole-body, constant velocity rotation at 50°/s). We found that BPPV, peripheral and central vestibular hypofunction were present in 38 and 1% of participants, respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5-1 Hz), and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction. PMID:26733940

  1. Particulate matter chemistry and dynamics in the Twilight Zone at VERTIGO ALOHA and K2 Sites

    SciTech Connect

    Bishop, James K.B.; Wood, T.J.

    2008-03-25

    Understanding particle dynamics in the 'Twilight Zone' is critical to prediction of the ocean's carbon cycle. As part of the VERTIGO (VERtical Transformations In the Global Ocean) project, this rarely sampled regime extending from the base of the euphotic layer to 1000 m, was characterized by double-paired day/night Multiple Unit Large Volume in-situ Filtration System (MULVFS) deployments and by {approx}100 high-frequency CTD/transmissometer/turbidity sensor profiles. VERTIGO studies lasting three weeks, contrasted oligotrophic station ALOHA (22.75{sup o}N 158{sup o}W), sampled in June-July 2004, with a biologically productive location (47{sup o}N 161{sup o}E) near station K2 in the Oyashio, occupied July-August 2005. Profiles of major and minor particulate components (C{sub org}, N, P, Ca, Si, Sr, Ba, Mn) in <1, 1-51, and >51 {micro}m size fractions, in-water optics, neutrally buoyant sediment trap (NBST) fluxes, and zooplankton data were intercompared. MULVFS total C{sub org} and C-Star particle beam attenuation coefficient (C{sub P}) were consistently related at both sites with a 27 {micro}M m{sup -1} conversion factor. 26 At K2, C{sub P} profiles further showed a multitude of transient spikes throughout the water column and spike abundance profiles closely paralleled the double peaked abundance profiles of zooplankton. Also at K2, copepods contributed {approx}40% and 10%, night and day, respectively to >51 {micro}m C{sub org} of MULVFS samples in the mixed layer, but few copepods were collected in deeper waters; however, non-swimming radiolarians were quantitatively sampled. A recent hypothesis regarding POC differences between pumps and bottles is examined in light of these results. Particulate >51 {micro}m C{sub org}, N, and P at both ALOHA and K2 showed strong attenuation with depth at both sites. Notable at ALOHA were unusually high levels of >51 {micro}m Sr (up to 4 nM) in the mixed layer, a reflection of high abundances of SrSO{sub 4} precipitating

  2. Particulate matter chemistry and dynamics in the twilight zone at VERTIGO ALOHA and K2 sites

    NASA Astrophysics Data System (ADS)

    Bishop, James K. B.; Wood, T. J.

    2008-12-01

    Understanding particle dynamics in the 'Twilight Zone' is critical to prediction of the ocean's carbon cycle. As part of the VERtical Transport In the Global Ocean (VERTIGO) project, this rarely sampled regime extending from the base of the euphotic layer to 1000 m, was characterized by double-paired day/night Multiple Unit Large Volume in-situ Filtration System (MULVFS) deployments and by ˜100 high-frequency CTD/transmissometer/turbidity sensor profiles. VERTIGO studies lasting 3 weeks, contrasted oligotrophic station ALOHA (22.75°N 158°W), sampled in June-July 2004, with a biologically productive location (47 °N 161°E) near station K2 in the Oyashio, occupied July-August 2005. Profiles of major and minor particulate components (C org, N, P, Ca, Si, Sr, Ba, Mn) in <1, 1-51, and >51 μm size fractions, in-water optics, neutrally buoyant sediment trap (NBST) fluxes, and zooplankton data were intercompared. MULVFS total C org and C-Star particle beam attenuation coefficient ( C P) were consistently related at both sites with a 27 μM m -1 conversion factor. At K2, C P profiles further showed a multitude of transient spikes throughout the water column and spike abundance profiles closely paralleled the double peaked abundance profiles of zooplankton. Also at K2, copepods contributed ˜40% and 10%, night and day, respectively to >51 μm C org of MULVFS samples in the mixed layer, but few copepods were collected in deeper waters; however, non-swimming radiolarians were quantitatively sampled. A recent hypothesis regarding POC differences between pumps and bottles is examined in light of these results. Particulate >51 μm C org, N, and P at both ALOHA and K2 showed strong attenuation with depth at both sites. Notable at ALOHA were unusually high levels of >51 μm Sr (up to 4 nM) in the mixed layer, a reflection of high abundances of SrSO 4 precipitating Acantharia. Notable at K2 were major changes in water column inventories of many particulate components to 700 m

  3. VERTIGO (VERtical Transport In the Global Ocean): A study of particle sources and flux attenuation in the North Pacific

    SciTech Connect

    Buesseler, K.O.; Trull, T.W.; Steinberg, D.K.; Silver, M.W.; Siegel, D.A.; Saitoh, S.-I.; Lamborg, C.H.; Lam, P.J.; Karl, D.M.; Jiao, N.Z.; Honda, M.C.; Elskens, M.; Dehairs, F.; Brown, S.L.; Boyd, P.W.; Bishop, J.K.B.; Bidigare, R.R.

    2008-06-10

    The VERtical Transport In the Global Ocean (VERTIGO) study examined particle sources and fluxes through the ocean's 'twilight zone' (defined here as depths below the euphotic zone to 1000 m). Interdisciplinary process studies were conducted at contrasting sites off Hawaii (ALOHA) and in the NW Pacific (K2) during 3 week occupations in 2004 and 2005, respectively. We examine in this overview paper the contrasting physical, chemical and biological settings and how these conditions impact the source characteristics of the sinking material and the transport efficiency through the twilight zone. A major finding in VERTIGO is the considerably lower transfer efficiency (T{sub eff}) of particulate organic carbon (POC), POC flux 500/150 m, at ALOHA (20%) vs. K2 (50%). This efficiency is higher in the diatom-dominated setting at K2 where silica-rich particles dominate the flux at the end of a diatom bloom, and where zooplankton and their pellets are larger. At K2, the drawdown of macronutrients is used to assess export and suggests that shallow remineralization above our 150 m trap is significant, especially for N relative to Si. We explore here also surface export ratios (POC flux/primary production) and possible reasons why this ratio is higher at K2, especially during the first trap deployment. When we compare the 500 m fluxes to deep moored traps, both sites lose about half of the sinking POC by >4000 m, but this comparison is limited in that fluxes at depth may have both a local and distant component. Certainly, the greatest difference in particle flux attenuation is in the mesopelagic, and we highlight other VERTIGO papers that provide a more detailed examination of the particle sources, flux and processes that attenuate the flux of sinking particles. Ultimately, we contend that at least three types of processes need to be considered: heterotrophic degradation of sinking particles, zooplankton migration and surface feeding, and lateral sources of suspended and sinking

  4. VERTIGO (VERtical Transport In the Global Ocean): A study of particle sources and flux attenuation in the North Pacific

    NASA Astrophysics Data System (ADS)

    Buesseler, K. O.; Trull, T. W.; Steinberg, D. K.; Silver, M. W.; Siegel, D. A.; Saitoh, S.-I.; Lamborg, C. H.; Lam, P. J.; Karl, D. M.; Jiao, N. Z.; Honda, M. C.; Elskens, M.; Dehairs, F.; Brown, S. L.; Boyd, P. W.; Bishop, J. K. B.; Bidigare, R. R.

    2008-07-01

    The VERtical Transport In the Global Ocean (VERTIGO) study examined particle sources and fluxes through the ocean's "twilight zone" (defined here as depths below the euphotic zone to 1000 m). Interdisciplinary process studies were conducted at contrasting sites off Hawaii (ALOHA) and in the NW Pacific (K2) during 3-week occupations in 2004 and 2005, respectively. We examine in this overview paper the contrasting physical, chemical and biological settings and how these conditions impact the source characteristics of the sinking material and the transport efficiency through the twilight zone. A major finding in VERTIGO is the considerably lower transfer efficiency ( Teff) of particulate organic carbon (POC), POC flux 500/150 m, at ALOHA (20%) vs. K2 (50%). This efficiency is higher in the diatom-dominated setting at K2 where silica-rich particles dominate the flux at the end of a diatom bloom, and where zooplankton and their pellets are larger. At K2, the drawdown of macronutrients is used to assess export and suggests that shallow remineralization above our 150-m trap is significant, especially for N relative to Si. We explore here also surface export ratios (POC flux/primary production) and possible reasons why this ratio is higher at K2, especially during the first trap deployment. When we compare the 500-m fluxes to deep moored traps, both sites lose about half of the sinking POC by >4000 m, but this comparison is limited in that fluxes at depth may have both a local and distant component. Certainly, the greatest difference in particle flux attenuation is in the mesopelagic, and we highlight other VERTIGO papers that provide a more detailed examination of the particle sources, flux and processes that attenuate the flux of sinking particles. Ultimately, we contend that at least three types of processes need to be considered: heterotrophic degradation of sinking particles, zooplankton migration and surface feeding, and lateral sources of suspended and sinking

  5. Evolutionary Pattern and Process within the Vertigo gouldii (Mollusca: Pulmonata, Pupillidae) group of minute North American Land Snails

    PubMed Central

    Nekola, Jeffrey C.; Coles, Brian F.; Bergthorsson, Ulfar

    2010-01-01

    A phylogenetic analysis of 19 sibling taxa in the Vertigo gouldii group was conducted on 73 individuals sampled across North America using DNA sequence data of the mitochondrial genes cytochrome oxidase subunit 1 (CO1) and 16S ribosomal RNA (16S), and the internal transcribed spacer-2 of the nuclear ribosomal RNA (ITS-2) gene. The results of these analyses were found incongruent with previous taxonomic concepts used to define the V. gouldii group and its composite taxa that were based entirely on conchological features. The mtDNA sequence data suggest that some previous members of the traditional V. gouldii group may be more closely related to V. modesta. They also suggest that V. gouldii may itself consist of seven species-level branches spread across two deeply rooted clades. Revision of geographical distributions on the basis of these analyses suggests that these Vertigo species may commonly possess continental-sized ranges in spite of their minute size and limited active dispersal ability. High levels of sympatry within the group are also confirmed, with up to four species being known to co-occur within single microsites. These data also suggest that rates of diversification have been non-constant. Assuming a 1%/my rate of base pair substitution, a 10-fold diversification pulse is indicated from 6.7-7.0 myBP, which would be co-incident with known mid-late Miocene global climate changes. PMID:19766197

  6. Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database

    PubMed Central

    Hwang, Juen-Haur

    2016-01-01

    Background Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. Methods We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses. Results Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness. Conclusions A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities. PMID:27631630

  7. Quantifying the surface-subsurface biogeochemical coupling during the VERTIGO ALOHA and K2 studies

    SciTech Connect

    Boyd, P.W.; Gall, M.P.; Silver, M.W.; Bishop, J.K.B.; Coale, Susan L.; Bidigare, Robert R.

    2008-02-25

    A central question addressed by the VERTIGO (VERtical Transport In the Global Ocean) study was 'What controls the efficiency of particle export between the surface and subsurface ocean'? Here, we present data from sites at ALOHA (N Central Pacific Gyre) and K2 (NW subarctic Pacific) on phytoplankton processes, and relate them via a simple planktonic foodweb model, to subsurface particle export (150-500 m). Three key factors enable quantification of the surface-subsurface coupling: a sampling design to overcome the temporal lag and spatial displacement between surface and subsurface processes; data on the size-partitioning of Net Primary Production (NPP) and subsequent transformations prior to export; estimates of the ratio of algal- to faecal-mediated vertical export flux. At ALOHA, phytoplankton were characterized by low stocks, NPP, F{sub v}/F{sub m} (N-limited), and were dominated by picoplankton. The HNLC waters at K2 were characterized by both two-fold changes in NPP and floristic shifts (high to low proportion of diatoms) between deployment 1 and 2. Prediction of export exiting the euphotic zone was based on size-partitioning of NPP, a copepod-dominated foodweb and a ratio of 0.2 (ALOHA) and 0.1 (K2) for algal:faecal particle flux. Predicted export was 20-22 mg POC m{sup -2} d{sup -1} at ALOHA (i.e. 10-11% NPP (0-125 m); 1.1-1.2 x export flux at 150 m (E{sub 150}). At K2, export was 111 mg C m{sup -2} d{sup -1} (21% NPP (0-50 m); 1.8 x E{sub 150}) and 33 mg POC m{sup -2} d{sup -1} (11% NPP, 0-55 m); 1.4 x E{sub 150}) for deployments 1 and 2, respectively. This decrease in predicted export at K2 matches the observed trend for E{sub 150}. Also, the low attenuation of export flux from 60 to 150 m is consistent with that between 150 to 500 m. This strong surface-subsurface coupling suggests that phytoplankton productivity and floristics play a key role at K2 in setting export flux, and moreover that pelagic particle transformations by grazers strongly influence

  8. Quantifying the surface subsurface biogeochemical coupling during the VERTIGO ALOHA and K2 studies

    NASA Astrophysics Data System (ADS)

    Boyd, Philip W.; Gall, Mark P.; Silver, Mary W.; Coale, Susan L.; Bidigare, Robert R.; Bishop, James L. K. B.

    2008-07-01

    A central question addressed by the VERtical Transport In the Global Ocean (VERTIGO) study was 'What controls the efficiency of particle export between the surface and subsurface ocean'? Here, we present data from sites at ALOHA (N Central Pacific Gyre) and K2 (NW subarctic Pacific) on phytoplankton processes, and relate them via a simple planktonic foodweb model, to subsurface particle export (150-500 m). Three key factors enable quantification of the surface-subsurface coupling: a sampling design to overcome the temporal lag and spatial displacement between surface and subsurface processes; data on the size partitioning of net primary production (NPP) and subsequent transformations prior to export; estimates of the ratio of algal- to faecal-mediated vertical export flux. At ALOHA, phytoplankton were characterized by low stocks, NPP, Fv/ Fm (N-limited), and were dominated by picoplankton. The HNLC waters at K2 were characterized by both two-fold changes in NPP and floristic shifts (high to low proportion of diatoms) between deployment 1 and 2. Prediction of export exiting the euphotic zone was based on size partitioning of NPP, a copepod-dominated foodweb and a ratio of 0.2 (ALOHA) and 0.1 (K2) for algal:faecal particle flux. Predicted export was 20-22 mg POC m -2 d -1 at ALOHA (i.e. 10-11% NPP (0-125 m); 1.1-1.2×export flux at 150 m ( E150). At K2, export was 111 mg C m -2 d -1 (21% NPP (0-50 m); 1.8× E150) and 33 mg POC m -2 d -1 (11% NPP, 0-55 m); 1.4× E150) for deployments 1 and 2, respectively. This decrease in predicted export at K2 matches the observed trend for E150. Also, the low attenuation of export flux from 60 to 150 m is consistent with that between 150 and 500 m. This strong surface-subsurface coupling suggests that phytoplankton productivity and floristics play a key role at K2 in setting export flux, and moreover that pelagic particle transformations by grazers strongly influence to what extent sinking particles are further broken down in the

  9. Removal of vertigo blue dyes from Batik textile wastewater by adsorption onto activated carbon and coal bottom ash

    NASA Astrophysics Data System (ADS)

    Kusmiyati, L., Puspita Adi; Deni, V.; Robi Indra, S.; Islamica, Dlia; Fuadi, M.

    2016-04-01

    Removal of vertigo blue dye from batik textile wastewater was studied by adsorptionprocess onto activated carbon (AC) and coal bottom ash (CBA).The influence of experimental conditions (pH solution, dye concentration, and contact time) were studied on the both adsorbents. At equilibrium conditions, the data were fitted to Langmuir and Freundlich adsorption models. The maximum adsorption capacity calculated from the Langmuir model for carbon active was 6.29mg/g at pH that found to be considerably higher than that obtained for coal bottom ash 3.72mg/g pH 9. From Freundlich model, the maximum adsorption capacity is less for coal bottom ash (pH 9) than that for carbon active (pH4).

  10. Role of orientation reference selection in motion sickness

    NASA Technical Reports Server (NTRS)

    Peterka, Robert J.; Black, F. Owen

    1988-01-01

    Previous experiments with moving platform posturography have shown that different people have varying abilities to resolve conflicts among vestibular, visual, and proprioceptive sensory signals used to control upright posture. In particular, there is one class of subjects with a vestibular disorder known as benign paroxysmal positional vertigo (BPPV) who often are particularly sensitive to inaccurate visual information. That is, they will use visual sensory information for the control of their posture even when that visual information is inaccurate and is in conflict with accurate proprioceptive and vestibular sensory signals. BPPV has been associated with disorders of both posterior semicircular canal function and possibly otolith function. The present proposal hopes to take advantage of the similarities between the space motion sickness problem and the sensory orientation reference selection problems associated with the BPPV syndrome. These similarities include both etiology related to abnormal vertical canal-otolith function, and motion sickness initiating events provoked by pitch and roll head movements. The objectives of this proposal are to explore and quantify the orientation reference selection abilities of subjects and the relation of this selection to motion sickness in humans.

  11. Saccades and Vergence Performance in a Population of Children with Vertigo and Clinically Assessed Abnormal Vergence Capabilities

    PubMed Central

    Bucci, Maria Pia; Kapoula, Zoï; Bui-Quoc, Emmanuel; Bouet, Aurelie; Wiener-Vacher, Sylvette

    2011-01-01

    Purpose Early studies reported some abnormalities in saccade and vergence eye movements in children with vertigo and vergence deficiencies. The purpose of this study was to further examine saccade and vergence performance in a population of 44 children (mean age: 12.3±1.6 years) with vertigo symptoms and with different levels of vergence abnormalities, as assessed by static orthoptic examination (near point of convergence, prism bar and cover-uncover test). Methods Three groups were identified on the basis of the orthoptic tests: group 1 (n = 13) with vergence spasms and mildly perturbed orthoptic scores, group 2 (n = 14) with moderately perturbed orthoptic scores, and group 3 (n = 17) with severely perturbed orthoptic scores. Data were compared to those recorded from 28 healthy children of similar ages. Latency, accuracy and peak velocity of saccades and vergence movements were measured in two different conditions: gap (fixation offset 200 ms prior to target onset) and simultaneous paradigms. Binocular horizontal movements were recorded by a photoelectric device. Results Group 2 of children with vergence abnormalities showed significantly longer latency than normal children in several types of eye movements recorded. For all three groups of children with vergence abnormalities, the gain was poor, particularly for vergence movement. The peak velocity values did not differ between the different groups of children examined. Interpretation Eye movement measures together with static orthoptic evaluation allowed us to better identify children with vergence abnormalities based on their slow initiation of eye movements. Overall, these findings support the hypothesis of a central deficit in the programming and triggering of saccades and vergence in these children. PMID:21858007

  12. Sinking fluxes of minor and trace elements in the North Pacific Ocean measured during the VERTIGO program

    NASA Astrophysics Data System (ADS)

    Lamborg, C. H.; Buesseler, K. O.; Lam, P. J.

    2008-07-01

    As part of the Vertical Transport in the Global Ocean (VERTIGO) program, we collected and analyzed sinking particles using sediment traps at three depths in the oceanic mesopelagic zone and at two biogeochemically contrasting sites (N. Central Pacific at ALOHA; N. Pacific Western Subarctic Gyre at K2). In this paper, we present the results of minor and trace element determinations made on these samples. Minor and trace elements in the sinking material showed 2 trends in flux with depth: increasing and constant. The sinking particulate phase of some elements (Al, Fe, Mn) was dominated by material of lithogenic origin and exhibited flux that was constant with depth and consistent with eolian dust inputs (ALOHA), or increasing in flux with depth as a result of lateral inputs from a shelf (K2). This shelf-derived material also appears to have been confined to very small particles, whose inherent sinking rates are slow, and residence time within the mesopelagic "twilight zone" would be consequently long. Furthermore, the flux of this material did not change with substantial changes in the rain of biogenic material from the surface (K2), suggesting mechanistic decoupling from the flux of organic carbon and macronutrients. Micronutrient (Fe, Co, Zn and Cu) fluxes examined in a 1-D mass balance suggest widely differing sources and sinks in the water column as well as impacts from biological uptake and regeneration. For example, total Fe fluxes into and out of the euphotic zone appeared to be dominated by lithogenic material and far exceed biological requirements. The export flux of Fe, however, appeared to be balanced by the eolian input of soluble Fe. For Zn and Cu, the situation is reversed, with atmospheric inputs insufficient to support fluxes, and the cycling therefore dominated by the draw down of an internal pool. For Co, the situation lies in between, with important, but ultimately insufficient atmospheric inputs.

  13. Gait characteristics of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input.

    PubMed

    Schniepp, Roman; Wuehr, Max; Huth, Sabrina; Pradhan, Cauchy; Brandt, Thomas; Jahn, Klaus

    2014-04-01

    Phobic postural vertigo (PPV) is the most common cause of chronic dizziness in middle-aged patients. Many patients report symptoms involving gait. We investigated the gait performance and its relationship to the fear of falling and attention of PPV patients in a prospective study of 24 patients with PPV and 24 healthy subjects (HS) using a pressure-sensitive mat (GAITRite(®)). Subjects walked at three different speeds (slow, preferred, fast), both during cognitive dual tasks (DTc) and with eyes closed (EC). Falls efficacy and balance confidence were rated by the Falls Efficacy Scale-International (FES-I) and the Activities-specific Balance Confidence Scale (ABC). PPV patients walked slower, with reduced cadence (all p < 0.01), stride length (p < 0.05), and increased double support (p < 0.01) compared to HS. These changes correlated with FES-I (R = -0.528, p < 0.001) and ABC (R = 0.481, p < 0.01). Walking deterioration under DTc did not differ between PPV patients and HS, but patients showed a reduced cognitive processing speed (p < 0.05). When walking with EC, gait speed decreased more in PPV patients compared to HS (p < 0.05). Patients with PPV show gait changes which correlate with their fear of falling and balance confidence. Absent visual feedback leads to more pronounced gait deteriorations in PPV patients than in HS, indicating a higher reliance of patients on visual information during walking. These findings support the view that the gait characteristics of PPV can be attributed to an inadequate, cautious gait control.

  14. Effects and tolerability of betahistine in patients with vestibular vertigo: results from the Romanian contingent of the OSVaLD study

    PubMed Central

    Băjenaru, Ovidiu; Roceanu, Adina Maria; Albu, Silviu; Zainea, Viorel; Pascu, Alexandru; Georgescu, Mădălina Gabriela; Cozma, Sebastian; Mărceanu, Luigi; Mureşanu, Dafin Fior

    2014-01-01

    Background and methods An efficacy population of 245 patients with vertigo of peripheral vestibular origin was recruited in Romania as part of a 3-month multinational, post-marketing surveillance study of open-label betahistine 48 mg/day (OSVaLD). Endpoints were changes in the Dizziness Handicap Index (primary endpoint), Medical Outcome Study Short-Form 36 (SF-36v2®), and the Hospital Anxiety and Depression Scale. Results During treatment, the total Dizziness Handicap Index score improved by 41 points (on a 100-point scale). Statistically significant improvements of 12–14 points were recorded in all three domains of the Dizziness Handicap Index scale (P<0.0001). Betahistine therapy was also accompanied by progressive improvements in mean Hospital Anxiety and Depression anxiety and depression scores (P<0.0001) and significant improvements in both the physical and mental component summary of the SF-36v2 (P<0.0001). Betahistine was well tolerated, with only one suspected adverse drug reaction recorded in the Romanian safety population (n=259). Conclusion Betahistine 48 mg/day was associated with improvements in multiple measures of health-related quality of life and had a good tolerability profile in these Romanian patients with recurrent peripheral vestibular vertigo. PMID:25506241

  15. Vincent's violent vertigo. An analysis of the original diagnosis of epilepsy vs. the current diagnosis of Meniére's disease.

    PubMed

    Arenberg, I K; Countryman, L L; Bernstein, L H; Shambaugh, G E

    1991-01-01

    The authors propose to correct the historical misimpression that Vincent van Gogh's medical problems resulted from epilepsy. Rather, the authors propose his main medical problem was Meniére's disease. The authors have reviewed the 796 personal letters written by van Gogh. The symptoms of his Vertigo attacks, their presentation and duration as described in these letters, taken as a whole, are consistent with the clinical picture of Meniére's disease, not epilepsy. They point out that Prosper Meniére's description of his syndrome was not well known at the time of van Gogh's death, and was often misdiagnosed as epilepsy. During the last years of his life, van Gogh was labeled epileptic, although no rigid criteria for this diagnosis are evident. This diagnosis is still prevalent in the art history literature today. His symptoms included episodic vertigo and dizziness, physical imbalance, hearing symptoms, ear noises (tinnitus) as well as a presumed secondary psychological reaction to his physical symptomatology. van Gogh's diagnosis of epilepsy is based on written diagnosis in his medical records in 1889 when he was interred (voluntarily) in St. Remy at an asylum for epileptics and lunatics.

  16. [The complete elimination of the episodes of benign positional paroxysmal vertigo in a patient with the involvement of the posterior semicircular canal following the eccentric rotation test].

    PubMed

    Matsnev, É I; Sigaleva, E É

    2015-01-01

    The objective of the present study was the clinical and neurophysiological analysis of the observations of a 42 year-old female patient suffering from benign paroxysmalpositional dizziness (BPPD) associated with the lesion of the posterior semicircular canal. The dynamic evaluation of the utricular function was performed during eccentric rotation of the patient in the vestibulometric chair at a speed of 300 degrees. The chair together with the patients was atomatically displaced during the rotation 3.5--4.0 cm to the right or left off the vertical axis, and the error in subjective perception of the deviation from the vertical was estimated. The saccular function was evaluated by recording cervical vestibular evoked myogenic potentials. The symptoms of BPPD were found to completely disappear after the eccentric rotation. Not a single spell of benign paroxysmalpositional dizziness was documented within 6 months after the eccentric rotation. The mechanisms underlying the elimination of these symptoms as a result of eccentric rotation are discussed.

  17. Nursing Positions

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Nursing Positions KidsHealth > For Parents > Nursing Positions Print A ... and actually needs to feed. Getting Comfortable With Breastfeeding Nursing can be one of the most challenging ...

  18. Positive Psychology

    ERIC Educational Resources Information Center

    Peterson, Christopher

    2009-01-01

    Positive psychology is a deliberate correction to the focus of psychology on problems. Positive psychology does not deny the difficulties that people may experience but does suggest that sole attention to disorder leads to an incomplete view of the human condition. Positive psychologists concern themselves with four major topics: (1) positive…

  19. Posttraumatic dizziness and vertigo.

    PubMed

    Szczupak, M; Hoffer, M E; Murphy, S; Balaban, C D

    2016-01-01

    Traumatic brain injury is an increasingly common public health issue, with the mild variant most clinically relevant for this chapter. Common causes of mild traumatic brain injury (mTBI) include motor vehicle accidents, athletics, and military training/deployment. Despite a range of clinically available testing platforms, diagnosis of mTBI remains challenging. Symptoms are primarily neurosensory, and include dizziness, hearing problems, headaches, cognitive, and sleep disturbances. Dizziness is nearly universally present in all mTBI patients, and is the easiest symptom to objectify for diagnosis. Aside from a thorough history and physical exam, in the near future specialized vestibular function tests will be key to mTBI diagnosis. A battery of oculomotor (antisaccade, predictive saccade) and vestibular tasks (head impulse test) has been demonstrated to sensitively and specifically identify individuals with acute mTBI. Vestibular therapy and rehabilitation have shown improvements for mTBI patients in cognitive function, ability to return to activities of daily living, and ability to return to work. Dizziness, as a contributor to short- and long-term disability following mTBI, is ultimately crucial not only for diagnosis but also for treatment. PMID:27638079

  20. Positional plagiocephaly

    PubMed Central

    Cummings, Carl

    2011-01-01

    Cranial asymmetry occurring as a result of forces that deform skull shape in the supine position is known as deformational plagiocephaly. The risk of plagiocephaly may be modified by positioning the baby on alternate days with the head to the right or the left side, and by increasing time spent in the prone position during awake periods. When deformational plagiocephaly is already present, physiotherapy (including positioning equivalent to the preventive positioning, and exercises as needed for torticollis and positional preference) has been shown to be superior to counselling about preventive positioning only. Helmet therapy (moulding therapy) to reduce skull asymmetry has some drawbacks: it is expensive, significantly inconvenient due to the long hours of use per day and associated with skin complications. There is evidence that helmet therapy may increase the initial rate of improvement of asymmetry, but there is no evidence that it improves the final outcome for patients with moderate or severe plagiocephaly. PMID:23024590

  1. Correlation between afferent rearrangements and behavioral deficits after local excitotoxic insult in the mammalian vestibule: a rat model of vertigo symptoms

    PubMed Central

    Travo, Cécile; Saleur, Aurélie; Broussy, Audrey; Brugeaud, Aurore; Chabbert, Christian

    2016-01-01

    ABSTRACT Damage to inner ear afferent terminals is believed to result in many auditory and vestibular dysfunctions. The sequence of afferent injuries and repair, as well as their correlation with vertigo symptoms, remains poorly documented. In particular, information on the changes that take place at the primary vestibular endings during the first hours following a selective insult is lacking. In the present study, we combined histological analysis with behavioral assessments of vestibular function in a rat model of unilateral vestibular excitotoxic insult. Excitotoxicity resulted in an immediate but transient alteration of the balance function that was resolved within a week. Concomitantly, vestibular primary afferents underwent a sequence of structural changes followed by spontaneous repair. Within the first two hours after the insult, a first phase of pronounced vestibular dysfunction coincided with extensive swelling of afferent terminals. In the next 24 h, a second phase of significant but incomplete reduction of the vestibular dysfunction was accompanied by a resorption of swollen terminals and fiber retraction. Eventually, within 1 week, a third phase of complete balance restoration occurred. The slow and progressive withdrawal of the balance dysfunction correlated with full reconstitution of nerve terminals. Competitive re-innervation by afferent and efferent terminals that mimicked developmental synaptogenesis resulted in full re-afferentation of the sensory epithelia. By deciphering the sequence of structural alterations that occur in the vestibule during selective excitotoxic impairment, this study offers new understanding of how a vestibular insult develops in the vestibule and how it governs the heterogeneity of vertigo symptoms. PMID:27483344

  2. Satellite positioning

    NASA Technical Reports Server (NTRS)

    Colombo, Oscar L.; Watkins, Michael M.

    1991-01-01

    Developments in satellite positioning techniques and their applications are reviewed on the basis of the theoretical and practical work published by U.S. researchers in 1987-1990. Current techniques are classified into two main categories: satellite laser tracking and radio tracking. Particular attention is given to the Geoscience Laser Ranging System, the Lunar Laser Ranging concept; GPS ephemerides determination, fiducial networks, and reference frame; static GPS positioning; and kinematic GPS positioning.

  3. Positive Psychotherapy

    ERIC Educational Resources Information Center

    Seligman, Martin E. P.; Rashid, Tayyab; Parks, Acacia C.

    2006-01-01

    Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported…

  4. Positioning Agility

    NASA Astrophysics Data System (ADS)

    Oza, Nilay; Abrahamsson, Pekka; Conboy, Kieran

    Agile methods are increasingly adopted by European companies. Academics too are conducting numerous studies on different tenets of agile methods. Companies often feel proud in marketing themselves as ‘agile’. However, the true notion of ‘being agile’ seems to have been overlooked due to lack of positioning of oneself for agility. This raises a call for more research and interactions between academia and the industry. The proposed workshop refers to this call. It will be highly relevant to participants, interested in positioning their company’s agility from organizational, group or project perspectives. The positioning of agility will help companies to better align their agile practices with stakeholder values. Results of the workshop will be shared across participants and they will also have opportunity to continue their work on agile positioning in their companies. At broader level, the work done in this workshop will contribute towards developing Agile Positioning System.

  5. Positive Proof.

    ERIC Educational Resources Information Center

    Auty, Geoffrey

    1988-01-01

    Presents experiments which show that in electrostatics there are logical reasons for describing charged materials as positive or negative. Indicates that static and current electricity are not separate areas of physics. Diagrams of experiments and circuits are included. (RT)

  6. Principles of Calcite Dissolution in Human and Artificial Otoconia

    PubMed Central

    Walther, Leif Erik; Blödow, Alexander; Buder, Jana; Kniep, Rüdiger

    2014-01-01

    Human otoconia provide mechanical stimuli to deflect hair cells of the vestibular sensory epithelium for purposes of detecting linear acceleration and head tilts. During lifetime, the volume and number of otoconia are gradually reduced. In a process of degeneration morphological changes occur. Structural changes in human otoconia are assumed to cause vertigo and balance disorders such as benign paroxysmal positional vertigo (BPPV). The aim of this study was to investigate the main principles of morphological changes in human otoconia in dissolution experiments by exposure to hydrochloric acid, EDTA, demineralized water and completely purified water respectively. For comparison reasons artificial (biomimetic) otoconia (calcite gelatin nanocomposits) and natural calcite were used. Morphological changes were detected in time steps by the use of environmental scanning electron microscopy (ESEM). Under in vitro conditions three main dissolution mechanisms were identified as causing characteristic morphological changes of the specimen under consideration: pH drops in the acidic range, complex formation with calcium ions and changes of ion concentrations in the vicinity of otoconia. Shifts in pH cause a more uniform reduction of otoconia size (isotropic dissolution) whereas complexation reactions and changes of the ionic concentrations within the surrounding medium bring about preferred attacks at specific areas (anisotropic dissolution) of human and artificial otoconia. Owing to successive reduction of material, all the dissolution mechanisms finally produce fragments and remnants of otoconia. It can be assumed that the organic component of otoconia is not significantly attacked under the given conditions. Artificial otoconia serve as a suitable model system mimicking chemical attacks on biogenic specimens. The underlying principles of calcite dissolution under in vitro conditions may play a role in otoconia degeneration processes such as BPPV. PMID:25048115

  7. Position indicator

    DOEpatents

    Tanner, David E.

    1981-01-01

    A nuclear reactor system is described in which a position indicator is provided for detecting and indicating the position of a movable element inside a pressure vessel. The movable element may be a valve element or similar device which moves about an axis. Light from a light source is transmitted from a source outside the pressure vessel to a first region inside the pressure vessel in alignment with the axis of the movable element. The light is redirected by a reflector prism to a second region displaced radially from the first region. The reflector prism moves in response to movement of the movable element about its axis such that the second region moves arcuately with respect to the first region. Sensors are arrayed in an arc corresponding to the arc of movement of the second region and signals are transmitted from the sensors to the exterior of the reactor vessel to provide indication of the position of the movable element.

  8. Positive psychotherapy.

    PubMed

    Seligman, Martin E P; Rashid, Tayyab; Parks, Acacia C

    2006-11-01

    Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported them to be "life-changing." Delivered on the Web, positive psychology exercises relieved depressive symptoms for at least 6 months compared with placebo interventions, the effects of which lasted less than a week. In severe depression, the effects of these Web exercises were particularly striking. This address reports two preliminary studies: In the first, PPT delivered to groups significantly decreased levels of mild-to-moderate depression through 1-year follow-up. In the second, PPT delivered to individuals produced higher remission rates than did treatment as usual and treatment as usual plus medication among outpatients with major depressive disorder. Together, these studies suggest that treatments for depression may usefully be supplemented by exercises that explicitly increase positive emotion, engagement, and meaning. ((c) 2006 APA, all rights reserved). PMID:17115810

  9. Positively Adolescent!

    ERIC Educational Resources Information Center

    Williamson, Sue

    2000-01-01

    Believes that music teachers should reassess their views toward adolescent behavior in the music classroom by learning to see their behavior in a positive light. Describes teaching strategies that build on four adolescent behaviors: (1) desire for peer acceptance; (2) abundant energy; (3) love of fun; and (4) limited time-managing skills. (CMK)

  10. Position sensor

    NASA Technical Reports Server (NTRS)

    Auer, Siegfried (Inventor)

    1988-01-01

    A radiant energy angle sensor is provided wherein the sensitive portion thereof comprises a pair of linear array detectors with each detector mounted normal to the other to provide X and Y channels and a pair of slits spaced from the pair of linear arrays with each of the slits positioned normal to its associated linear array. There is also provided electrical circuit means connected to the pair of linear array detectors and to separate X and Y axes outputs.

  11. Effectiveness of a Vestibular Rehabilitation Protocol to Improve the Health-Related Quality of Life and Postural Balance in Patients with Vertigo

    PubMed Central

    Tsukamoto, Heloísa Freiria; Costa, Viviane de Souza Pinho; Silva, Rubens Alexandre da; Pelosi, Gislaine Garcia; Marchiori, Luciana Lozza de Moraes; Vaz, Cláudia Regina Sanches; Fernandes, Karen Barros Parron

    2015-01-01

    Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment. PMID:26157499

  12. Positive Psychologists on Positive Constructs

    ERIC Educational Resources Information Center

    Lyubomirsky, Sonja

    2012-01-01

    Comments on the original article by McNulty and Fincham (see record 2011-15476-001). In their article, the authors offered compelling evidence that constructs such as forgiveness and optimism can have both beneficial and adverse consequences, depending on the context. Their caution about labeling particular psychological processes as "positive" is…

  13. Positioning apparatus

    DOEpatents

    Vogel, M.A.; Alter, P.

    1983-07-07

    An apparatus is provided for precisely adjusting the position of an article relative to a beam emerging from a neutron source disposed in a housing. The apparatus includes a support pivotably mounted on a movable base plate and freely suspended therefrom. The support is gravity biased toward the housing and carries an article holder movable in a first direction longitudinally of the axis of said beam and normally urged into engagement against said housing. Means are provided for moving the base plate in two directions to effect movement of the suspended holder in two mutually perpendicular directions, respectively, normal to the axis of the beam.

  14. Positioning apparatus

    DOEpatents

    Vogel, Max A.; Alter, Paul

    1986-05-06

    An apparatus for precisely positioning materials test specimens within the optimum neutron flux path emerging from a neutron source located in a housing. The test specimens are retained in a holder mounted on the free end of a support pivotably mounted and suspended from a movable base plate. The support is gravity biased to urge the holder in a direction longitudinally of the flux path against the housing. Means are provided for moving the base plate in two directions to effect movement of the holder in two mutually perpendicular directions normal to the axis of the flux path.

  15. Positioning apparatus

    DOEpatents

    Vogel, Max A.; Alter, Paul

    1986-01-01

    An apparatus for precisely positioning materials test specimens within the optimum neutron flux path emerging from a neutron source located in a housing. The test specimens are retained in a holder mounted on the free end of a support pivotably mounted and suspended from a movable base plate. The support is gravity biased to urge the holder in a direction longitudinally of the flux path against the housing. Means are provided for moving the base plate in two directions to effect movement of the holder in two mutually perpendicular directions normal to the axis of the flux path.

  16. POSITIONING DEVICE

    DOEpatents

    Wall, R.R.; Peterson, D.L.

    1959-09-15

    A positioner is described for a vertical reactor-control rod. The positioner comprises four grooved friction rotatable members that engage the control rod on all sides and shift it longitudinally. The four friction members are drivingly interconnected for conjoint rotation and comprise two pairs of coaxial members. The members of each pair are urged toward one another by hydraulic or pneumatic pressure and thus grip the control rod so as to hold it in any position or adjust it. Release of the by-draulic or pneumatic pressure permits springs between the friction members of each pair to force them apart, whereby the control rod moves quickly by gravity into the reactor.

  17. Positive maps, positive polynomials and entanglement witnesses

    NASA Astrophysics Data System (ADS)

    Skowronek, Łukasz; Życzkowski, Karol

    2009-08-01

    We link the study of positive quantum maps, block positive operators and entanglement witnesses with problems related to multivariate polynomials. For instance, we show how indecomposable block positive operators relate to biquadratic forms that are not sums of squares. Although the general problem of describing the set of positive maps remains open, in some particular cases we solve the corresponding polynomial inequalities and obtain explicit conditions for positivity.

  18. Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test.

    PubMed

    Kim, Chang-Hee; Kim, Yong Gyu; Shin, Jung Eun; Yang, Young Soo; Im, Donghyuk

    2016-10-01

    Accurate lateralization is important to improve treatment outcomes in horizontal semicircular canal (HSCC) benign paroxysmal positional vertigo (BPPV). To determine the involved side in HSCC-BPPV, the intensity of nystagmus has been compared in a head-roll test (HRT) and the direction of nystagmus was evaluated in a bow and lean test (BLT). The aim of this study is to compare the results of a BLT with those of a HRT for lateralization of HSCC-canalolithiasis and cupulopathy (heavy cupula and light cupula), and evaluate treatment outcomes in patients with HSCC-canalolithiasis. We conducted retrospective case reviews in 66 patients with HSCC-canalolithiasis and 63 patients with HSCC-cupulopathy. The affected side was identified as the direction of bowing nystagmus on BLT in 55 % (36 of 66) of patients with canalolithiasis, which was concordant with the HRT result in 67 % (24 of 36) of cases (concordant group). Lateralization was determined by comparison of nystagmus intensity during HRT in 30 patients who did not show bowing or leaning nystagmus. The remission rate after the first treatment was 71 % (17 of 24) in the concordant group and 45 % (5 of 11) in the discordant group. Both bowing and leaning nystagmus were observed in all patients with cupulopathy, and the side of the null plane was identified as the affected side. In conclusion, bowing and/or leaning nystagmus were observed in only 55 % of patients with HSCC-canalolithiasis, and the first treatment based on the result of BLT alone was effective in only 45 % of the patients in whom the BLT and HRT were discordant, which may suggest that the usefulness of BLT in lateralizing the HSCC-canalolithiasis may be limited. PMID:26758464

  19. Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test.

    PubMed

    Kim, Chang-Hee; Kim, Yong Gyu; Shin, Jung Eun; Yang, Young Soo; Im, Donghyuk

    2016-10-01

    Accurate lateralization is important to improve treatment outcomes in horizontal semicircular canal (HSCC) benign paroxysmal positional vertigo (BPPV). To determine the involved side in HSCC-BPPV, the intensity of nystagmus has been compared in a head-roll test (HRT) and the direction of nystagmus was evaluated in a bow and lean test (BLT). The aim of this study is to compare the results of a BLT with those of a HRT for lateralization of HSCC-canalolithiasis and cupulopathy (heavy cupula and light cupula), and evaluate treatment outcomes in patients with HSCC-canalolithiasis. We conducted retrospective case reviews in 66 patients with HSCC-canalolithiasis and 63 patients with HSCC-cupulopathy. The affected side was identified as the direction of bowing nystagmus on BLT in 55 % (36 of 66) of patients with canalolithiasis, which was concordant with the HRT result in 67 % (24 of 36) of cases (concordant group). Lateralization was determined by comparison of nystagmus intensity during HRT in 30 patients who did not show bowing or leaning nystagmus. The remission rate after the first treatment was 71 % (17 of 24) in the concordant group and 45 % (5 of 11) in the discordant group. Both bowing and leaning nystagmus were observed in all patients with cupulopathy, and the side of the null plane was identified as the affected side. In conclusion, bowing and/or leaning nystagmus were observed in only 55 % of patients with HSCC-canalolithiasis, and the first treatment based on the result of BLT alone was effective in only 45 % of the patients in whom the BLT and HRT were discordant, which may suggest that the usefulness of BLT in lateralizing the HSCC-canalolithiasis may be limited.

  20. Positional Plagiocephaly (Flattened Head)

    MedlinePlus

    ... Simple practices like changing a baby's sleep position, holding your baby, and providing lots of "tummy time" ... devices to keep your baby in one position. Alternate positions in the crib. Consider how you lay ...

  1. Positive Education: Positive Psychology and Classroom Interventions

    ERIC Educational Resources Information Center

    Seligman, Martin E. P.; Ernst, Randal M.; Gillham, Jane; Reivich, Karen; Linkins, Mark

    2009-01-01

    Positive education is defined as education for both traditional skills and for happiness. The high prevalence worldwide of depression among young people, the small rise in life satisfaction, and the synergy between learning and positive emotion all argue that the skills for happiness should be taught in school. There is substantial evidence from…

  2. Want Positive Behavior? Use Positive Language

    ERIC Educational Resources Information Center

    Wood, Chip; Freeman-Loftis, Babs

    2012-01-01

    Positive adult language is the professional use of words and tone of voice to enable students to learn in an engaged, active way. This includes learning social skills. To guide children toward choosing and maintaining positive behaviors, adults need to carefully choose the words and tone of voice used when speaking to them. Learning to use…

  3. [Positive Activities Campaign.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Prevention.

    This packet contains four pamphlets that are part of a campaign to encourage adults to provide and promote positive activities for youth and to serve as role models for young people. "Positive Activities: A Campaign for Youth" includes information on what positive activities are, how to get involved in helping to provide positive activities for…

  4. On Positive Functions with Positive Derivatives

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2002-01-01

    Three proofs are given for the fact that the derivative of an everywhere-positive non-constant real polynomial function must change sign. This self-contained note could find classroom use in courses on calculus or abstract algebra.

  5. Sample positioning in microgravity

    NASA Technical Reports Server (NTRS)

    Sridharan, Govind (Inventor)

    1991-01-01

    Repulsion forces arising from laser beams are provided to produce mild positioning forces on a sample in microgravity vacuum environments. The system of the preferred embodiment positions samples using a plurality of pulsed lasers providing opposing repulsion forces. The lasers are positioned around the periphery of a confinement area and expanded to create a confinement zone. The grouped laser configuration, in coordination with position sensing devices, creates a feedback servo whereby stable position control of a sample within microgravity environment can be achieved.

  6. Sample positioning in microgravity

    NASA Technical Reports Server (NTRS)

    Sridharan, Govind (Inventor)

    1993-01-01

    Repulsion forces arising from laser beams are provided to produce mild positioning forces on a sample in microgravity vacuum environments. The system of the preferred embodiment positions samples using a plurality of pulsed lasers providing opposing repulsion forces. The lasers are positioned around the periphery of a confinement area and expanded to create a confinement zone. The grouped laser configuration, in coordination with position sensing devices, creates a feedback servo whereby stable position control of a sample within microgravity environment can be achieved.

  7. Sharing a Faculty Position.

    ERIC Educational Resources Information Center

    O'Kane, Patricia K.; Meyer, Mary

    1982-01-01

    Describes the experience of two nursing faculty members who shared an assistant professor of nursing position. Discusses positive and negative aspects of the experience and notes that a unified and creative approach must be taken for it to succeed. (JOW)

  8. Positive battery plate

    NASA Technical Reports Server (NTRS)

    Rowlette, John R. (Inventor)

    1985-01-01

    The power characteristics of a lead acid battery are improved by incorporating a dispersion of 1 to 10% by weight of a thermodynamically stable conductivity additive, such as conductive tin oxide coated glass fibers (34) of filamentary glass wool (42) in the positive active layer (32) carried on the grid (30) of the positive plate (16). Positive plate potential must be kept high enough to prevent reduction of the tin oxide to tin by utilizing an oversized, precharged positive paste.

  9. The Positivity Scale

    ERIC Educational Resources Information Center

    Caprara, Gian Vittorio; Alessandri, Guido; Eisenberg, Nancy; Kupfer, A.; Steca, Patrizia; Caprara, Maria Giovanna; Yamaguchi, Susumu; Fukuzawa, Ai; Abela, John

    2012-01-01

    Five studies document the validity of a new 8-item scale designed to measure "positivity," defined as the tendency to view life and experiences with a positive outlook. In the first study (N = 372), the psychometric properties of Positivity Scale (P Scale) were examined in accordance with classical test theory using a large number of college…

  10. Prone positioning for surgery.

    PubMed

    Bowers, Mark

    2012-05-01

    The role of the registered perioperative practitioner (Operating Department Practitioner or Registered Nurse) includes the responsibility for safely positioning patients for surgery. The prone position is in common use for a variety of surgical procedures. The formal term for this surgical position is ventral decubitus (meaning laying face down). PMID:22720505

  11. Precision positioning device

    DOEpatents

    McInroy, John E.

    2005-01-18

    A precision positioning device is provided. The precision positioning device comprises a precision measuring/vibration isolation mechanism. A first plate is provided with the precision measuring mean secured to the first plate. A second plate is secured to the first plate. A third plate is secured to the second plate with the first plate being positioned between the second plate and the third plate. A fourth plate is secured to the third plate with the second plate being positioned between the third plate and the fourth plate. An adjusting mechanism for adjusting the position of the first plate, the second plate, the third plate, and the fourth plate relative to each other.

  12. Perceived positions determine crowding.

    PubMed

    Maus, Gerrit W; Fischer, Jason; Whitney, David

    2011-01-01

    Crowding is a fundamental bottleneck in object recognition. In crowding, an object in the periphery becomes unrecognizable when surrounded by clutter or distractor objects. Crowding depends on the positions of target and distractors, both their eccentricity and their relative spacing. In all previous studies, position has been expressed in terms of retinal position. However, in a number of situations retinal and perceived positions can be dissociated. Does retinal or perceived position determine the magnitude of crowding? Here observers performed an orientation judgment on a target Gabor patch surrounded by distractors that drifted toward or away from the target, causing an illusory motion-induced position shift. Distractors in identical physical positions led to worse performance when they drifted towards the target (appearing closer) versus away from the target (appearing further). This difference in crowding corresponded to the difference in perceived positions. Further, the perceptual mislocalization was necessary for the change in crowding, and both the mislocalization and crowding scaled with drift speed. The results show that crowding occurs after perceived positions have been assigned by the visual system. Crowding does not operate in a purely retinal coordinate system; perceived positions need to be taken into account.

  13. Linear Path Integration Deficits in Patients with Abnormal Vestibular Afference

    PubMed Central

    Arthur, Joeanna C.; Kortte, Kathleen B.; Shelhamer, Mark; Schubert, Michael C.

    2014-01-01

    Effective navigation requires the ability to keep track of one’s location and maintain orientation during linear and angular displacements. Path integration is the process of updating the representation of body position by integrating internally-generated self-motion signals over time (e.g., walking in the dark). One major source of input to path integration is vestibular afference. We tested patients with reduced vestibular function (unilateral vestibular hypofunction, UVH), patients with aberrant vestibular function (benign paroxysmal positional vertigo, BPPV), and healthy participants (controls) on two linear path integration tasks: experimenter-guided walking and target-directed walking. The experimenter-guided walking task revealed a systematic underestimation of self-motion signals in UVH patients compared to the other groups. However, we did not find any difference in the distance walked between the UVH group and the control group for the target-directed walking task. Results from neuropsychological testing and clinical balance measures suggest that the errors in experimenter-guided walking were not attributable to cognitive and/or balance impairments. We conclude that impairment in linear path integration in UVH patients stem from deficits in self-motion perception. Importantly, our results also suggest that patients with a UVH deficit do not lose their ability to walk accurately without vision to a memorized target location. PMID:22726251

  14. Positive criminology in practice.

    PubMed

    Ronel, Natti; Segev, Dana

    2014-11-01

    The discourse regarding offender rehabilitation has been criticized by various scholars who have claimed that reducing negative causes and managing risk will not automatically prompt positive human development and elements that are associated with desistance. Positive criminology is an innovative concept that challenges the common preoccupation with negative elements, by placing emphasis on human encounters and forces of inclusion that are experienced positively by target individuals and that can promote crime desistance. However, as the concept is relatively new, there are still no guiding principles for the practice of positive criminology that could direct research and the criminal justice system. This article attempts to fill that gap by providing principles that could be practiced by criminal justice personnel and examples of different interventions that reflect positive criminology. The article also provides ideological explanations for adopting the concept of positive criminology in practice.

  15. Beam position monitor

    DOEpatents

    Alkire, Randy W.; Rosenbaum, Gerold; Evans, Gwyndaf

    2003-07-22

    An apparatus for determining the position of an x-ray beam relative to a desired beam axis. Where the apparatus is positioned along the beam path so that a thin metal foil target intersects the x-ray beam generating fluorescent radiation. A PIN diode array is positioned so that a portion of the fluorescent radiation is intercepted by the array resulting in an a series of electrical signals from the PIN diodes making up the array. The signals are then analyzed and the position of the x-ray beam is determined relative to the desired beam path.

  16. Positioning and locking apparatus

    DOEpatents

    Hayward, Milton L.; Harper, William H.

    1987-01-01

    A positioning and locking apparatus including a fixture having a rotatable torque ring provided with a plurality of cam segments for automatically guiding a container into a desired location within the fixture. Rotation of the ring turns the container into a final position in pressure sealing relation against a hatch member.

  17. Positioning and locking apparatus

    DOEpatents

    Hayward, M.L.; Harper, W.H.

    1987-06-30

    A positioning and locking apparatus are disclosed including a fixture having a rotatable torque ring provided with a plurality of cam segments for automatically guiding a container into a desired location within the fixture. Rotation of the ring turns the container into a final position in pressure sealing relation against a hatch member. 6 figs.

  18. Positioning and locking apparatus

    DOEpatents

    Hayward, M.L.; Harper, W.H.

    1985-06-19

    A positioning and locking apparatus including a fixture having a rotatable torque ring provided with a plurality of cam segments for automatically guiding a container into a desired location within the fixture. Rotation of the ring turns the container into a final position in pressure sealing relation against a hatch member.

  19. Position Resolution in DROIDs

    NASA Astrophysics Data System (ADS)

    Samedov, Victor V.

    2008-04-01

    Since the very beginning, Distributed Read-Out Imaging Devices (DROIDs) were proposed to achieve both good position and energy resolutions. In DROIDs, the absorption of primary particle energy occurs in a long superconductive strip. Quasiparticles produced in the absorber diffuse along the strip and counted by the superconductive tunnel junctions positioned at the two ends of the strip. In this paper the formula for estimation DROID’s position resolution from experimental data was derived. This formula takes into account correlation between fluctuations of signals of DROID’s detectors.

  20. CRANE POSITIONING APPARATUS

    DOEpatents

    Landsiedel, F.W.; Wolff, H.

    1960-06-28

    An apparatus is described for automatically accomplishing the final accurate horizontal positioning of a crane after the latter has been placed to within 1/8 in. of its selected position. For this purpose there is provided a tiltable member on the crane mast for lowering into contact with a stationary probe. Misalignment of the tiltable member, with respect to the probe as the member is lowered, causes tilting of the latter to actuate appropriate switches that energize motors for bringing the mast into proper position. When properly aligned the member is not tilted and a central switch is actuated to indicate the final alignment of the crane.

  1. Approach to dizziness in the emergency department

    PubMed Central

    Jung, Ileok; Kim, Ji-Soo

    2015-01-01

    Acute dizziness/vertigo is among the most common causes for visiting the emergency department. The traditional approach to dizziness starts with categorizing dizziness into four types: vertigo, presyncope, disequilibrium, and nonspecific dizziness. However, a recently proposed approach begins with classifying dizziness/vertigo as acute prolonged spontaneous dizziness/vertigo, recurrent spontaneous dizziness/vertigo, recurrent positional vertigo, or chronic persistent dizziness and imbalance. Vestibular neuritis and stroke are key disorders causing acute prolonged spontaneous dizziness/vertigo, but the diagnosis of isolated vascular vertigo has increased by virtue of developments in clinical neurotology and neuroimaging. However, a well-organized bedside examination appears more sensitive than brain imaging in diagnosing strokes presenting with acute dizziness/vertigo. A detailed history is vital to diagnose recurrent spontaneous dizziness/vertigo since confirmatory diagnostic tests are usually unavailable. Isolated positional vertigo is usually caused by benign paroxysmal positional vertigo, which can be treated at the bedside. In recent years, marked progress has occurred in the evaluation/management of acute dizziness/vertigo. However, even with developments in imaging technology, the diagnosis of acute dizziness/vertigo largely relies on bedside examination. PMID:27752577

  2. Dizziness in the elderly: diagnosing its causes in a multidisciplinary dizziness unit.

    PubMed

    van Leeuwen, Roeland B; Bruintjes, Tjasse D

    2014-01-01

    We conducted a study to determine the causes of dizziness in patients aged 70 years and older who had been referred to our multidisciplinary dizziness clinic between Nov. 1, 2000, and Dec. 31, 2008. This population was made up of 731 patients--254 men (34.7%) and 477 women (65.3%). During their consultations, all of these patients were evaluated simultaneously by an ENT surgeon and a neurologist. We were able to identify the cause of dizziness in 620 of these patients (84.8%). The two most common causes were benign paroxysmal positional vertigo (BPPV), which was found in 202 patients (27.6%), and hyperventilation/anxiety, which was diagnosed in 112 patients (15.3%). Based on our findings, we conclude that the cause of dizziness can be established in the vast majority of elderly patients. We also compare our findings in these older patients with those of a group of 2,556 younger patients who were seen at our hospital and with the findings reported in other studies.

  3. Role of orientation reference selection in motion sickness, supplement 2S

    NASA Technical Reports Server (NTRS)

    Peterka, Robert J.; Black, F. Owen

    1987-01-01

    Previous experiments with moving platform posturography have shown that different people have varying abilities to resolve conflicts among vestibular, visual, and proprioceptive sensory signals. The conceptual basis of the present proposal hinges on the similarities between the space motion sickness problem and the sensory orientation reference selection problems associated with benign paroxysmal positional vertigo (BPPV) syndrome. These similarities include both etiology related to abnormal vertical canal-otolith function, and motion sickness initiating events provoked by pitch and roll head movements. The objectives are to explore and quantify the orientation reference selection abilities of subjects and the relation of this selection to motion sickness in humans. The overall objectives are to determine: if motion sickness susceptibility is related to sensory orientation reference selection abilities of subjects; if abnormal vertical canal-otolith function is the source of abnormal posture control strategies and if it can be quantified by vestibular and oculomotor reflex measurements, and if it can be quantified by vestibular and oculomotor reflex measurements; and quantifiable measures of perception of vestibular and visual motion cues can be related to motion sickness susceptibility and to orientation reference selection ability.

  4. Fluorescent optical position sensor

    DOEpatents

    Weiss, Jonathan D.

    2005-11-15

    A fluorescent optical position sensor and method of operation. A small excitation source side-pumps a localized region of fluorescence at an unknown position along a fluorescent waveguide. As the fluorescent light travels down the waveguide, the intensity of fluorescent light decreases due to absorption. By measuring with one (or two) photodetectors the attenuated intensity of fluorescent light emitted from one (or both) ends of the waveguide, the position of the excitation source relative to the waveguide can be determined by comparing the measured light intensity to a calibrated response curve or mathematical model. Alternatively, excitation light can be pumped into an end of the waveguide, which generates an exponentially-decaying continuous source of fluorescent light along the length of the waveguide. The position of a photodetector oriented to view the side of the waveguide can be uniquely determined by measuring the intensity of the fluorescent light emitted radially at that location.

  5. Reflection Positivity for Parafermions

    NASA Astrophysics Data System (ADS)

    Jaffe, Arthur; Pedrocchi, Fabio L.

    2015-07-01

    We establish reflection positivity for Gibbs trace states for a class of gauge-invariant, reflection-invariant Hamiltonians describing parafermion interactions on a lattice. We relate these results to recent work in the condensed-matter physics literature.

  6. Art of Positive Principalship.

    ERIC Educational Resources Information Center

    Bailey, Martha

    1979-01-01

    An elementary school principal explains how she promotes a positive working and learning environment in her school through written and verbal praise, open communications, and the sharing of ideas. (SJL)

  7. Video image position determination

    DOEpatents

    Christensen, Wynn; Anderson, Forrest L.; Kortegaard, Birchard L.

    1991-01-01

    An optical beam position controller in which a video camera captures an image of the beam in its video frames, and conveys those images to a processing board which calculates the centroid coordinates for the image. The image coordinates are used by motor controllers and stepper motors to position the beam in a predetermined alignment. In one embodiment, system noise, used in conjunction with Bernoulli trials, yields higher resolution centroid coordinates.

  8. Optimal Centroid Position Estimation

    SciTech Connect

    Candy, J V; McClay, W A; Awwal, A S; Ferguson, S W

    2004-07-23

    The alignment of high energy laser beams for potential fusion experiments demand high precision and accuracy by the underlying positioning algorithms. This paper discusses the feasibility of employing online optimal position estimators in the form of model-based processors to achieve the desired results. Here we discuss the modeling, development, implementation and processing of model-based processors applied to both simulated and actual beam line data.

  9. Nucleosome positioning determinants.

    PubMed

    Fernandez, Alfonso G; Anderson, John N

    2007-08-17

    A previous report demonstrated that one site in a nucleosome assembled onto a synthetic positioning sequence known as Fragment 67 is hypersensitive to permanganate. The site is required for positioning activity and is located 1.5 turns from the dyad, which is a region of high DNA curvature in the nucleosome. Here, the permanganate sensitivity of the nucleosome positioning Fragment 601 was examined in order to expand the dataset of nucleosome sequences containing KMnO(4) hypersensitive sites. The hyperreactive T residue in the six sites detected as well as the one in Fragment 67 and three in the 5 S rDNA positioning sequence were contained within a TA step. Seven of the ten sequences were of the form CTAGPuG or the related sequence TTAAPu. These motifs were also found in the binding sites of several transcriptional regulatory proteins that kink DNA. In order to assess the significance of these sites, the 10 bp positioning determinant in Fragment 67 was removed and replaced by the nine sequences from the 5 S rDNA and Fragment 601. The results demonstrated that these derivative fragments promoted high nucleosome stability and positioning as compared to a control sequence that contained an AT step in place of the TA step. The importance of the TA step was further tested by making single base-pair substitutions in Fragment 67 and the results revealed that stability and positioning activity followed the order: TA>TG>TT>/=TC approximately GG approximately GA approximately AT. Sequences flanking the TA step were also shown to be critical for nucleosome stability and positioning. Nucleosome positioning was restored to near wild-type levels with (CTG)(3), which can form slipped stranded structures and with one base bulges that kink DNA. The results of this study suggest that local DNA structures are important for positioning and that single base-pair changes at these sites could have profound effects on those genomic functions that depend on ordered nucleosomes. PMID

  10. Local positioning system

    SciTech Connect

    Kyker, R.

    1995-07-25

    Navigation systems have been vital to transportation ever since man took to the air and sea. Early navigation systems utilized the sextant to navigate by starlight as well as the magnetic needle compass. As electronics and communication technologies improved, inertial navigation systems were developed for use in ships and missile delivery. These systems consisted of electronic compasses, gyro-compasses, accelerometers, and various other sensors. Recently, systems such as LORAN and the Global Positioning System (GPS) have utilized the properties of radio wave propagation to triangulate position. The Local Positioning System (LPS), described in this paper, is an implementation of a limited inertial navigation system designed to be used on a bicycle. LPS displays a cyclist`s current position relative to a starting location. This information is displayed in Cartesian-like coordinates. To accomplish this, LPS relies upon two sensors, an electronic compass sensor and a distance sensor. The compass sensor provides directional information while the distance sensor provides the distance traveled. This information yields a distance vector for each point in time which when summed produces the cyclist`s current position. LPS is microprocessor controlled and is designed for a range of less than 90 miles.

  11. Beyond Positive Psychology?

    PubMed Central

    McNulty, James K.; Fincham, Frank D.

    2014-01-01

    The field of positive psychology rests on the assumption that certain psychological traits and processes are inherently beneficial for well-being. We review evidence that challenges this assumption. First, we review data from 4 independent longitudinal studies of marriage revealing that 4 ostensibly positive processes—forgiveness, optimistic expectations, positive thoughts, and kindness—can either benefit or harm well-being depending on the context in which they operate. Although all 4 processes predicted better relationship well-being among spouses in healthy marriages, they predicted worse relationship well-being in more troubled marriages. Then, we review evidence from other research that reveals that whether ostensibly positive psychological traits and processes benefit or harm well-being depends on the context of various noninterpersonal domains as well. Finally, we conclude by arguing that any movement to promote well-being may be most successful to the extent that it (a) examines the conditions under which the same traits and processes may promote versus threaten well-being, (b) examines both healthy and unhealthy people, (c) examines well-being over substantial periods of time, and (d) avoids labeling psychological traits and processes as positive or negative. PMID:21787036

  12. Taking a Position

    NASA Technical Reports Server (NTRS)

    1999-01-01

    "TerrAvoid" and "Position Integrity" combine Global Positioning Satellite (GPS) data with high-resolution maps of the Earth's topography. Dubbs & Severino, Inc., based in Irvine, California, has developed software that allows the system to be run on a battery-powered laptop in the cockpit. The packages, designed primarily for military sponsors and now positioned to hit the consumer market in coming months, came about as the result of the Jet Propulsion Laboratory's Technology Affiliates Program. Intended to give American industry assistance from NASA experts and to facilitate business use of intellectual property developed for the space program, the Technology Affiliates Program introduced the start-up company of Dubbs & Severino to JPL's Dr. Nevin Bryant four years ago. GeoTIFF is now in the public domain, and its use for commercial product development has evolved into an industry standard over the last year.

  13. Turbine nozzle positioning system

    DOEpatents

    Norton, Paul F.; Shaffer, James E.

    1996-01-30

    A nozzle guide vane assembly having a preestablished rate of thermal expansion is positioned in a gas turbine engine and being attached to conventional metallic components. The nozzle guide vane assembly includes an outer shroud having a mounting leg with an opening defined therein, a tip shoe ring having a mounting member with an opening defined therein, a nozzle support ring having a plurality of holes therein and a pin positioned in the corresponding opening in the outer shroud, opening in the tip shoe ring and the hole in the nozzle support ring. A rolling joint is provided between metallic components of the gas turbine engine and the nozzle guide vane assembly. The nozzle guide vane assembly is positioned radially about a central axis of the gas turbine engine and axially aligned with a combustor of the gas turbine engine.

  14. Turbine nozzle positioning system

    DOEpatents

    Norton, P.F.; Shaffer, J.E.

    1996-01-30

    A nozzle guide vane assembly having a preestablished rate of thermal expansion is positioned in a gas turbine engine and being attached to conventional metallic components. The nozzle guide vane assembly includes an outer shroud having a mounting leg with an opening defined therein, a tip shoe ring having a mounting member with an opening defined therein, a nozzle support ring having a plurality of holes therein and a pin positioned in the corresponding opening in the outer shroud, opening in the tip shoe ring and the hole in the nozzle support ring. A rolling joint is provided between metallic components of the gas turbine engine and the nozzle guide vane assembly. The nozzle guide vane assembly is positioned radially about a central axis of the gas turbine engine and axially aligned with a combustor of the gas turbine engine. 9 figs.

  15. Uncharged positive electrode composition

    DOEpatents

    Kaun, Thomas D.; Vissers, Donald R.; Shimotake, Hiroshi

    1977-03-08

    An uncharged positive-electrode composition contains particulate lithium sulfide, another alkali metal or alkaline earth metal compound other than sulfide, e.g., lithium carbide, and a transition metal powder. The composition along with a binder, such as electrolytic salt or a thermosetting resin is applied onto an electrically conductive substrate to form a plaque. The plaque is assembled as a positive electrode within an electrochemical cell opposite to a negative electrode containing a material such as aluminum or silicon for alloying with lithium. During charging, lithium alloy is formed within the negative electrode and transition metal sulfide such as iron sulfide is produced within the positive electrode. Excess negative electrode capacity over that from the transition metal sulfide is provided due to the electrochemical reaction of the other than sulfide alkali metal or alkaline earth metal compound.

  16. Nucleosome Positioning and Epigenetics

    NASA Astrophysics Data System (ADS)

    Schwab, David; Bruinsma, Robijn

    2008-03-01

    The role of chromatin structure in gene regulation has recently taken center stage in the field of epigenetics, phenomena that change the phenotype without changing the DNA sequence. Recent work has also shown that nucleosomes, a complex of DNA wrapped around a histone octamer, experience a sequence dependent energy landscape due to the variation in DNA bend stiffness with sequence composition. In this talk, we consider the role nucleosome positioning might play in the formation of heterochromatin, a compact form of DNA generically responsible for gene silencing. In particular, we discuss how different patterns of nucleosome positions, periodic or random, could either facilitate or suppress heterochromatin stability and formation.

  17. Positive isolation disconnect

    NASA Technical Reports Server (NTRS)

    Friedell, M. V.

    1980-01-01

    Positive-isolation-disconnect (PID) device with two mating halves prevents leakage or spillover when two fluid lines are disconnected. Each half has shutoff poppet to stop fluid flow. When flow is shut, poppets are flush against each other, leaving no space for fluid to remain it.

  18. Positive Discipline. (Revised Edition).

    ERIC Educational Resources Information Center

    Nelsen, Jane

    Understanding why children do not behave the way they used to, and why both controlling and overly-permissive discipline styles are ineffective, is the first step for parents and teachers who are facing child-discipline problems. This book describes a program of positive discipline principles aimed at assisting parents and teachers in…

  19. Nursing Research: Position Statement.

    ERIC Educational Resources Information Center

    Copp, Laurel; And Others

    The role of the American Association of Colleges of Nursing (AACN) in encouraging research through the programs and activities of the member schools is discussed. It is suggested that the dean or administrative head of a college of nursing is in a position to influence nursing research activities. The principal role of the academic dean in…

  20. Positive: HIV Affirmative Counseling.

    ERIC Educational Resources Information Center

    Kain, Craig D.

    At the end of the 1980s, counselors largely lacked an integrated approach to counseling people living with HIV disease. This book describes the experience of counseling this group of persons. The major premise here is that counselors who counsel HIV-positive clients must come to understand and affirm their clients' experiences. The text defines a…

  1. Creating Positive Task Constraints

    ERIC Educational Resources Information Center

    Mally, Kristi K.

    2006-01-01

    Constraints are characteristics of the individual, the task, or the environment that mold and shape movement choices and performances. Constraints can be positive--encouraging proficient movements or negative--discouraging movement or promoting ineffective movements. Physical educators must analyze, evaluate, and determine the effect various…

  2. Position feedback control system

    DOEpatents

    Bieg, Lothar F.; Jokiel, Jr., Bernhard; Ensz, Mark T.; Watson, Robert D.

    2003-01-01

    Disclosed is a system and method for independently evaluating the spatial positional performance of a machine having a movable member, comprising an articulated coordinate measuring machine comprising: a first revolute joint; a probe arm, having a proximal end rigidly attached to the first joint, and having a distal end with a probe tip attached thereto, wherein the probe tip is pivotally mounted to the movable machine member; a second revolute joint; a first support arm serially connecting the first joint to the second joint; and coordinate processing means, operatively connected to the first and second revolute joints, for calculating the spatial coordinates of the probe tip; means for kinematically constraining the articulated coordinate measuring machine to a working surface; and comparator means, in operative association with the coordinate processing means and with the movable machine, for comparing the true position of the movable machine member, as measured by the true position of the probe tip, with the desired position of the movable machine member.

  3. Schoolwide Positive Behavior Supports

    ERIC Educational Resources Information Center

    Flannery, K. Brigid; Guest, Elise M.; Horner, Robert H.

    2010-01-01

    Schools are complex communities that play a major role in the social fabric of culture. Effective schools provide access to both good instruction and a social culture that supports engagement, community, and success. Over the past 10 years, more than 11,000 elementary, middle level, and high schools have adopted schoolwide positive behavior…

  4. Immunizations. Position Statement. Revised

    ERIC Educational Resources Information Center

    Bobo, Nichole; Garrett, Jennifer; Teskey, Carmen; Duncan, Kay; Strasser, Kathy; Burrows-Mezu, Alicia L.

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood. Promotion of immunizations by the registered professional school nurse (hereinafter referred to as school nurse) is central to the public health focus of school nursing practice…

  5. A Position Paper.

    ERIC Educational Resources Information Center

    Hixson, Richard A.

    This position paper covers possible problems of collective bargaining. (1) The two sides should not bring prejudgments of good or bad to the negotiating table. (2) Neither side should exaggerate its strength or minimize its weakness. (3) Neither side should confuse intransigence with firmness. (4) The composition of each team must be carefully…

  6. Positive reinforcement for viruses

    PubMed Central

    Vigant, Frederic; Jung, Michael; Lee, Benhur

    2010-01-01

    Summary Virus-cell membrane fusion requires a critical transition from positive to negative membrane curvature. St. Vincent et al., in PNAS (St Vincent, et al., 2010), designed a class of antivirals that targets this transition. These Rigid Amphipathic Fusion Inhibitors are active against an array of enveloped viruses. PMID:21035726

  7. Positive reinforcement for viruses.

    PubMed

    Vigant, Frederic; Jung, Michael; Lee, Benhur

    2010-10-29

    Virus-cell membrane fusion requires a critical transition from positive to negative membrane curvature. St. Vincent et al. (2010), in PNAS, designed a class of antivirals that targets this transition. These rigid amphipathic fusion inhibitors are active against an array of enveloped viruses.

  8. Review of HRP Positions

    SciTech Connect

    Center for Reliability Studies

    2007-01-01

    The Department of Energy (DOE) Human Reliability Program (HRP), published as 10 CFR Part 712, is currently being reviewed and revised to address concerns identified during its implementation. Although these ''page changes'' primarily incorporate clarification of terms and language, the following discussion relates to broadening the definition of positions that require HRP certification that is found in {section}712.10.

  9. Delegation. Position Statement. Revised

    ERIC Educational Resources Information Center

    Board, Connie; Bushmiaer, Margo; Davis-Alldritt, Linda; Fekaris, Nina; Morgitan, Judith; Murphy, M. Kathleen; Yow, Barbara

    2010-01-01

    It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the school nurse, when based on the nursing definition of delegation and in compliance with state nursing regulations and guidance. Delegation in school nursing is a complex process in which…

  10. Positioning for Competition.

    ERIC Educational Resources Information Center

    Lapovsky, Lucie; Hubbell, Loren Loomis

    2000-01-01

    Analyzes results of the 1999 National Association of College and Business Officers tuition discounting survey and identifies trends. Finds colleges and universities are reactively responding to market pressures and proactively trying to analyze and position themselves ahead of the competition, often regional rather than national, for the…

  11. Magnetic beam position monitor

    SciTech Connect

    Varfolomeev, A.A.; Ivanchenkov, S.N.; Khlebnikov, A.S.

    1995-12-31

    Many nondestructive beam position monitors are known. However, these devices can not be used for DC particle beam diagnostics. We investigated a method of beam diagnostics applicable for the operative control of DC high power e-beam inside closed waveguide. A design of the detector for determination of{open_quote} center of mass {close_quote} position of DC particle beam was developed. It was shown that the monitor can be used as a nondestructive method for the beam position control in resonators. Magnetic field of the particle beam outside a resonator is used. The detector consists of the steel yokes and magnetic field sensors. The sensors measure magnetic fluxes in the steel yokes fixed outside the resonator. When the particle beam changes its position, these magnetic fluxes also change. Beam displacement sensitivity of the monitor depends on the steel yoke dimensions. The detector sensitivity is equal to 1 Gauss/mm for the conditions adequate to the FOM-FEM project.

  12. Position Sensitive Microcalorimeters

    NASA Technical Reports Server (NTRS)

    Sadleir, J. E.; Hammock, C.; Figueroa-Feliciano, E.; Stahle, C. K.; Bandler, S.; Saab, T.; Lindeman, M.; Porter, F. S.; Chervenak, J.; Brown, G.

    2004-01-01

    A Position Sensitive Transition-Edge Sensor (PoST) is a microcalorimeter device capable of one-dimensional imaging spectroscopy. The device consists of two Transition-Edge Sensors (TESs) connected to the ends of a long X-ray absorbing strip. The energy of a photon hitting the absorber and the position of the absorption event along the strip is measured from the response in the two sensors by analyzing the relative signal sizes, pulse rise times, and the sum of the pulses measured at each sensor, We report on the recent PoST effort at Goddard for applications to large field of view, high-energy- resolution, X-ray astrophysics.

  13. Positive isolation disconnect

    NASA Technical Reports Server (NTRS)

    Rosener, A. A.; Jonkoniec, T. G.

    1975-01-01

    A positive isolation disconnect was developed for component replacement in serviced liquid and gaseous spacecraft systems. Initially a survey of feasible concepts was made to determine the optimum method for fluid isolation, sealing techniques, coupling concepts, and foolproofing techniques. The top concepts were then further evaluated, including the fabrication of a semifunctional model. After all tradeoff analyses were made, a final configuration was designed and fabricated for development testing. This resulted in a 6.35 mm (1/4 inch) line and 12.7 mm (1/2 inch) line positive isolation disconnect, each unit consisting of two coupled disconnect halves, each capable of fluid isolation with essentially zero clearance between them for zero leakage upon disconnect half disengagement. An interlocking foolproofing technique was incorporated that prevents uncoupling of disconnect halves prior to fluid isolation.

  14. Positive isolation disconnect

    NASA Technical Reports Server (NTRS)

    Friedell, M. V. (Inventor)

    1978-01-01

    A disconnect composed basically of two halves each consisting of a poppet valve operable to isolate fluid with essentially zero fluid loss is presented. The two halves are coupled together by a quickly releasable coupling which may be either a coupling ring tightened or loosened by a twisting motion, or a clamp operated by a pivoted to prevent disconnecting the two halves until both valves are in closed condition. The positive feature of the device is one requiring a valve closing step before a disconnect step, and takes structural form in an accentric lobe mounted on the valve operating stem. If some obstruction prevents the poppet from moving to its seat, the eccentric lobe cannot be rotated to the closed position, and the interlock prevents a disconnect.

  15. Size and position matter.

    PubMed

    Warren, Graham

    2013-12-01

    The 2013 Nobel Prize in Physiology or Medicine emphasizes the progress made in understanding the molecular mechanisms that underpin the vesicular movement of cargo through the exocytic and endocytic pathways. Attention now focuses on those mechanisms that govern the relative size and position of the many different membrane-bound compartments. These homeostatic mechanisms are discussed in this issue of Nature Reviews Molecular Cell Biology and must be integrated so as to satisfy the needs of the cell and the organism.

  16. Membrane position control

    NASA Technical Reports Server (NTRS)

    Su, Ji (Inventor); Harrison, Joycelyn S. (Inventor)

    2004-01-01

    A membrane structure includes at least one electroactive bending actuator fixed to a supporting base. Each electroactive bending actuator is operatively connected to the membrane for controlling membrane position. Any displacement of each electroactive bending actuator effects displacement of the membrane. More specifically, the operative connection is provided by a guiding wheel assembly and a track, wherein displacement of the bending actuator effects translation of the wheel assembly along the track, thereby imparting movement to the membrane.

  17. Nuclear core positioning system

    DOEpatents

    Garkisch, Hans D.; Yant, Howard W.; Patterson, John F.

    1979-01-01

    A structural support system for the core of a nuclear reactor which achieves relatively restricted clearances at operating conditions and yet allows sufficient clearance between fuel assemblies at refueling temperatures. Axially displaced spacer pads having variable between pad spacing and a temperature compensated radial restraint system are utilized to maintain clearances between the fuel elements. The core support plates are constructed of metals specially chosen such that differential thermal expansion produces positive restraint at operating temperatures.

  18. Mapping your competitive position.

    PubMed

    D'Aveni, Richard A

    2007-11-01

    A price-benefit positioning map helps you see, through your customers' eyes, how your product compares with all its competitors in a market. You can draw such a map quickly and objectively, without having to resort to costly, time-consuming consumer surveys or subjective estimates of the excellence of your product and the shortcomings of all the others. Creating a positioning map involves three steps: First, define your market to include everything your customers might consider to be your product's competitors or substitutes. Second, track the price your customers actually pay (wholesale or retail? bundled or unbundled?) and identify what your customers see as your offering's primary benefit. This is done through regression analysis, determining which of the product's attributes (as described objectively by rating services, government agencies, R&D departments, and the like) explains most of the variance in its price. Third, draw the map by plotting on a graph the position of every product in the market you've selected according to its price and its level of primary benefit, and draw a line that runs through the middle of the points. What you get is a picture of the competitive landscape of your market, where all the products above the line command a price premium owing to some secondary benefit customers value, and all those below the line are positioned to earn market share through lower prices and reduced secondary benefits. Using examples as varied as Harley-Davidson motorcycles, Motorola cell phones, and the New York restaurant market, Tuck professor D'Aveni demonstrates some of the many ways the maps can be used: to locate unoccupied or less-crowded spaces in highly competitive markets, for instance, or to identify opportunities created through changes in the relationship between the primary benefit and prices. The maps even allow companies to anticipate--and counter-- rivals' strategies. R eprint RO711G PMID:18159791

  19. Thermolysis Of Positive Photoresists

    NASA Astrophysics Data System (ADS)

    Johnson, Donald W.

    1984-05-01

    Positive photoresists are currently being pushed to their limits to develop new processes for fine line lithography. Much of this processing is done in high temperature environments or with processes which generate a great deal of localized heat. Other processes use highly reactive free radical or ionic species. Further, current requirements demand that this processing be accomplished with minimal degredation of the resist image. All these requirements put increasing demands on the thermal stability of photoresist products. In view of these demands, a more complete understanding of the thermal chemistry of resist products would be of beneficial interest to those utilizing or designing these processes. This is of major importance in the development of new equipment, materials, and processes; especially where considerable heat is generated in the presence of resist materials. This paper attempts to provide a basic background to develop this understanding. It provides a description of the effects of thermal processing on positive photoresists. The paper discusses the thermal chemistry, particularly at temperatures above 100 degrees C, of the major positive photoresists used in microelectronic applications. The major emphasis is placed on common positive photoresist products containing diazo-oxide PAC and novolak resin. The paper gives a brief description of composition of the resists, and then an analysis of the thermolysis products at various temperatures. Analysis of the thermal reactions of the PAC, resin, and resist are given. The chemistry of the bulk films as well as the localized surface effects are examined. Finally, the effects of thermolysis are related to their impact on subsequent processing steps.

  20. Mapping your competitive position.

    PubMed

    D'Aveni, Richard A

    2007-11-01

    A price-benefit positioning map helps you see, through your customers' eyes, how your product compares with all its competitors in a market. You can draw such a map quickly and objectively, without having to resort to costly, time-consuming consumer surveys or subjective estimates of the excellence of your product and the shortcomings of all the others. Creating a positioning map involves three steps: First, define your market to include everything your customers might consider to be your product's competitors or substitutes. Second, track the price your customers actually pay (wholesale or retail? bundled or unbundled?) and identify what your customers see as your offering's primary benefit. This is done through regression analysis, determining which of the product's attributes (as described objectively by rating services, government agencies, R&D departments, and the like) explains most of the variance in its price. Third, draw the map by plotting on a graph the position of every product in the market you've selected according to its price and its level of primary benefit, and draw a line that runs through the middle of the points. What you get is a picture of the competitive landscape of your market, where all the products above the line command a price premium owing to some secondary benefit customers value, and all those below the line are positioned to earn market share through lower prices and reduced secondary benefits. Using examples as varied as Harley-Davidson motorcycles, Motorola cell phones, and the New York restaurant market, Tuck professor D'Aveni demonstrates some of the many ways the maps can be used: to locate unoccupied or less-crowded spaces in highly competitive markets, for instance, or to identify opportunities created through changes in the relationship between the primary benefit and prices. The maps even allow companies to anticipate--and counter-- rivals' strategies. R eprint RO711G

  1. Aircraft control position indicator

    NASA Technical Reports Server (NTRS)

    Dennis, Dale V. (Inventor)

    1987-01-01

    An aircraft control position indicator was provided that displayed the degree of deflection of the primary flight control surfaces and the manner in which the aircraft responded. The display included a vertical elevator dot/bar graph meter display for indication whether the aircraft will pitch up or down, a horizontal aileron dot/bar graph meter display for indicating whether the aircraft will roll to the left or to the right, and a horizontal dot/bar graph meter display for indicating whether the aircraft will turn left or right. The vertical and horizontal display or displays intersect to form an up/down, left/right type display. Internal electronic display driver means received signals from transducers measuring the control surface deflections and determined the position of the meter indicators on each dot/bar graph meter display. The device allows readability at a glance, easy visual perception in sunlight or shade, near-zero lag in displaying flight control position, and is not affected by gravitational or centrifugal forces.

  2. Photon beam position monitor

    DOEpatents

    Kuzay, Tuncer M.; Shu, Deming

    1995-01-01

    A photon beam position monitor for use in the front end of a beamline of a high heat flux and high energy photon source such as a synchrotron radiation storage ring detects and measures the position and, when a pair of such monitors are used in tandem, the slope of a photon beam emanating from an insertion device such as a wiggler or an undulator inserted in the straight sections of the ring. The photon beam position monitor includes a plurality of spaced blades for precisely locating the photon beam, with each blade comprised of chemical vapor deposition (CVD) diamond with an outer metal coating of a photon sensitive metal such as tungsten, molybdenum, etc., which combination emits electrons when a high energy photon beam is incident upon the blade. Two such monitors are contemplated for use in the front end of the beamline, with the two monitors having vertically and horizontally offset detector blades to avoid blade "shadowing". Provision is made for aligning the detector blades with the photon beam and limiting detector blade temperature during operation.

  3. Photon beam position monitor

    DOEpatents

    Kuzay, T.M.; Shu, D.

    1995-02-07

    A photon beam position monitor is disclosed for use in the front end of a beamline of a high heat flux and high energy photon source such as a synchrotron radiation storage ring detects and measures the position and, when a pair of such monitors are used in tandem, the slope of a photon beam emanating from an insertion device such as a wiggler or an undulator inserted in the straight sections of the ring. The photon beam position monitor includes a plurality of spaced blades for precisely locating the photon beam, with each blade comprised of chemical vapor deposition (CVD) diamond with an outer metal coating of a photon sensitive metal such as tungsten, molybdenum, etc., which combination emits electrons when a high energy photon beam is incident upon the blade. Two such monitors are contemplated for use in the front end of the beamline, with the two monitors having vertically and horizontally offset detector blades to avoid blade ''shadowing''. Provision is made for aligning the detector blades with the photon beam and limiting detector blade temperature during operation. 18 figs.

  4. Welding nozzle position manipulator

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L. (Inventor); Gutow, David A. (Inventor)

    1994-01-01

    The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

  5. Positional information, in bits

    PubMed Central

    Dubuis, Julien O.; Tkačik, Gašper; Wieschaus, Eric F.; Gregor, Thomas; Bialek, William

    2013-01-01

    Cells in a developing embryo have no direct way of “measuring” their physical position. Through a variety of processes, however, the expression levels of multiple genes come to be correlated with position, and these expression levels thus form a code for “positional information.” We show how to measure this information, in bits, using the gap genes in the Drosophila embryo as an example. Individual genes carry nearly two bits of information, twice as much as would be expected if the expression patterns consisted only of on/off domains separated by sharp boundaries. Taken together, four gap genes carry enough information to define a cell’s location with an error bar of along the anterior/posterior axis of the embryo. This precision is nearly enough for each cell to have a unique identity, which is the maximum information the system can use, and is nearly constant along the length of the embryo. We argue that this constancy is a signature of optimality in the transmission of information from primary morphogen inputs to the output of the gap gene network. PMID:24089448

  6. Position statement on cannabis.

    PubMed

    Stein For The Executive Committee Of The Central Drug Authority, Dan Joseph

    2016-05-16

    There is an ongoing national debate around cannabis policy. This brief position statement by the Executive Committee of the Central Drug Authorityoutlines some of the factors that have contributed to this debate, delineates reduction strategies, summarises the harms and benefits ofmarijuana, and provides recommendations. These recommendations emphasise an integrated and evidence-based approach, the need forresources to implement harm reduction strategies against continued and chronic use of alcohol and cannabis, and the potential value of afocus on decriminalisation rather than the legalisation of cannabis.

  7. Position from gravity

    NASA Technical Reports Server (NTRS)

    Mather, R. S.

    1973-01-01

    Procedures for obtaining position from surface gravity observations are reviewed and their relevance assessed in the context of the application of modern geodetic techniques to programs of Earth and ocean physics. Solutions based on the use of surface layer techniques, the discrete value approach, and the development from Green's theorem are stated in summary, the latter being extended to order e cubed in the height anomaly. The representation of the surface gravity field which is required in order that this accuracy may be achieved is discussed. Interim techniques which could be used in the absence of such a representation are also outlined.

  8. Deep Space Positioning System

    NASA Technical Reports Server (NTRS)

    Vaughan, Andrew T. (Inventor); Riedel, Joseph E. (Inventor)

    2016-01-01

    A single, compact, lower power deep space positioning system (DPS) configured to determine a location of a spacecraft anywhere in the solar system, and provide state information relative to Earth, Sun, or any remote object. For example, the DPS includes a first camera and, possibly, a second camera configured to capture a plurality of navigation images to determine a state of a spacecraft in a solar system. The second camera is located behind, or adjacent to, a secondary reflector of a first camera in a body of a telescope.

  9. Global Positioning Satellite Recorder

    1997-11-10

    The GPS Tracker is a device (automotive unit) that records position (latitude and longitude), date, and time autonomously with time. The data from the GPS Tracker can be used offline with a personal computer and map data base to plot the track of where a vehicle or other mobile battery powered object has been. The invention simplifies field operations for recording location autonomously by obviating the need to execute a set of detailed instructions priormore » to operation. The vehicle combines GPS technology and a cpu with custom software to accomplish the task.« less

  10. A cutaneous positioning system.

    PubMed

    Martin, Bernard J; Lee, Beom-Chan; Sienko, Kathleen H

    2015-04-01

    Our previous work revealed that torso cutaneous information contributes to the internal representation of the torso and plays a role in postural control. Hence, the aims of this study were to assess whether posture could be manipulated by patterns of vibrotactile stimulation and to determine whether resulting modified postures were associated with specific and consistent spatial attitudes. Ten healthy young adults stood in normal and Romberg stances with six vibrating actuators positioned on the torso in contact with the skin over the anatomical locations corresponding to left and right external oblique, internal oblique and erector spinae muscles at the L4/L5 vertebrae level. A 250-Hz tactile vibration was applied for 5 s either at a single location or consecutively at each location in clockwise or counterclockwise sequences. Kinematic analysis of the body segments indicated that postural responses observed in response to single and sequential stimulation patterns were similar, while the center of pressure remained unaltered in any situations. Moreover, torso inclinations followed rectilinear-like path segments chartered by stimuli loci during sequential stimulations. Comparison of torso attitudes with previous results obtained with co-vibration patterns of the same duration showed that torso inclination amplitudes are equivalent for single (one location) and co-vibration (pairs of locations) patterns inducing the same directional effect. Hence, torso cutaneous information exhibits kinesthetic properties, appears to provide a map of upper body spatial configuration, and could assume the role of an internal positioning system for the upper body. PMID:25600816

  11. Positional Information, in bits

    NASA Astrophysics Data System (ADS)

    Dubuis, Julien; Bialek, William; Wieschaus, Eric; Gregor, Thomas

    2010-03-01

    Pattern formation in early embryonic development provides an important testing ground for ideas about the structure and dynamics of genetic regulatory networks. Spatial variations in the concentration of particular transcription factors act as ``morphogens,'' driving more complex patterns of gene expression that in turn define cell fates, which must be appropriate to the physical location of the cells in the embryo. Thus, in these networks, the regulation of gene expression serves to transmit and process ``positional information.'' Here, using the early Drosophila embryo as a model system, we measure the amount of positional information carried by a group of four genes (the gap genes Hunchback, Kr"uppel, Giant and Knirps) that respond directly to the primary maternal morphogen gradients. We find that the information carried by individual gap genes is much larger than one bit, so that their spatial patterns provide much more than the location of an ``expression boundary.'' Preliminary data indicate that, taken together these genes provide enough information to specify the location of every row of cells along the embryo's anterior-posterior axis.

  12. Government Positions for Physicists.

    NASA Astrophysics Data System (ADS)

    Seiler, David

    2006-03-01

    There are a number of government agencies that employ physicists in a wide variety of jobs -- from student internships to post docs to full time staff positions. You can do real, creative, fore-front physics or pursue a wide range of leadership positions. The possibilities are almost unlimited and so is the impact your work can have on the government, academia, and industry. So how do you go about finding a government job? What qualities or abilities are deemed valuable? What are the advantages and disadvantages to working in the government? I will bring some personal experiences and observations from working in the government (one year as a rotator at the National Science Foundation in the Division of Materials Research and almost 18 years at the National Institute of Standards and Technology, both as a Group Leader and a Division Chief) to bear on these questions and more. Prior to my government career I was a physics professor pursuing research and teaching in academia.

  13. Positioning of bacterial chemoreceptors.

    PubMed

    Jones, Christopher W; Armitage, Judith P

    2015-05-01

    For optimum growth, bacteria must adapt to their environment, and one way that many species do this is by moving towards favourable conditions. To do so requires mechanisms to both physically drive movement and provide directionality to this movement. The pathways that control this directionality comprise chemoreceptors, which, along with an adaptor protein (CheW) and kinase (CheA), form large hexagonal arrays. These arrays can be formed around transmembrane receptors, resulting in arrays embedded in the inner membrane, or they can comprise soluble receptors, forming arrays in the cytoplasm. Across bacterial species, chemoreceptor arrays (both transmembrane and soluble) are localised to a variety of positions within the cell; some species with multiple arrays demonstrate this variety within individual cells. In many cases, the positioning pattern of the arrays is linked to the need for segregation of arrays between daughter cells on division, ensuring the production of chemotactically competent progeny. Multiple mechanisms have evolved to drive this segregation, including stochastic self-assembly, cellular landmarks, and the utilisation of ParA homologues. The variety of mechanisms highlights the importance of chemotaxis to motile species.

  14. Thermal motor positions magnetometer sensors

    NASA Technical Reports Server (NTRS)

    Kerwin, W. J.; Scott, S. G.

    1966-01-01

    Reversing, thermal, motor-driven device positions magnetometer sensors for checking zero offset. The device alternately positions two sensors at fixed positions 90 degrees apart. The thermal motor is fabricated completely of nonmagnetic materials.

  15. Metallic positive expulsion diaphragms

    NASA Technical Reports Server (NTRS)

    Gleich, D.

    1972-01-01

    High-cycle life ring-reinforced hemispherical type positive expulsion diaphragm performance was demonstrated by room temperature fluid expulsion tests of 13" diameter, 8 mil thick stainless steel configurations. A maximum of eleven (11) leak-free, fluid expulsions were achieved by a 25 deg cone angle diaphragm hoop-reinforced with .110-inch cross-sectional diameter wires. This represents a 70% improvement in diaphragm reversal cycle life compared to results previously obtained. The reversal tests confirmed analytic predictions for diaphragm cycle life increases due to increasing values of diaphragm cone angle, radius to thickness ratio and material strain to necking capacity. Practical fabrication techniques were demonstrated for forming close-tolerance, thin corrugated shells and for obtaining closely controlled reinforcing ring stiffness required to maximize diaphragm cycle life. A non-destructive inspection technique for monitoring large local shell bending strains was developed.

  16. Solar system positioning system

    NASA Technical Reports Server (NTRS)

    Penanen, Konstantin I.; Chui, Talso

    2006-01-01

    Power-rich spacecraft envisioned in Prometheus initiative open up possibilities for long-range high-rate communication. A constellation of spacecraft on orbits several A.U. from the Sun, equipped with laser transponders and precise clocks can be configured to measure their mutual distances to within few cm. High on-board power can create substantial non-inertial contribution to the spacecraft trajectory. We propose to alleviate this contribution by employing secondary ranging to a passive daughter spacecraft. Such constellation can form the basis of it navigation system capable of providing position information anywhere in the soIar system with similar accuracy. Apart from obvious Solar System exploration implications, this system can provide robust reference for GPS and its successors.

  17. Inductive Position Sensor

    NASA Technical Reports Server (NTRS)

    Youngquist, Robert C. (Inventor); Simmons, Stephen M. (Inventor)

    2015-01-01

    An inductive position sensor uses three parallel inductors, each of which has an axial core that is an independent magnetic structure. A first support couples first and second inductors and separate them by a fixed distance. A second support coupled to a third inductor disposed between the first and second inductors. The first support and second support are configured for relative movement as distance changes from the third inductor to each of the first and second inductors. An oscillating current is supplied to the first and second inductors. A device measures a phase component of a source voltage generating the oscillating current and a phase component of voltage induced in the third inductor when the oscillating current is supplied to the first and second inductors such that the phase component of the voltage induced overlaps the phase component of the source voltage.

  18. Inductive Position Sensor

    NASA Technical Reports Server (NTRS)

    Youngquist, Robert C. (Inventor); Simmons, Stephen M. (Inventor)

    2015-01-01

    An inductive position sensor uses three independent inductors inductively coupled by a common medium such as air. First and second inductors are separated by a fixed distance with the first inductor's axial core and second inductor's axial core maintained parallel to one another. A third inductor is disposed between the first and second inductors with the third inductor's axial core being maintained parallel to those of the first and second inductors. The combination of the first and second inductors are configured for relative movement with the third inductor's axial core remaining parallel to those of the first and second inductors as distance changes from the third inductor to each of the first inductor and second inductor. An oscillating current can be supplied to at least one of the three inductors, while voltage induced in at least one of the three inductors not supplied with the oscillating current is measured.

  19. Shaft Position Optical Sensor

    NASA Technical Reports Server (NTRS)

    Blumenstock, Kenneth A. (Inventor); Hakum, Claef F. (Inventor); Johnson, Clarence S. (Inventor)

    2001-01-01

    The present invention is an optical sensor that senses the movement of a shaft. Detection of radial movement is made when a portion of light incident on the shaft sensor-target is blocked. For detection of axial movement, a disk with flat surface is mounted and used to block a portion of light. The variation in the amount of light allowed to pass through is a measure of the position of the shaft. As proposed by this invention, significant improvement is made with respect to sensitivity and linearity of the system when the light is permanently partially blocked. To accomplish this goal this invention adds a boss to the system. To eliminate possible drift of system performance due to LED degradation or temperature variation, a feedback feature is added to the system.

  20. The Global Positioning System

    USGS Publications Warehouse

    ,

    1999-01-01

    The Global Positioning System (GPS) is a constellation of navigation satellites called Navigation Satellite Timing And Ranging (NAVSTAR), maintained by the U.S. Department of Defense. Many outdoor enthusiasts recognize that a handheld GPS receiver can be an accurate tool for determining their location on the terrain. The GPS receiver helps determine locations on the Earth's surface by collecting signals from three or more satellites through a process called triangulation. Identifying a location on the Earth is more useful if you also know about the surrounding topographic conditions. Using a topographic map with the GPS receiver provides important information about features of the surrounding terrain and can help you plot an effective route from one location to another.

  1. A POSITIONAL DATA SYSTEM

    DOEpatents

    Forster, G.A.

    1963-09-24

    between master and slave synchros is described. A threephase a-c power source is connected to the stators of the synchros and an error detector is connected to the rotors of the synchros to measure the phasor difference therebetween. A phase shift network shifts the phase of one of the rotors 90 degrees and a demodulator responsive thereto causes the phasor difference signal of the rotors to shift phase 180 degrees whenever the 90 degree phase shifted signal goes negative. The phase shifted difference signal has a waveform which, with the addition of small values of resistance and capacitance, gives a substantially pure d-c output whose amplitude and polarity is proportional to the magnitude and direction of the difference in the angular positions of the synchro's rotors. (AEC)

  2. Beyond complete positivity

    NASA Astrophysics Data System (ADS)

    Dominy, Jason M.; Lidar, Daniel A.

    2016-04-01

    We provide a general and consistent formulation for linear subsystem quantum dynamical maps, developed from a minimal set of postulates, primary among which is a relaxation of the usual, restrictive assumption of uncorrelated initial system-bath states. We describe the space of possibilities admitted by this formulation, namely that, far from being limited to only completely positive (CP) maps, essentially any C-linear, Hermiticity-preserving, trace-preserving map can arise as a legitimate subsystem dynamical map from a joint unitary evolution of a system coupled to a bath. The price paid for this added generality is a trade-off between the set of admissible initial states and the allowed set of joint system-bath unitary evolutions. As an application, we present a simple example of a non-CP map constructed as a subsystem dynamical map that violates some fundamental inequalities in quantum information theory, such as the quantum data processing inequality.

  3. [Epidemiology of Vertigo on Hospital Emergency].

    PubMed

    Roque Reis, Luis; Lameiras, Rita; Cavilhas, Pedro; Escada, Pedro

    2016-05-01

    Introdução: A vertigem é um dos motivos mais frequentes na procura de atendimento médico especializado na urgência. O objetivo deste estudo foi avaliar o peso real que as alterações do equilíbrio têm na urgência de Otorrinolaringologia, as suas características epidemiológicas e uma eventual sazonalidade por estações do ano. Usou-se uma amostra de doentes que utilizou o serviço de urgência desta especialidade de um hospital central universitário de Lisboa durante um período de quatro anos. Material e Métodos: O projeto foi concebido como um estudo epidemiológico descritivo de tipo populacional, retrospectivo, no período de 2010 a 2013. Incluiu uma população total de 40 173 atendimentos de doentes que nesse período utilizou o serviço de urgência de Otorrinolaringologia. As variáveis estudadas incluíram a idade, género, número anual de casos (total e percentual), data da crise de vertigem, distribuição sazonal por estações do ano e proporção anual de casos internados. Resultados: Um total de 4 347 doentes (10,8%) procurou atendimento médico devido a vertigem ou alterações do equilíbrio ao longo dos quatro anos do estudo. Verificou-se um aumento anual do número de casos entre 7,6% (em 2010) a 17% (em 2013). As mulheres foram mais frequentemente afetadas (68,3%) e as crises ocorreram mais frequentemente em indivíduos entre os 60 e 79 anos de idade (40%). Os casos distribuíram-se de forma heterogénea entre as estações do ano, havendo mais episódios de vertigem no verão e no outono e com uma tendência crescente entre 2010 e 2013. O número de internamentos aumentou anualmente nesse período. Discussão: A epidemiologia da vertigem e dos distúrbios vestibulares específicos é ainda um campo a estudar, pois pode ter utilidade para a tomada de decisões clínicas e para o planeamento dos cuidados de saúde. Conclusão: O estudo revelou que os casos de vertigem na urgência aumentaram anualmente e são mais frequentes no sexo feminino, na população idosa e no verão e outono.

  4. Vertigo in America: A Social Comment.

    ERIC Educational Resources Information Center

    Donnelly, Peter

    1977-01-01

    Participation in high-risk sports appears to have increased in the 1970s. This article analyzes this trend from a sociological perspective, citing examples from a number of commercial and noncommercial sports. (DS)

  5. Bayesian model selection techniques as decision support for shaping a statistical analysis plan of a clinical trial: An example from a vertigo phase III study with longitudinal count data as primary endpoint

    PubMed Central

    2012-01-01

    Background A statistical analysis plan (SAP) is a critical link between how a clinical trial is conducted and the clinical study report. To secure objective study results, regulatory bodies expect that the SAP will meet requirements in pre-specifying inferential analyses and other important statistical techniques. To write a good SAP for model-based sensitivity and ancillary analyses involves non-trivial decisions on and justification of many aspects of the chosen setting. In particular, trials with longitudinal count data as primary endpoints pose challenges for model choice and model validation. In the random effects setting, frequentist strategies for model assessment and model diagnosis are complex and not easily implemented and have several limitations. Therefore, it is of interest to explore Bayesian alternatives which provide the needed decision support to finalize a SAP. Methods We focus on generalized linear mixed models (GLMMs) for the analysis of longitudinal count data. A series of distributions with over- and under-dispersion is considered. Additionally, the structure of the variance components is modified. We perform a simulation study to investigate the discriminatory power of Bayesian tools for model criticism in different scenarios derived from the model setting. We apply the findings to the data from an open clinical trial on vertigo attacks. These data are seen as pilot data for an ongoing phase III trial. To fit GLMMs we use a novel Bayesian computational approach based on integrated nested Laplace approximations (INLAs). The INLA methodology enables the direct computation of leave-one-out predictive distributions. These distributions are crucial for Bayesian model assessment. We evaluate competing GLMMs for longitudinal count data according to the deviance information criterion (DIC) or probability integral transform (PIT), and by using proper scoring rules (e.g. the logarithmic score). Results The instruments under study provide excellent

  6. In situ measurement of mesopelagic particle sinking rates and the control of carbon transfer to the ocean interior during the Vertical Flux in the Global Ocean (VERTIGO) voyages in the North Pacific

    NASA Astrophysics Data System (ADS)

    Trull, T. W.; Bray, S. G.; Buesseler, K. O.; Lamborg, C. H.; Manganini, S.; Moy, C.; Valdes, J.

    2008-07-01

    sinking slower than 137 m d -1. At K2, less than 1% of the POC flux sank at >820 m d -1, but a large fraction (˜15-45%) of the flux was contributed by other fast-sinking classes (410 and 205 m d -1). PIC and BSi minerals were not present in higher proportions in the faster sinking fractions, but the observations were too limited to rule out a ballasting contribution to the control of sinking rates. Photographic evidence for a wide range of particle types within individual sinking-rate fractions suggests that biological processes that set the porosity and shape of particles are also important and may mask the role of minerals. Comparing the spectrum of sinking rates observed at K2 with the power-law profile of flux attenuation with depth obtained from other VERTIGO sediment traps deployed at multiple depths [Buesseler, K.O., Lamborg, C.H., Boyd, P.W., Lam, P.J., Trull, T.W., Bidigare, R.R., Bishop, J.K.B., Casciotti, K.L., Dehairs, F., Elskens, M., Honda, M., Karl, D.M., Siegel, D., Silver, M., Steinberg, D., Valdes, J., Van Mooy, B., Wilson, S.E., 2007b. Revisiting carbon flux through the Ocean's twilight zone. Science 316(5824), 567-570, doi: 10.1126/science.1137959] emphasizes the importance of particle transformations within the mesopelagic zone in the control of carbon transport to the ocean interior.

  7. Relationship between multidetector CT imaging of the vestibular aqueduct and inner ear pathologies.

    PubMed

    Maiolo, Vincenzo; Savastio, Gabriella; Modugno, Giovanni Carlo; Barozzi, Libero

    2013-12-01

    This study investigated the relationships between morphological changes in the vestibular aqueduct (VA) in different inner ear pathologies. Eighty-eight patients (34 males and 54 females, ranging from seven to 88 years of age; average age 49.2 years) with cochleovestibular disorders underwent temporal bone CT (with a 64-channel helical CT system according to temporal bone protocol parameters; 0.6 mm slice thickness, 0.6 mm collimation, bone reconstruction algorithm). All patients with cochleovestibular disorders who underwent temporal bone CT had been previously divided into six different suspected clinical classes: A) suspected pathology of the third window; B) suspected retrocochlear hearing loss; C) defined Ménière's disease; D) labyrinth lithiasis; E) recurrent vertigo. On CT images we analyzed the length, width and morphology of the VA, contact between the VA and the jugular bulb (JB), the thickness of the osseous capsule covering the semicircular canals, the pneumatization rate of the temporal bone and the diameter of the internal auditory canal. At the end of the diagnostic work-up all patients were grouped into six pathological classes, represented as follow: 1) benign paroxysmal positional vertigo (BPPV), 2) recurrent vertigo (RV), 3) enlarged vestibular aqueduct syndrome (EVAS), 4) sudden or progressive unilateral sensorineural hearing loss (SNHL), 5) superior semicircular canal dehiscence syndrome (SSCD), 6) recurrent vestibulocochlear symptoms in Ménière's disease. We evaluated 176 temporal bones in 88 patients. The VA was clearly visualized in 166/176 temporal bones; in ten ears the VA was not visualized. In 14 ears (11 patients, in three of whom bilaterally) we found an enlarged VA while in 31 ears the VA was significantly narrower. In 16 ears a dehiscence of the JB with the vestibular or cochlear aqueduct was noted. In all six patients with suspected EVAS we found a AV wider than 1.5 mm on CT scans; moreover CT identified four patients with large

  8. Positive Pressure Therapy

    PubMed Central

    Sanders, Mark H.; Montserrat, Josep M.; Farré, Ramon; Givelber, Rachel J.

    2008-01-01

    The sleep medicine community has increasingly recognized the necessity that clinical care be based on high-quality levels of evidence. Although research supports a favorable influence of positive airway pressure (PAP) therapy on risk for significant adverse outcomes in patients with severe obstructive sleep apnea–hypopnea (OSAH), well-designed trials are still required to elucidate the effect of PAP on health, quality of life, and economic risks in patients with milder OSAH. Similarly, although there is strong evidence supporting various PAP titration strategies and PAP modalities in patients with severe OSAH without significant medical and psychiatric comorbidities, there is insufficient high-level evidence assessing and comparing the clinical efficacy and health care cost implications of various titration paradigms and various PAP modalities in individuals with milder OSAH and those with comorbid conditions. For ethical and other reasons, it may not be possible to apply a randomized controlled design to address all questions. However, whichever design is employed, it must be rigorously developed with attention to all potential confounders with adequate power to provide compelling, high-quality evidence. PMID:18250208

  9. Position detectors, methods of detecting position, and methods of providing positional detectors

    DOEpatents

    Weinberg, David M.; Harding, L. Dean; Larsen, Eric D.

    2002-01-01

    Position detectors, welding system position detectors, methods of detecting various positions, and methods of providing position detectors are described. In one embodiment, a welding system positional detector includes a base that is configured to engage and be moved along a curved surface of a welding work piece. At least one position detection apparatus is provided and is connected with the base and configured to measure angular position of the detector relative to a reference vector. In another embodiment, a welding system positional detector includes a weld head and at least one inclinometer mounted on the weld head. The one inclinometer is configured to develop positional data relative to a reference vector and the position of the weld head on a non-planar weldable work piece.

  10. Positive Psychology and Positive Education: Old Wine in New Bottles?

    ERIC Educational Resources Information Center

    Kristjansson, Kristjan

    2012-01-01

    The recently fashionable theories of positive psychology have educational ramifications at virtually every level of engagement, culminating in the model of positive education. In this critical review, I scrutinize positive education as a potential theory in educational psychology. Special attention is given to conceptual controversies and…

  11. Videofluoroscopic Investigation of Body Position on Articulatory Positioning

    ERIC Educational Resources Information Center

    Bae, Youkyung; Perry, Jamie L.; Kuehn, David P.

    2014-01-01

    Purpose: To quantitatively examine the effects of body position on the positioning of the epiglottis, tongue, and velum at rest and during speech. Method: Videofluoroscopic data were obtained from 12 healthy adults in the supine and upright positions at rest and during speech while the participants produced 12 VCV sequences. The effects of body…

  12. False Position, Double False Position and Cramer's Rule

    ERIC Educational Resources Information Center

    Boman, Eugene

    2009-01-01

    We state and prove the methods of False Position (Regula Falsa) and Double False Position (Regula Duorum Falsorum). The history of both is traced from ancient Egypt and China through the work of Fibonacci, ending with a connection between Double False Position and Cramer's Rule.

  13. Positional nystagmus showing neutral points.

    PubMed

    Hiruma, Kiyoshi; Numata, Tsutomu

    2004-01-01

    We encountered patients who had their static direction-changing positional nystagmus canceled at about 20-30 degrees yaw head rotation from the supine position. This nystagmus was also canceled when the head was rotated 180 degrees from this position. We call these head positions neutral points. At the neutral points, the cupula of the horizontal semicircular canal of the affected ear is positioned vertical to the gravitational plane and no deflection of the cupula occurs. The positional nystagmus observed (except the neutral points) was thought to occur due to a "heavy cupula" or "light cupula", which may be determined by the specific gravity of its endolymph.

  14. Robot Position Sensor Fault Tolerance

    NASA Technical Reports Server (NTRS)

    Aldridge, Hal A.

    1997-01-01

    Robot systems in critical applications, such as those in space and nuclear environments, must be able to operate during component failure to complete important tasks. One failure mode that has received little attention is the failure of joint position sensors. Current fault tolerant designs require the addition of directly redundant position sensors which can affect joint design. A new method is proposed that utilizes analytical redundancy to allow for continued operation during joint position sensor failure. Joint torque sensors are used with a virtual passive torque controller to make the robot joint stable without position feedback and improve position tracking performance in the presence of unknown link dynamics and end-effector loading. Two Cartesian accelerometer based methods are proposed to determine the position of the joint. The joint specific position determination method utilizes two triaxial accelerometers attached to the link driven by the joint with the failed position sensor. The joint specific method is not computationally complex and the position error is bounded. The system wide position determination method utilizes accelerometers distributed on different robot links and the end-effector to determine the position of sets of multiple joints. The system wide method requires fewer accelerometers than the joint specific method to make all joint position sensors fault tolerant but is more computationally complex and has lower convergence properties. Experiments were conducted on a laboratory manipulator. Both position determination methods were shown to track the actual position satisfactorily. A controller using the position determination methods and the virtual passive torque controller was able to servo the joints to a desired position during position sensor failure.

  15. Translation and rotation positioning motor

    DOEpatents

    Schmid, Andreas; Schaff, Oliver

    2005-02-01

    A positioning device provides the capability of moving an object in both a linear and a rotational direction. The positioning device includes a first piezo stack with plural piezo plates that are capable of movement in orthogonal directions with respect to each other. The positioning device further includes a second piezo stack with plural piezo plates that are capable of movement in orthogonal directions with respect to each other. The positioning device also includes a first bearing that is disposed against the first piezo stack. The positioning device further includes a second bearing that is disposed against the second piezo stack. The positioning device also includes a spring element and a fifth bearing that is disposed against the spring element. The first through fifth bearings are disposed around and against the object to be positioned, to provide for positioning of the object in at least one of a linear direction and a rotational direction.

  16. Translation and rotation positioning motor

    DOEpatents

    Schmid, Andreas; Schaff, Oliver

    2006-07-04

    A positioning device provides the capability of moving an object in both a linear and a rotational direction. The positioning device includes a first piezo stack with plural piezo plates that are capable of movement in orthogonal directions with respect to each other. The positioning device further includes a second piezo stack with plural piezo plates that are capable of movement in orthogonal directions with respect to each other. The positioning device also includes a first bearing that is disposed against the first piezo stack. The positioning device further includes a second bearing that is disposed against the second piezo stack. The positioning device also includes a spring element and a fifth bearing that is disposed against the spring element. The first through fifth bearings are disposed around and against the object to be positioned, to provide for positioning of the object in at least one of a linear direction and a rotational direction.

  17. Components of Positive Mental Health

    ERIC Educational Resources Information Center

    Wright, Logan

    1971-01-01

    Thirty items designed to measure behavior in the six areas described by Jahoda as comprising positive mental health were administered. The data contraindicate the hypothesis that positive mental health is a unitary factor. (Author)

  18. Positive Psychology and Outdoor Education

    ERIC Educational Resources Information Center

    Berman, Dene S.; Davis-Berman, Jennifer

    2005-01-01

    A relatively new movement in psychology, positive psychology, has many implications for the field of outdoor education. Positive psychology has the goal of fostering excellence through the understanding and enhancement of factors that lead to growth. It embraces the view that growth occurs when positive factors are present, as opposed to the…

  19. The Kepler False Positive Table

    NASA Astrophysics Data System (ADS)

    Bryson, Steve; Kepler False Positive Working Group

    2015-01-01

    The Kepler Space Telescope has detected thousands of candidate exoplanets by observing transit signals in a sample of more than 190,000 stars. Many of these transit signals are false positives, defined as a transit-like signal that is not due to a planet orbiting the target star (or a bound companion if the target is a multiple-star system). Astrophysical causes of false positives include background eclipsing binaries, planetary transits not associated with the target star, and non-planetary eclipses of the target star by stellar companions. The fraction of Kepler planet candidates that are false positives ranges from about 10% at high Galactic latitudes to 40% at low Galactic latitudes. Creating a high-reliability planet candidate catalog for statistical studies such as occurrence rate calculations requires removing clearly identified false positives.The Kepler Object of Interest (KOI) catalog at the NExScI NASA Exoplanet Archive flags false positives, and will soon provide a high-level classification of false positives, but lacks detailed description of why a KOI was determined to be a false positive. The Kepler False Positive Working Group (FPWG) examines each false positive in detail to certify that it is correctly identified as a false positive, and determines the primary reason(s) a KOI is classified as a false positive. The work of the FPWG will be published as the Kepler False Positive Table, hosted at the NExScI NASA Exoplanet Archive.The Kepler False Positive Table provides detailed information on the evidence for background binaries, transits caused by stellar companions, and false alarms. In addition to providing insight into the Kepler false positive population, the false positive table gives information about the background binary population and other areas of astrophysical interest. Because a planet around a star not associated with the target star is considered a false positive, the false positive table likely contains further planet candidates

  20. What Good Are Positive Emotions?

    PubMed Central

    Fredrickson, Barbara L.

    2011-01-01

    This article opens by noting that positive emotions do not fit existing models of emotions. Consequently, a new model is advanced to describe the form and function of a subset of positive emotions, including joy, interest, contentment, and love. This new model posits that these positive emotions serve to broaden an individual’s momentary thought–action repertoire, which in turn has the effect of building that individual’s physical, intellectual, and social resources. Empirical evidence to support this broaden-and-build model of positive emotions is reviewed, and implications for emotion regulation and health promotion are discussed. PMID:21850154

  1. Geodetic positioning using a global positioning system of satellites

    NASA Technical Reports Server (NTRS)

    Fell, P. J.

    1980-01-01

    Geodetic positioning using range, integrated Doppler, and interferometric observations from a constellation of twenty-four Global Positioning System satellites is analyzed. A summary of the proposals for geodetic positioning and baseline determination is given which includes a description of measurement techniques and comments on rank deficiency and error sources. An analysis of variance comparison of range, Doppler, and interferometric time delay to determine their relative geometric strength for baseline determination is included. An analytic examination to the effect of a priori constraints on positioning using simultaneous observations from two stations is presented. Dynamic point positioning and baseline determination using range and Doppler is examined in detail. Models for the error sources influencing dynamic positioning are developed. Included is a discussion of atomic clock stability, and range and Doppler observation error statistics based on random correlated atomic clock error are derived.

  2. Steady potential correlates of positive reinforcement: reward contingent positive variation.

    PubMed

    Marczynski, T J; York, J L; Hackett, J T

    1969-01-17

    A positive reinforcement with food produced high-voltage bursts of alpha activity over the posterior marginal gyrus in a cat deprived of food and water. This synchronization was always associated with a large (180 to 300 microvolt), positive steady potential shift comparable to that occurring during the onset of sleep. Since this shift was contingent upon the relative appropriateness and desirability of food reward, it was termed reward contingent positive variation.

  3. Detecting Positioning Errors and Estimating Correct Positions by Moving Window

    PubMed Central

    Song, Ha Yoon; Lee, Jun Seok

    2015-01-01

    In recent times, improvements in smart mobile devices have led to new functionalities related to their embedded positioning abilities. Many related applications that use positioning data have been introduced and are widely being used. However, the positioning data acquired by such devices are prone to erroneous values caused by environmental factors. In this research, a detection algorithm is implemented to detect erroneous data over a continuous positioning data set with several options. Our algorithm is based on a moving window for speed values derived by consecutive positioning data. Both the moving average of the speed and standard deviation in a moving window compose a moving significant interval at a given time, which is utilized to detect erroneous positioning data along with other parameters by checking the newly obtained speed value. In order to fulfill the designated operation, we need to examine the physical parameters and also determine the parameters for the moving windows. Along with the detection of erroneous speed data, estimations of correct positioning are presented. The proposed algorithm first estimates the speed, and then the correct positions. In addition, it removes the effect of errors on the moving window statistics in order to maintain accuracy. Experimental verifications based on our algorithm are presented in various ways. We hope that our approach can help other researchers with regard to positioning applications and human mobility research. PMID:26624282

  4. Detecting Positioning Errors and Estimating Correct Positions by Moving Window.

    PubMed

    Song, Ha Yoon; Lee, Jun Seok

    2015-01-01

    In recent times, improvements in smart mobile devices have led to new functionalities related to their embedded positioning abilities. Many related applications that use positioning data have been introduced and are widely being used. However, the positioning data acquired by such devices are prone to erroneous values caused by environmental factors. In this research, a detection algorithm is implemented to detect erroneous data over a continuous positioning data set with several options. Our algorithm is based on a moving window for speed values derived by consecutive positioning data. Both the moving average of the speed and standard deviation in a moving window compose a moving significant interval at a given time, which is utilized to detect erroneous positioning data along with other parameters by checking the newly obtained speed value. In order to fulfill the designated operation, we need to examine the physical parameters and also determine the parameters for the moving windows. Along with the detection of erroneous speed data, estimations of correct positioning are presented. The proposed algorithm first estimates the speed, and then the correct positions. In addition, it removes the effect of errors on the moving window statistics in order to maintain accuracy. Experimental verifications based on our algorithm are presented in various ways. We hope that our approach can help other researchers with regard to positioning applications and human mobility research.

  5. Detecting Positioning Errors and Estimating Correct Positions by Moving Window.

    PubMed

    Song, Ha Yoon; Lee, Jun Seok

    2015-01-01

    In recent times, improvements in smart mobile devices have led to new functionalities related to their embedded positioning abilities. Many related applications that use positioning data have been introduced and are widely being used. However, the positioning data acquired by such devices are prone to erroneous values caused by environmental factors. In this research, a detection algorithm is implemented to detect erroneous data over a continuous positioning data set with several options. Our algorithm is based on a moving window for speed values derived by consecutive positioning data. Both the moving average of the speed and standard deviation in a moving window compose a moving significant interval at a given time, which is utilized to detect erroneous positioning data along with other parameters by checking the newly obtained speed value. In order to fulfill the designated operation, we need to examine the physical parameters and also determine the parameters for the moving windows. Along with the detection of erroneous speed data, estimations of correct positioning are presented. The proposed algorithm first estimates the speed, and then the correct positions. In addition, it removes the effect of errors on the moving window statistics in order to maintain accuracy. Experimental verifications based on our algorithm are presented in various ways. We hope that our approach can help other researchers with regard to positioning applications and human mobility research. PMID:26624282

  6. Accentuate the Positive: Positive Sentiments and Status in Task Groups

    ERIC Educational Resources Information Center

    Bianchi, Alison J.; Lancianese, Donna A.

    2007-01-01

    We explore the capacity of positive sentiments, those enduring affective states one achieves when one likes another, to impact status structures. Do positive sentiments combine with existing aspects of interaction to create status hierarchies and potentially change the social order, or do they moderate the effects of extant structure by dampening…

  7. Positive mood broadens visual attention to positive stimuli

    PubMed Central

    Wadlinger, Heather A.; Isaacowitz, Derek M.

    2010-01-01

    In an attempt to investigate the impact of positive emotions on visual attention within the context of Fredrickson's (1998) broaden-and-build model, eye tracking was used in two studies to measure visual attentional preferences of college students (n=58, n=26) to emotional pictures. Half of each sample experienced induced positive mood immediately before viewing slides of three similarly-valenced images, in varying central-peripheral arrays. Attentional breadth was determined by measuring the percentage viewing time to peripheral images as well as by the number of visual saccades participants made per slide. Consistent with Fredrickson's theory, the first study showed that individuals induced into positive mood fixated more on peripheral stimuli than did control participants; however, this only held true for highly-valenced positive stimuli. Participants under induced positive mood also made more frequent saccades for slides of neutral and positive valence. A second study showed that these effects were not simply due to differences in emotional arousal between stimuli. Selective attentional broadening to positive stimuli may act both to facilitate later building of resources as well as to maintain current positive affective states. PMID:20431711

  8. Positive fractional linear electrical circuits

    NASA Astrophysics Data System (ADS)

    Kaczorek, Tadeusz

    2013-10-01

    The positive fractional linear systems and electrical circuits are addressed. New classes of fractional asymptotically stable and unstable electrical circuits are introduced. The Caputo and Riemann-Liouville definitions of fractional derivatives are used to analysis of the positive electrical circuits composed of resistors, capacitors, coils and voltage (current) sources. The positive fractional electrical and specially unstable different types electrical circuits are analyzed. Some open problems are formulated.

  9. Indoor Positioning - An Ad-Hoc Positioning System

    NASA Astrophysics Data System (ADS)

    Mautz, Rainer

    2008-06-01

    The aim of this paper is to discuss the development of an automatic, low-cost system that exploits current or near future wireless communications technology to enable continuous tracking of the location of devices in all environments. The development of such a wireless sensor network involves system design, digital signal processing, protocol development, extraction of ranges and localisation. This paper focuses on the user requirements, system architecture and network positioning. The user requirements are presented with a focus on applications in geodesy. A high level strategy for the positioning function is presented based on an ad-hoc geodetic network positioning method including issues of accuracy, quality and reliability of the node positions. Results show that it is possible to achieve a position deviation that is of the size of the ranging error.

  10. Positive technology: using interactive technologies to promote positive functioning.

    PubMed

    Riva, Giuseppe; Baños, Rosa M; Botella, Cristina; Wiederhold, Brenda K; Gaggioli, Andrea

    2012-02-01

    It is generally assumed that technology assists individuals in improving the quality of their lives. However, the impact of new technologies and media on well-being and positive functioning is still somewhat controversial. In this paper, we contend that the quality of experience should become the guiding principle in the design and development of new technologies, as well as a primary metric for the evaluation of their applications. The emerging discipline of Positive Psychology provides a useful framework to address this challenge. Positive Psychology is the scientific study of optimal human functioning and flourishing. Instead of drawing on a "disease model" of human behavior, it focuses on factors that enable individuals and communities to thrive and build the best in life. In this paper, we propose the "Positive Technology" approach--the scientific and applied approach to the use of technology for improving the quality of our personal experience through its structuring, augmentation, and/or replacement--as a way of framing a suitable object of study in the field of cyberpsychology and human-computer interaction. Specifically, we suggest that it is possible to use technology to influence three specific features of our experience--affective quality, engagement/actualization, and connectedness--that serve to promote adaptive behaviors and positive functioning. In this framework, positive technologies are classified according to their effects on a specific feature of personal experience. Moreover, for each level, we have identified critical variables that can be manipulated to guide the design and development of positive technologies.

  11. Neutral position of persistent direction-changing positional nystagmus.

    PubMed

    Ichijo, Hiroaki

    2016-02-01

    The aim of this study was to measure the neutral position of direction-changing apogeotropic positional nystagmus (heavy cupula of the horizontal semicircular canal) and persistent direction-changing geotropic positional nystagmus (light cupula of the horizontal semicircular canal). We conducted a prospective case series study on 31 patients with heavy cupula (12 males, 19 females; mean age, 64.3 years) and 33 patients with light cupula (10 males, 23 females; mean age, 60.9 years). We measured the angle of the neutral position in patients with heavy cupula (θ 1) and that in patients with light cupula (θ 2) using a large protractor. The mean value and standard deviation of θ 1 was 31.6 ± 22.4°, minimum value was 5°, and maximum value was 89°. The mean value and standard deviation of θ 2 was 44.4 ± 20.5°, minimum value was 5°, and maximum value was 85°. θ 2 was significantly greater than θ 1 (p < 0.05). The neutral position varies widely. Some patients exhibit a great angle (more than 40°); therefore, examiners should make patients adopt a completely lateral position in the supine head roll test and should confirm the direction of nystagmus in order to avoid mistaking positional nystagmus for spontaneous nystagmus.

  12. A New Positioning Algorithm for Position-Sensitive Avalanche Photodiodes.

    PubMed

    Zhang, Jin; Olcott, Peter D; Levin, Craig S

    2007-06-01

    We are using a novel position sensitive avalanche photodiode (PSAPD) for the construction of a high resolution positron emission tomography (PET) camera. Up to now most researchers working with PSAPDs have been using an Anger-like positioning algorithm involving the four corner readout signals of the PSAPD. This algorithm yields a significant non-linear spatial "pin-cushion" distortion in raw crystal positioning histograms. In this paper, we report an improved positioning algorithm, which combines two diagonal corner signals of the PSAPD followed by a 45° rotation to determine the X or Y position of the interaction. We present flood positioning histogram data generated with the old and new positioning algorithms using a 3 × 4 array of 2 × 2 × 3 mm(3) and a 3 × 8 array of 1 × 1 × 3 mm(3) of LSO crystals coupled to 8 × 8 mm(2) PSAPDs. This new algorithm significantly reduces the pin-cushion distortion in raw flood histogram image. PMID:24307743

  13. Positioning Fixture For Survey Antenna

    NASA Technical Reports Server (NTRS)

    Dinardo, Steven J.; Smith, Mark A.

    1994-01-01

    Improved positioning fixture designed to simplify and accelerate accurate alignment of antenna for use in land survey aided by satellites of Global Positioning System. Holds antenna at fixed height and orientation over station monument so survey measurements made with accuracy and precision.

  14. Positioning Vise for Crystal Cleavage

    NASA Technical Reports Server (NTRS)

    Hallberg, F. C.; Morgan, C. J.

    1984-01-01

    Vise manipulates brittle crystals, such as lithium fluoride, so they are in proper position for cleaving. Vise allows crystals as thin as 2 millimeters or less positioned so that cleaved without breakage. Vise holds workpiece firmly but gently. Bushings, shafts and adjusting screw designed to move jaws smoothly and uniformly with great tactile sensitivity.

  15. Positive Parenting and Challenging Children

    ERIC Educational Resources Information Center

    Knoll, Melissa

    2007-01-01

    Positive parenting focuses on developing proactive ways to teach and reinforce desirable behaviors, as opposed to focusing on reacting to and attempting to decrease negative behaviors. Dr. Sheldon Braaten, Executive Director of Behavioral Institute for Children and Adolescents, offers some keys for setting up and using a positive reinforcement…

  16. Positive reinforcement in clinical teaching.

    PubMed

    Gallagher, L M

    1992-01-01

    Contrary to the idea that nursing students are intrinsically motivated, findings in research studies show that students repeatedly report the significance of positive feedback to them. Delivery of positive reinforcement by clinical instructors can be developed so that the reinforcement is more meaningful to students and more effective in promoting or maintaining desired student behaviors.

  17. Acoustic positioning and orientation prediction

    NASA Astrophysics Data System (ADS)

    Barmatz, Martin B.; Aveni, Glenn; Putterman, Seth; Rudnick, Joseph

    1990-10-01

    A method is described for use with an acoustic positioner, which enables a determination of the equilibrium position and orientation which an object assumes in a zero gravity environment, as well as restoring forces and torques of an object in an acoustic standing wave field. An acoustic standing wave field is established in the chamber, and the object is held at several different positions near the expected equilibrium position. While the object is held at each position, the center resonant frequency of the chamber is determined, by noting which frequency results in the greatest pressure of the acoustic field. The object position which results in the lowest center resonant frequency is the equilibrium position. The orientation of a nonspherical object is similarly determined, by holding the object in a plurality of different orientations at its equilibrium position, and noting the center resonant frequency for each orientation. The orientation which results in the lowest center resonant frequency is the equilibrium orientation. Where the acoustic frequency is constant, but the chamber length is variable, the equilibrium position or orientation is that which results in the greatest chamber length at the center resonant frequency.

  18. Acoustic positioning and orientation prediction

    NASA Technical Reports Server (NTRS)

    Barmatz, Martin B. (Inventor); Aveni, Glenn (Inventor); Putterman, Seth (Inventor); Rudnick, Joseph (Inventor)

    1990-01-01

    A method is described for use with an acoustic positioner, which enables a determination of the equilibrium position and orientation which an object assumes in a zero gravity environment, as well as restoring forces and torques of an object in an acoustic standing wave field. An acoustic standing wave field is established in the chamber, and the object is held at several different positions near the expected equilibrium position. While the object is held at each position, the center resonant frequency of the chamber is determined, by noting which frequency results in the greatest pressure of the acoustic field. The object position which results in the lowest center resonant frequency is the equilibrium position. The orientation of a nonspherical object is similarly determined, by holding the object in a plurality of different orientations at its equilibrium position, and noting the center resonant frequency for each orientation. The orientation which results in the lowest center resonant frequency is the equilibrium orientation. Where the acoustic frequency is constant, but the chamber length is variable, the equilibrium position or orientation is that which results in the greatest chamber length at the center resonant frequency.

  19. Serial position encoding of signs.

    PubMed

    Miozzo, Michele; Petrova, Anna; Fischer-Baum, Simon; Peressotti, Francesca

    2016-09-01

    Reduced short-term memory (STM) capacity has been reported for sign as compared to speech when items have to be recalled in a specific order. This difference has been attributed to a more precise and efficient serial position encoding in verbal STM (used for speech) than visuo-spatial STM (used for sign). We tested in the present investigation whether the reduced STM capacity with signs stems from a lack of positional encoding available in verbal STM. Error analyses reported in prior studies have revealed that positions are defined in verbal STM by distance from both the start and the end of the sequence (both-edges positional encoding scheme). Our analyses of the errors made by deaf participants with finger-spelled letters revealed that the both-edges positional encoding scheme underlies the STM representation of signs. These results indicate that the cause of the STM disadvantage is not the type of positional encoding but rather the difficulties in binding an item in visuo-spatial STM to its specific position in the sequence. Both-edges positional encoding scheme could be specific of sign, since it has not been found in visuo-spatial STM tasks conducted with hearing participants. PMID:27244095

  20. Positive Illusion of Exemplary Altruists

    ERIC Educational Resources Information Center

    Lee, Jee Y.; Chung, Hae Y.

    2008-01-01

    This paper examines the relationship between altruism and positive illusion, as formulated by Taylor and Brown (1988). It was predicted that, compared to the non-exemplary, general population, exemplary altruists would exhibit a higher level of positive illusion, which, in turn, suggests a higher level of mental health. Forty exemplary altruists…

  1. A Blueprint for Positive Parenting.

    ERIC Educational Resources Information Center

    Caruso, Saf Lerman

    1991-01-01

    With support and education from various sources, parents can be introduced to positive, nonhurtful, constructive approaches to child rearing that permit children to grow in an environment which nurtures the body, soul, and mind. The article presents guidelines for positive parenting that teach children to look to adults for support. (SM)

  2. Variable-Position Acoustic Levitation

    NASA Technical Reports Server (NTRS)

    Barmatz, M. B.; Stoneburner, J. D.; Jacobi, N.; Wang, T. G.

    1983-01-01

    Method of acoustic levitation supports objects at positions other than acoustic nodes. Acoustic force is varied so it balances gravitational (or other) force, thereby maintaining object at any position within equilibrium range. Levitation method applicable to containerless processing. Such objects as table-tennis balls, hollow plastic spheres, and balsa-wood spheres levitated in laboratory by new method.

  3. Signature Strengths in Positive Psychology

    ERIC Educational Resources Information Center

    Molony, Terry; Henwood, Maureen

    2010-01-01

    Positive psychology can be thought of as the scientific study of what is "right about people" as opposed to the traditional focus on the healing of psychological pain or trauma. The philosophical roots of positive psychology can be traced back to Confucianism, Taoism, Buddhism, Hinduism, Judaism, Christianity, as well as Islamic and Athenian…

  4. Updated thinking on positivity ratios.

    PubMed

    Fredrickson, Barbara L

    2013-12-01

    This article presents my response to the article by Brown, Sokal, and Friedman (2013), which critically examined Losada's conceptual and mathematical work (as presented in Losada, 1999; Losada & Heaphy, 2004; and Fredrickson & Losada; 2005) and concluded that mathematical claims for a critical tipping point positivity ratio are unfounded. In the present article, I draw recent empirical evidence together to support the continued value of computing and seeking to elevate positivity ratios. I also underscore the necessity of modeling nonlinear effects of positivity ratios and, more generally, the value of systems science approaches within affective science and positive psychology. Even when scrubbed of Losada's now-questioned mathematical modeling, ample evidence continues to support the conclusion that, within bounds, higher positivity ratios are predictive of flourishing mental health and other beneficial outcomes. PMID:23855895

  5. A Pilot Study on the Efficacy of Continuous Positive Airway Pressure on the Manifestations of Ménière's Disease in Patients with Concomitant Obstructive Sleep Apnea Syndrome

    PubMed Central

    Nakayama, Meiho; Masuda, Ayako; Ando, Kayoko Bhardwaj; Arima, Sachie; Kabaya, Kayoko; Inagaki, Akira; Nakamura, Yoshihisa; Suzuki, Motohiko; Brodie, Hilary; Diaz, Rodney C.; Murakami, Shingo

    2015-01-01

    Objective: To evaluate the effect of continuous positive airway pressure (CPAP) therapy on Ménière's disease patients with concomitant obstructive sleep apnea syndrome (OSAS), since recent reports suggest OSAS may cause dysfunction of the vestibular system. Study Design: Prospective study using CPAP administered to patients diagnosed with “Definite Ménière's disease” according to the guidelines of the American Academy of Otolaryngology— Head and Neck Surgery and combined with OSAS. Setting: University hospital. Methods: Twenty consecutive patients, 14 male and 6 female with active, unilateral, cochleovestibular Ménière's disease refractory to medical management who also had concurrent OSAS as defined by International Classification of Sleep Disorders, Second Edition were selected to undergo solitary CPAP therapy. Audiometric testing, caloric testing, and DHI survey were conducted before and after CPAP therapy and compared to assess effectiveness of CPAP therapy as utilized for treatment of Ménière's disease. Results: Although caloric testing did not show significant difference, audiometric testing and results of dizziness handicap inventory were significantly improved (p < 0.05) after CPAP therapy only, without standard treatment for Ménière's disease. Conclusions: Recent reports have suggested that OSAS may cause dysfunction of the vestibular system. We investigated whether standard therapy for OSAS would be of benefit in the management of vertigo and hearing loss in Ménière's disease patients. Our study cohort demonstrated significant improvement in both DHI and audiometric testing following solitary CPAP therapy for OSAS. Solitary CPAP therapy may become a new effective treatment strategy for Ménière's disease patients with OSAS, not just only for control of dizziness and vertigo but also for potential benefit of hearing. Citation: Nakayama M, Masuda A, Ando KB, Arima S, Kabaya K, Inagaki A, Nakamura Y, Suzuki M, Brodie H, Diaz RC, Murakami S

  6. Positioning performance of a maglev fine positioning system

    SciTech Connect

    Wronosky, J.B.; Smith, T.G.; Jordan, J.D.; Darnold, J.R.

    1996-12-01

    A wafer positioning system was recently developed by Sandia National Laboratories for an Extreme Ultraviolet Lithography (EUVL) research tool. The system, which utilizes a magnetically levitated fine stage to provide ultra-precise positioning in all six degrees of freedom, incorporates technological improvements resulting from four years of prototype development experience. System enhancements, implemented on a second generation design for an ARPA National Center for Advanced Information Component Manufacturing (NCAICM) project, introduced active structural control for the levitated structure of the system. Magnetic levitation (maglev) is emerging as an important technology for wafer positioning systems in advanced lithography applications. The advantages of maglev stem from the absence of physical contact. The resulting lack of friction enables accurate, fast positioning. Maglev systems are mechanically simple, accomplishing full six degree-of-freedom suspension and control with a minimum of moving parts. Power-efficient designs, which reduce the possibility of thermal distortion of the platen, are achievable. Manufacturing throughput will be improved in future systems with the addition of active structural control of the positioning stages. This paper describes the design, implementation, and functional capability of the maglev fine positioning system. Specifics regarding performance design goals and test results are presented.

  7. PHOTOELECTRIC CONTROL FOR TAPE POSITIONING

    DOEpatents

    Woody, J.W. Jr.

    1961-07-25

    A control system is described for producing control impulses which may be used to start, stop, and position a magnetic tape with respect to a transducer, and to locate discrete areas on the tape. Means are provided for positive identification of data blocks, exact positioning of the tape under the magnetic head, drive in either direction, accurate skip-over of imperfect regions of the tape, stopping the tape if equipment malfunction results in a failure to detect the block-identifying signals, and starting and stopping those parts of the tape between of the tape drive clutches.

  8. SWITCHING TRANSMITTER POSITIONING OF SYNCHROS

    DOEpatents

    Wolff, H.

    1962-03-13

    A transformer apparatus is designed for effecting the step positioning of synchro motors. The apparatus is provided with ganged switches and pre- selected contacts to permit the units and tens selection of the desired angular position for the synchro motor rotor with only the movement of two selector knobs required. With the selection thus made, the appropriate pre-selected signal is delivered to the synchro motor for positioning the rotor of the latter as selected. The transformer apparatus is divided into smaller arrangements to conform with coraputed trigonometric relations which will give the desired results. (AEC)

  9. Navstar/Global Positioning System

    NASA Technical Reports Server (NTRS)

    Ananda, M.

    1982-01-01

    The Global Positioning System (GPS) was developed to provide highly precise position, velocity, and time information to users anywhere in the area of the Earth and at any time. The GPS, when fully operational, will consist of 18 satellites in six orbital planes. Any GPS user, by receiving and processing the radio signals from the satellite network can instantaneously determine navigation information to an accuracy of about 15 m in position and 0.1 m/s in velocity. The GPS is compared with other systems such as Loran-C, Omega, TACAN and Transit.

  10. Positive technology: using interactive technologies to promote positive functioning.

    PubMed

    Riva, Giuseppe; Baños, Rosa M; Botella, Cristina; Wiederhold, Brenda K; Gaggioli, Andrea

    2012-02-01

    It is generally assumed that technology assists individuals in improving the quality of their lives. However, the impact of new technologies and media on well-being and positive functioning is still somewhat controversial. In this paper, we contend that the quality of experience should become the guiding principle in the design and development of new technologies, as well as a primary metric for the evaluation of their applications. The emerging discipline of Positive Psychology provides a useful framework to address this challenge. Positive Psychology is the scientific study of optimal human functioning and flourishing. Instead of drawing on a "disease model" of human behavior, it focuses on factors that enable individuals and communities to thrive and build the best in life. In this paper, we propose the "Positive Technology" approach--the scientific and applied approach to the use of technology for improving the quality of our personal experience through its structuring, augmentation, and/or replacement--as a way of framing a suitable object of study in the field of cyberpsychology and human-computer interaction. Specifically, we suggest that it is possible to use technology to influence three specific features of our experience--affective quality, engagement/actualization, and connectedness--that serve to promote adaptive behaviors and positive functioning. In this framework, positive technologies are classified according to their effects on a specific feature of personal experience. Moreover, for each level, we have identified critical variables that can be manipulated to guide the design and development of positive technologies. PMID:22149077

  11. The Case for Positive Discrimination

    ERIC Educational Resources Information Center

    Miller, S. M.

    1973-01-01

    Discusses both three basic strategies, preferences, allocational priorities, and incentives--and four principles of positive discrimination--compensation and rectification, appropriate meritocratic criteria, the development of the discriminated, and fairness. (JM)

  12. Policy Statements and Position Papers.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1984

    1984-01-01

    The American Association of Dental Schools position is presented on dental school curriculum and administration, peer review, freedoms and responsibilities of individuals and institutions, national health programs, interdisciplinary education, ionizing radiation in dental education facilities, and due process. (MSE)

  13. Negative effects of positive reinforcement

    PubMed Central

    Perone, Michael

    2003-01-01

    Procedures classified as positive reinforcement are generally regarded as more desirable than those classified as aversive—those that involve negative reinforcement or punishment. This is a crude test of the desirability of a procedure to change or maintain behavior. The problems can be identified on the basis of theory, experimental analysis, and consideration of practical cases. Theoretically, the distinction between positive and negative reinforcement has proven difficult (some would say the distinction is untenable). When the distinction is made purely in operational terms, experiments reveal that positive reinforcement has aversive functions. On a practical level, positive reinforcement can lead to deleterious effects, and it is implicated in a range of personal and societal problems. These issues challenge us to identify other criteria for judging behavioral procedures. ImagesFigure 1Figure 2 PMID:22478391

  14. Negative effects of positive reinforcement.

    PubMed

    Perone, Michael

    2003-01-01

    Procedures classified as positive reinforcement are generally regarded as more desirable than those classified as aversive-those that involve negative reinforcement or punishment. This is a crude test of the desirability of a procedure to change or maintain behavior. The problems can be identified on the basis of theory, experimental analysis, and consideration of practical cases. Theoretically, the distinction between positive and negative reinforcement has proven difficult (some would say the distinction is untenable). When the distinction is made purely in operational terms, experiments reveal that positive reinforcement has aversive functions. On a practical level, positive reinforcement can lead to deleterious effects, and it is implicated in a range of personal and societal problems. These issues challenge us to identify other criteria for judging behavioral procedures.

  15. The Power of Positive Emotions

    MedlinePlus

    ... toes, crossing a boundary, or violating our trust. Anger can be a signal that we might need ... lot of negative feelings such as fear, sadness, anger, frustration, or stress. Building a daily positivity habit ...

  16. Positioning your baby for breastfeeding

    MedlinePlus

    ... Adjust your baby's position if you need to. FOOTBALL HOLD Use the football hold if you had a C-section. This ... large breasts or flat nipples also like the football hold. Hold your baby like a football. Tuck ...

  17. Positivity of the English Language

    PubMed Central

    Kloumann, Isabel M.; Danforth, Christopher M.; Harris, Kameron Decker; Bliss, Catherine A.; Dodds, Peter Sheridan

    2012-01-01

    Over the last million years, human language has emerged and evolved as a fundamental instrument of social communication and semiotic representation. People use language in part to convey emotional information, leading to the central and contingent questions: (1) What is the emotional spectrum of natural language? and (2) Are natural languages neutrally, positively, or negatively biased? Here, we report that the human-perceived positivity of over 10,000 of the most frequently used English words exhibits a clear positive bias. More deeply, we characterize and quantify distributions of word positivity for four large and distinct corpora, demonstrating that their form is broadly invariant with respect to frequency of word use. PMID:22247779

  18. Positive Emotion following a Stroke

    PubMed Central

    Ostir, Glenn V.; Berges, Ivonne; Ottenbacher, Margaret; Graham, James E.; Ottenbacher, Kenneth J.

    2008-01-01

    OBJECTIVES As populations age, interest in exploring the emotional health of adults has increased. In the current study we were interested in investigating the positive emotion of adults with stroke at discharge from in-patient medical rehabilitation and 3 months post discharge. DESIGN A longitudinal study using information from the Stroke Recovery in Underserved Patients database. SETTING Information was collected during in-patient medical rehabilitation stay and approximately 3 months post discharge. PARTICIPANTS The study included 856 persons aged 55 or older with stroke admitted to in-patient medical rehabilitation in the U.S. MEASUREMENTS Positive emotion. RESULTS The average age was 72.5 years, 78.7% were non-Hispanic white and 51.9% were women. The average length of in-patient hospital stay was 20.2 (SD 10.1) days. More than a third (35.6%) reported higher positive emotion over the 3 month follow-up, while 29.7% reported lower positive emotion. In addition to discharge positive emotion, three factors including depression (b = −0.05, SE .02, p = .0001), level of education (b = 0.08, SE .04, p = .04) and functional status (b = 0.04, SE .006, p = .001) significantly predicted higher positive emotion at 3 month follow-up. CONCLUSION A large percentage of adults report high positive emotion in the initial months following a stroke. This finding adds to work on stroke recovery and indicates the resilience of adults when faced with a health challenge. Understanding the role of positive emotion in persons living with stroke may provide critical insight into long-term recovery. PMID:18509564

  19. Sleeping position and rectal temperature.

    PubMed

    Petersen, S A; Anderson, E S; Lodemore, M; Rawson, D; Wailoo, M P

    1991-08-01

    The effects of sleeping position upon body temperature were assessed by continuous monitoring of rectal temperature in 137 babies sleeping at home under conditions chosen by their parents. There were three groups of subjects: (1) normal babies aged 12-22 weeks whose temperature rhythms were developed, (2) normal babies aged 6-12 weeks who were developing their night time temperature rhythms, and (3) babies the night after diphtheria, pertussis, and tetanus immunisation, whose temperature rhythms were disturbed. Sleeping in the prone position was not associated with higher rectal temperatures at any time of night in young babies, nor did it exaggerate the disturbance of rectal temperature rhythm after immunisation. In older normal babies the prone position did not disturb rectal temperature in the first part of the night, though prone sleepers warmed a little faster prior to walking, especially in warm conditions. Prone sleepers were, however, born earlier in gestation and tended to be of lower birth weight. Normal babies can therefore thermoregulate effectively whatever their sleeping posture, even in warm conditions, though the prone position may make it slightly more difficult to lose heat. It is difficult to see how the prone position, even interacting with warm conditions, could induce lethal hyperthermia in otherwise normal babies. Perhaps the prone position is associated with other risk factors for sudden infant death syndrome.

  20. Positive amplitudes in the amplituhedron

    NASA Astrophysics Data System (ADS)

    Arkani-Hamed, Nima; Hodges, Andrew; Trnka, Jaroslav

    2015-08-01

    The all-loop integrand for scattering amplitudes in planar SYM is determined by an "amplitude form" with logarithmic singularities on the boundary of the amplituhedron. In this note we provide strong evidence for a new striking property of the superamplitude, which we conjecture to be true to all loop orders: the amplitude form is positive when evaluated inside the amplituhedron. The statement is sensibly formulated thanks to the natural "bosonization" of the superamplitude associated with the amplituhedron geometry. However this positivity is not manifest in any of the current approaches to scattering amplitudes, and in particular not in the cellulations of the amplituhedron related to on-shell diagrams and the positive grassmannian. The surprising positivity of the form suggests the existence of a "dual amplituhedron" formulation where this feature would be made obvious. We also suggest that the positivity is associated with an extended picture of amplituhedron geometry, with the amplituhedron sitting inside a co-dimension one surface separating "legal" and "illegal" local singularities of the amplitude. We illustrate this in several simple examples, obtaining new expressions for amplitudes not associated with any triangulations, but following in a more invariant manner from a global view of the positive geometry.

  1. Positive Surface over Positive Scattered Data Sites

    PubMed Central

    Ibraheem, Farheen; Hussain, Malik Zawwar; Bhatti, Akhlaq Ahmad

    2015-01-01

    The aim of this paper is to develop a local positivity preserving scheme when the data amassed from different sources is positioned at sparse points. The proposed algorithm first triangulates the irregular data using Delauny triangulation method, therewith interpolates each boundary and radial curve of the triangle by C¹ rational trigonometric cubic function. Half of the parameters in the description of the interpolant are constrained to keep up the positive shape of data while the remaining half are set free for users’ requirement. Orthogonality of trigonometric function assures much smoother surface as compared to polynomial functions. The proposed scheme can be of great use in areas of surface reconstruction and deformation, signal processing, CAD/CAM design, solving differential equations, and image restoration. PMID:26057122

  2. Positional demands of professional rugby.

    PubMed

    Lindsay, Angus; Draper, Nick; Lewis, John; Gieseg, Steven P; Gill, Nicholas

    2015-01-01

    Rugby union is a physically intense intermittent sport coupled with high force collisions. Each position within a team has specific requirements which are typically based on speed, size and skill. The aim of this study was to investigate the contemporary demands of each position and whether they can explain changes in psychophysiological stress. Urine and saliva samples were collected before and after five selected Super 15 rugby games from 37 players. Total neopterin (NP), cortisol and immunoglobulin A were analysed by SCX-high performance liquid chromatography and enzyme linked immunosorbent assay. Global positioning system software provided distance data, while live video analysis provided impact data. All contemporary demands were analysed as events per minute of game time. Forwards were involved in more total impacts, tackles and rucks compared to backs (p < 0.001), while backs were involved in more ball carries and covered more total distance and distance at high speed per minute of game time (p < 0.01). Loose forwards, inside and outside backs covered significantly more distance at high speed (p < 0.01), while there was a negligible difference with number of impacts between the forward positions. There was also minimal difference between positions in the percentage change in NP, cortisol and sIgA. The results indicate distance covered and number of impacts per minute of game time is position-dependent whereas changes in psychophysiological stress are independent. This information can be used to adapt training and recovery interventions to better prepare each position based on the physical requirements of the game.

  3. Positional demands of professional rugby.

    PubMed

    Lindsay, Angus; Draper, Nick; Lewis, John; Gieseg, Steven P; Gill, Nicholas

    2015-01-01

    Rugby union is a physically intense intermittent sport coupled with high force collisions. Each position within a team has specific requirements which are typically based on speed, size and skill. The aim of this study was to investigate the contemporary demands of each position and whether they can explain changes in psychophysiological stress. Urine and saliva samples were collected before and after five selected Super 15 rugby games from 37 players. Total neopterin (NP), cortisol and immunoglobulin A were analysed by SCX-high performance liquid chromatography and enzyme linked immunosorbent assay. Global positioning system software provided distance data, while live video analysis provided impact data. All contemporary demands were analysed as events per minute of game time. Forwards were involved in more total impacts, tackles and rucks compared to backs (p < 0.001), while backs were involved in more ball carries and covered more total distance and distance at high speed per minute of game time (p < 0.01). Loose forwards, inside and outside backs covered significantly more distance at high speed (p < 0.01), while there was a negligible difference with number of impacts between the forward positions. There was also minimal difference between positions in the percentage change in NP, cortisol and sIgA. The results indicate distance covered and number of impacts per minute of game time is position-dependent whereas changes in psychophysiological stress are independent. This information can be used to adapt training and recovery interventions to better prepare each position based on the physical requirements of the game. PMID:25830235

  4. Relativistic positioning systems: Numerical simulations

    NASA Astrophysics Data System (ADS)

    Puchades Colmenero, Neus

    The position of users located on the Earth's surface or near it may be found with the classic positioning systems (CPS). Certain information broadcast by satellites of global navigation systems, as GPS and GALILEO, may be used for positioning. The CPS are based on the Newtonian formalism, although relativistic post-Newtonian corrections are done when they are necessary. This thesis contributes to the development of a different positioning approach, which is fully relativistic from the beginning. In the relativistic positioning systems (RPS), the space-time position of any user (ship, spacecraft, and so on) can be calculated with the help of four satellites, which broadcast their proper times by means of codified electromagnetic signals. In this thesis, we have simulated satellite 4-tuples of the GPS and GALILEO constellations. If a user receives the signals from four satellites simultaneously, the emission proper times read -after decoding- are the user "emission coordinates". In order to find the user "positioning coordinates", in an appropriate almost inertial reference system, there are two possibilities: (a) the explicit relation between positioning and emission coordinates (broadcast by the satellites) is analytically found or (b) numerical codes are designed to calculate the positioning coordinates from the emission ones. Method (a) is only viable in simple ideal cases, whereas (b) allows us to consider realistic situations. In this thesis, we have designed numerical codes with the essential aim of studying two appropriate RPS, which may be generalized. Sometimes, there are two real users placed in different positions, which receive the same proper times from the same satellites; then, we say that there is bifurcation, and additional data are needed to choose the real user position. In this thesis, bifurcation is studied in detail. We have analyzed in depth two RPS models; in both, it is considered that the satellites move in the Schwarzschild's space

  5. The Secondary Principal Position: Preparatory Position for the Superintendency

    ERIC Educational Resources Information Center

    Farmer, Tod Allen

    2007-01-01

    The following paper is a synopsis of a study which examined career paths to the Texas public school superintendency. The most common pathways to the superintendency were identified and delineated by educational attainment and gender. Five career paths were identified as the major pathways to the superintendent position. The secondary teacher,…

  6. Global Position and Position Taking: The Case of Australia

    ERIC Educational Resources Information Center

    Marginson, Simon

    2007-01-01

    From 1990 to 2003, Australia's share of the global market in cross-border degrees grew from 1% to 9%. Full fee-paying foreign students now constitute one quarter of enrolments, and education is Australia's third largest services export. Positioned as an Anglo-American system on the edge of Asia, Australia has differentiated itself from the United…

  7. Positioning mental health nursing practice within a positive health paradigm.

    PubMed

    Wand, Timothy

    2013-04-01

    Mental health service provision has traditionally been dominated by biomedical models of illness and disorder, a problem-based orientation, and the assessment and management of risk. While psychotherapeutic approaches are numerous and have been widely utilized, psychotropic medications, either as monotherapy or in conjunction with psychological therapies, remain the mainstay for the 'treatment' of mental health problems. This is despite growing uncertainty over the effectiveness of psychotropic medications (particularly antidepressants), as well as their potential for enduring and debilitating side-effects. This discussion paper outlines the emerging field of positive health, which eschews a psychiatric disorder and illness focus, and is instead oriented towards the identification of strengths, abilities, hopes, and the individual's preferred future. The shift in positive health, from illness towards wellness, aims to build health literacy and the capacity of individuals to make decisions conducive to health, and thereby make more effective the use of health-care services. A positioning of mental health nursing practice within a positive health paradigm is promoted. By illustration, a number of solution-focused mental health assessment questions are tabled to contrast the current format for mental health assessment, which rather than being 'comprehensive', is predominantly concerned only with problem and risk identification, and the search for pathology in the individual.

  8. Positive Youth Psychology: Lessons from Positive Peer Culture

    ERIC Educational Resources Information Center

    Steinebach, Christoph; Steinebach, Ursula; Brendtro, Larry K.

    2013-01-01

    Positive Peer Culture (PPC) is a strength-oriented approach developed by Vorrath and Brendtro (1985) to prevent or reverse negative peer influence by building a climate of peer concern and respect. PPC operates in a range of settings including residential treatment, alternative schools, juvenile justice, and youth leadership groups. It is an…

  9. Asserting a Positive Role: HIV-Positive People in Prevention

    ERIC Educational Resources Information Center

    Allan, Brent; Leonard, William

    2005-01-01

    The best HIV prevention programs--those that effect change on a multiplicity of levels by changing knowledge, attitudes, and behaviors and that are sustained over time--are also those that place HIV-positive people at the center of program design, implementation, and evaluation.

  10. A prescription for the Epley maneuver: www.youtube.com?

    PubMed Central

    Burke, James F.; Skolarus, Lesli E.; Callaghan, Brian C.; Fife, Terry D.; Baloh, Robert W.; Fendrick, A. Mark

    2012-01-01

    Objectives: Video-sharing Web sites are being used for information about common conditions including dizziness. The Epley maneuver (EM) is a simple and effective treatment for benign paroxysmal positional vertigo (BPPV) of the posterior canal. However, the maneuver is underused in routine care. In this study, we aimed to describe and analyze the available information about the EM on youtube.com. Methods: A YouTube search was performed on August 31, 2011, for videos that demonstrated the entire EM. Detailed data were abstracted from each video and corresponding Web site. Videos were rated on the accuracy of the maneuver by 2 authors, with differences resolved by adjudication. Comments posted by viewers were assessed for themes regarding video use. Results: Of the 3,319 videos identified, 33 demonstrated the EM. The total number of hits for all videos was 2,755,607. The video with the most hits (802,471) was produced by the American Academy of Neurology. Five of the videos accounted for 85% of all the hits. The maneuver demonstration was rated as accurate in 64% (21) of the videos. Themes derived from the 424 posted comments included patients self-treating with the maneuver after reviewing the videos, and providers using the videos as a prescribed treatment or for educational purposes. Conclusion: Accurate video demonstration of the Epley maneuver is available and widely viewed on YouTube. Video-sharing media may be an important way to disseminate effective interventions such as the EM. The impact of video Web sites on outcomes and costs of care is not known and warrants future study. PMID:22826542

  11. Olfactory dysfunction in head injured workers.

    PubMed

    Ogawa, T; Rutka, J

    1999-01-01

    Olfactory dysfunction following trauma has been widely reported and is currently compensable according to existing American Medical Association guidelines when it occurs in the occupational setting. Its presence and the risk factors for its development, however, have not been clearly delineated in occupationally head injured workers. In order to assess this phenomenon, a series of 365 consecutive head injured workers from 1993-1997 was assessed in order to determine the incidence of post-traumatic olfactory dysfunction and its association with the severity of the head injury, the mechanism of injury and other neurotological abnormalities in the same cohort group. Olfactory dysfunction was identified in 13.7% (9.3% with anosmia, 4.4% with hyposmia/dysosmia). It was more likely where the loss of consciousness > 1 h (p < 0.002), in more severe head injuries (grades II-V) (p < 0.001) and when skull fracture (p < 0.001) occurred. The direction of the blow applied to the skull did not influence its presence, although radiologically confirmed skull fractures in the frontal, occipital, skull base and midface were twice as likely as temporal and parietal fractures to result in an olfactory change. From a neurotologic perspective, approximately 21.9% of head injured workers were determined to have recognizable evidence of cochleovestibular dysfunction. Olfactory dysfunction as a physical finding post-head injury compares favourably with the presence of post-traumatic benign positional paroxysmal vertigo (BPPV) and its atypical variants in 11.2% of head injured workers. PMID:10445080

  12. The future of positive therapy.

    PubMed

    Wong, Y Joel

    2006-01-01

    Responds to commentary by S. J. Lopez and B. A. Kerr (see record 2006-07640-002) on the current author's original article (see record 2006-07640-001). In their commentary on strength-centered therapy (ST), Lopez and Kerr (2006) called for an open-source approach to developing positive psychological practices. In this rejoinder, the author responds to their comments, provides clarifications on ST, and discusses the future of positive therapy. Specifically, the author calls for future scholarship to address (1) the contributions of social constructionist therapies, (2) positive systemic influences in psychotherapy, and (3) diverse conceptualizations of strengths and optimal human functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  13. INTEGRAL POSITIONING AND INDICATING DEVICE

    DOEpatents

    Frantz, C.E.; Cawley, W.E.; Warnick, R.F.

    1961-07-25

    A variable capacitor which may be used as an integral positioning and indicating device is descried. The apparatus comprises a hollow metal cylinder with a metal rod mounted fixedly along the axis thereof and insulated therefrom. A hollow shaft is slidably mounted between the cylinder and the rod in electrical connection with the cylinder and insulated from the rod. One end of the shaft is disposed between the cylinder and the rod and the other end extends therefrom and may be connected to an object whose position is to be monitored. Means are provided to move the hollow shaft by pressure fluid in the cylinder whereby the capacitance between the rod and the cylinder is varied and measurement of which is a function of the position of the hollow shaft.

  14. Impact micro-positioning actuator

    NASA Technical Reports Server (NTRS)

    Cuerden, Brian (Inventor); Angel, J. Roger P. (Inventor); Burge, James H. (Inventor); DeRigne, Scott T. (Inventor)

    2006-01-01

    An impact micro-positioning actuator. In one aspect of the invention, a threaded shaft is threadably received in a nut and the nut is impacted by an impacting device, causing the nut first to rotate relative to the shaft by slipping as a result of shaft inertia and subsequently to stick to the shaft as a result of the frictional force therebetween. The nut is returned to its initial position by a return force provided by a return mechanism after impact. The micro-positioning actuator is further improved by controlling at least one and preferably all of the following: the friction, the impact provided by the impacting device, the return force provided by the return mechanism, and the inertia of the shaft. In another aspect of the invention, a threaded shaft is threadably received in a nut and the shaft is impacted by an impacting device, causing the shaft to rotate relative to the nut.

  15. Sleep position and shoulder pain.

    PubMed

    Zenian, John

    2010-04-01

    The overuse theory for musculoskeletal joint pain cannot explain adequately the occurrence of shoulder pain in those who do not engage in activities that involve repeated and stressful use of the shoulder since the percentage of the painful right shoulders usually does not match the percentage of dominant right arms in such individuals. An alternative hypothesis is presented to propose that shoulder pain is caused by postural immobility in the decubitus or side position during sleep. Prolonged pressure on the shoulder caused by the weight of the thorax can produce enough damage to cause subsequent shoulder pain. In order to test this hypothesis, a preliminary study was carried out to compare the laterality of shoulder pain with the laterality of sleep position. The calculated laterality ratios for sleep position and shoulder pain were found to be strikingly similar, suggesting a causal relationship between the two phenomena. However, the prevalence of shoulder pain in the general population was found to be smaller than the percentage of the time people would spend sleeping in the decubitus position. This discrepancy could be explained by the idea that in order for shoulder pain to develop subjects may have to spend longer times in the same decubitus position before changing to another position than the average person would. Additional evidence from published clinical studies also supports the postural theory of shoulder pain. More studies can be done to test this hypothesis by focusing on the sleep habits of patients with shoulder pain. According to the present hypothesis shoulder pain should for the most part occur on the side that the patient preferred to sleep on before the onset of shoulder pain. The postural theory of shoulder pain provides the possibility for a new and noninvasive method to treat shoulder pain by the modification of posture during sleep.

  16. False positives in imaging genetics.

    PubMed

    Meyer-Lindenberg, Andreas; Nicodemus, Kristin K; Egan, Michael F; Callicott, Joseph H; Mattay, Venkata; Weinberger, Daniel R

    2008-04-01

    Imaging genetics provides an enormous amount of functional-structural data on gene effects in living brain, but the sheer quantity of potential phenotypes raises concerns about false discovery. Here, we provide the first empirical results on false positive rates in imaging genetics. We analyzed 720 frequent coding SNPs without significant association with schizophrenia and a subset of 492 of these without association with cognitive function. Effects on brain structure (using voxel-based morphometry, VBM) and brain function, using two archival imaging tasks, the n-back working memory task and an emotional face matching task, were studied in whole brain and regions of interest and corrected for multiple comparisons using standard neuroimaging procedures. Since these variants are unlikely to impact relevant brain function, positives obtained provide an upper empirical estimate of the false positive association rate. In a separate analysis, we randomly permuted genotype labels across subjects, removing any true genotype-phenotype association in the data, to derive a lower empirical estimate. At a set correction level of 0.05, in each region of interest and data set used, the rate of positive findings was well below 5% (0.2-4.1%). There was no relationship between the region of interest and the false positive rate. Permutation results were in the same range as empirically derived rates. The observed low rates of positives provide empirical evidence that the type I error rate is well controlled by current commonly used correction procedures in imaging genetics, at least in the context of the imaging paradigms we have used. In fact, our observations indicate that these statistical thresholds are conservative.

  17. Solar cell angular position transducer

    NASA Technical Reports Server (NTRS)

    Sandford, M. C.; Gray, D. L. (Inventor)

    1980-01-01

    An angular position transducer utilizing photocells and a light source is disclosed. The device uses a fully rotatable baffle which is connected via an actuator shaft to the body whose rotational displacement is to be measured. The baffle blocks the light path between the light source and the photocells so that a constant semicircular beam of light reaches the photocells. The current produced by the photocells is fed through a resistor, a differential amplifier measures the voltage drop across the resistor which indicates the angular position of the actuator shaft and hence of the object.

  18. Multi-position photovoltaic assembly

    DOEpatents

    Dinwoodie, Thomas L.

    2003-03-18

    The invention is directed to a PV assembly, for use on a support surface, comprising a base, a PV module, a multi-position module support assembly, securing the module to the base at shipping and inclined-use angles, a deflector, a multi-position deflector support securing the deflector to the base at deflector shipping and deflector inclined-use angles, the module and deflector having opposed edges defining a gap therebetween. The invention permits transport of the PV assemblies in a relatively compact form, thus lowering shipping costs, while facilitating installation of the PV assemblies with the PV module at the proper inclination.

  19. Low noise optical position sensor

    DOEpatents

    Spear, J.D.

    1999-03-09

    A novel optical position sensor is described that uses two component photodiodes electrically connected in parallel, with opposing polarities. A lens provides optical gain and restricts the acceptance angle of the detector. The response of the device to displacements of an optical spot is similar to that of a conventional bi-cell type position sensitive detector. However, the component photodiode design enables simpler electronic amplification with inherently less electrical noise than the bi-cell. Measurements by the sensor of the pointing noise of a focused helium-neon laser as a function of frequency demonstrate high sensitivity and suitability for optical probe beam deflection experiments. 14 figs.

  20. Low noise optical position sensor

    DOEpatents

    Spear, Jonathan David

    1999-01-01

    A novel optical position sensor is described that uses two component photodiodes electrically connected in parallel, with opposing polarities. A lens provides optical gain and restricts the acceptance angle of the detector. The response of the device to displacements of an optical spot is similar to that of a conventional bi-cell type position sensitive detector. However, the component photodiode design enables simpler electronic amplification with inherently less electrical noise than the bi-cell. Measurements by the sensor of the pointing noise of a focused helium-neon laser as a function of frequency demonstrate high sensitivity and suitability for optical probe beam deflection experiments.

  1. A Positive Psychology That Matters

    ERIC Educational Resources Information Center

    Lopez, Shane L.; Magyar-Moe, Jeana L.

    2006-01-01

    The Major Contribution intended to situate positive psychology in counseling psychology's past and future and in the complex world we live and work in today. The four reactions (Frazier, Lee,& Steger; Gerstein; Linley; Mollen, Ethington,& Ridley) provide new insights into how counseling psychology has and will contribute to the study of human…

  2. Positive Psychology: Transforming Young Lives

    ERIC Educational Resources Information Center

    Brendtro, Larry K.; Mitchell, Martin L.

    2011-01-01

    To reach responsible independence, young people must become invested in setting their life course. A rich history of research and practice shows that democratic group climates foster autonomy and prosocial behavior. This article explores principles and practices for creating positive peer cultures to develop strengths and help youth meet their…

  3. Positive Approaches to Classroom Discipline.

    ERIC Educational Resources Information Center

    Martin, Betty B.; Quilling, Joan

    To provide educators with an alternative perspective on discipline, this handbook examines the concept of discipline, presents four models of disciplinary strategy, and discusses factors related to classroom discipline. After briefly analyzing different definitions of discipline and their positive and negative outcomes, the authors discuss each of…

  4. Marijuana and Children. Position Statement

    ERIC Educational Resources Information Center

    Endsley, Patricia; Embrey, Mary Louise

    2014-01-01

    Registered professional school nurses (hereinafter referred to as school nurses) promote wellness and disease prevention to improve health outcomes for our nation's children. It is the position of the National Association of School Nurses (NASN) that the marijuana plant remain under the United States Drug Enforcement Agency's (DEA) Schedule I…

  5. Positive Psychology: The Emerging Paradigm.

    ERIC Educational Resources Information Center

    Csikszentmihalyi, Mihaly

    2000-01-01

    Discusses positive psychology, which focuses on health and well-being utilizing the elements of belief, hope, self-esteem, responsibility, elation, and wisdom as the basis of psychological theory and practice. Describes efforts to change the psychology field, including identifying promising young professionals, establishing monetary prizes, and…

  6. Perfect imaging with positive refraction

    NASA Astrophysics Data System (ADS)

    Leonhardt, Ulf; Tyc, Tomáš; Danner, Aaron

    2010-10-01

    We present several refractive index profiles for perfect imaging with positive refraction other than Maxwell's fish eye. Numerical simulations show that these profiles may transfer images with, in principle, unlimited resolution. Such profiles could overcome the fundamental limitations of perfect imaging with negative refraction and find practical applications in nanolithography.

  7. Aerospace Education. NSTA Position Statement

    ERIC Educational Resources Information Center

    National Science Teachers Association (NJ1), 2008

    2008-01-01

    National Science Teachers Association (NSTA) has developed a new position statement, "Aerospace Education." NSTA believes that aerospace education is an important component of comprehensive preK-12 science education programs. This statement highlights key considerations that should be addressed when implementing a high quality aerospace education…

  8. One School's Positive Action Plan.

    ERIC Educational Resources Information Center

    McCormack, Sammie

    Because they felt that students can be responsible for their own behavior, the staff of Jefferson Elementary School, serving 300 students in grades 1 through 4 in a small rural community, developed a program which promoted self-management. In September 1979, teachers participated in an assertive discipline workshop. A Positive Action Plan evolved,…

  9. Caseload Assignments. Position Statement. Revised

    ERIC Educational Resources Information Center

    DuRant, Bonnie V.; Gibbons, Linda J.; Poole, Cynthia; Suessmann, Mary; Wyckoff, Leah

    2010-01-01

    It is the position of the National Association of School Nurses (NASN) that schools should employ professionally prepared Registered Nurses, to conduct and supervise school health programs which address the variety of health problems experienced by school children. NASN recommends a formula-based approach with minimum ratios of nurses-to-students…

  10. HR Positions on the Internet.

    ERIC Educational Resources Information Center

    Coghill, Carey Cox; Kirk, James J.

    The question of whether the online job market reflects the trends predicted for the job market was examined in a study of a random sample of 690 Internet job postings over a 6-month period. Each listing was categorized by type of position, desired qualifications, salary, and job specifications. Of the human resources (HR) jobs posted, 7.2% were…

  11. Bistable Head Positioning Arm Latch

    NASA Astrophysics Data System (ADS)

    Wasson, Ken; Endo, Juro; Mita, Masahiro; Abelein, Nathan

    A simple, low cost, yet effective device has been developed for immobilizing the head-arm assembly in a disk drive or similar mechanism during power-off conditions. The latching scheme also provides a consistent means of releasing the head-arm assembly from the immobilized position upon power up of the disk drive. The latch uses no electrical power in either immobilized or released state. This design is immune to extreme torque and linear shock forces applied to the disk drive case. The latch system can use the energy stored in the spinning disks to drive the head-arm assembly toward a safe position while simultaneously arming the latch mechanism to secure the head-arm assembly in the safe position upon arrival. A low energy five msec pulse of current drives the latch from one state to the other. Solenoids as presently used in latch mechanisms are bulky, expensive, have variable force characteristics, and often generate contaminants. The latch described in this paper is expected to replace such solenoids. It may also replace small magnet latches, which have limited latch force and apply unwanted torque to a proximate head positioning arm.

  12. Positive Adolescent Choices Training (PACT).

    ERIC Educational Resources Information Center

    Hammond, W. Rodney; And Others

    Positive Adolescent Choices Training (PACT) is a health promotion program providing violence prevention programming targeted at black youth, at high risk for becoming either perpetrators or victims of violence. Conducted by the School of Professional Psychology of Wright State University in Dayton, Ohio, in cooperation with Dayton Public Schools,…

  13. Positive Culture in Urban Schools

    ERIC Educational Resources Information Center

    Osher, David; Fleischman, Steve

    2005-01-01

    Many urban schools are providing high-quality education and are producing high-achieving students, despite facing high student poverty and mobility rates, large number of English language learners and unsafe neighborhood. Positive behavioral supports, caring connections, and social and emotional learning are very essential in creating positive…

  14. Position Papers on Career Education.

    ERIC Educational Resources Information Center

    National Advisory Council on Vocational Education, Washington, DC.

    This document contains position papers presented at a 3-day conference dealing with the implications of career education for minority groups. Texts of these papers are included: (1) "Career Education Improves the Self Concept" by D.R. Baylor, (2) "Career Education and Black Americans" by W.F. Brazziel, (3) "Career Education: Expanded Options for…

  15. Independent modal space control with positive position feedback

    NASA Technical Reports Server (NTRS)

    Baz, A.; Poh, S.; Fedor, J.

    1989-01-01

    An independent modal space control (IMSC) algorithm is presented, whose modal control forces are generated from a positive position feedback (PPF) strategy. The proposed algorithm combines the attributes of both the IMSC and the PPF, and maintains the simplicity of the IMSC as it designs the controller of a complex structure at the uncoupled modal level. The effectiveness of the algorithm in damping out the vibration of flexible structures is validated experimentally. A simple cantilevered beam is employed as an example of a flexible structure whose multimodes of vibration are controlled by a single actuator. Performance of the active control system is determined in the frequency and the time domains. The experimental results indicate the potential of the proposed methodology as a viable method for controlling the vibration of large flexible structures.

  16. Renewable Energy Positioning System: Energy Positioning: Control and Economics

    SciTech Connect

    2012-03-01

    GENI Project: The University of Washington and the University of Michigan are developing an integrated system to match well-positioned energy storage facilities with precise control technologies so the electric grid can more easily include energy from renewable power sources like wind and solar. Because renewable energy sources provide intermittent power, it is difficult for the grid to efficiently allocate those resources without developing solutions to store their energy for later use. The two universities are working with utilities, regulators, and the private sector to position renewable energy storage facilities in locations that optimize their ability to provide and transmit electricity where and when it is needed most. Expanding the network of transmission lines is prohibitively expensive, so combining well-placed storage facilities with robust control systems to efficiently route their power will save consumers money and enable the widespread use of safe, renewable sources of power.

  17. Method and apparatus for determining position using global positioning satellites

    NASA Technical Reports Server (NTRS)

    Ward, John (Inventor); Ward, William S. (Inventor)

    1998-01-01

    A global positioning satellite receiver having an antenna for receiving a L1 signal from a satellite. The L1 signal is processed by a preamplifier stage including a band pass filter and a low noise amplifier and output as a radio frequency (RF) signal. A mixer receives and de-spreads the RF signal in response to a pseudo-random noise code, i.e., Gold code, generated by an internal pseudo-random noise code generator. A microprocessor enters a code tracking loop, such that during the code tracking loop, it addresses the pseudo-random code generator to cause the pseudo-random code generator to sequentially output pseudo-random codes corresponding to satellite codes used to spread the L1 signal, until correlation occurs. When an output of the mixer is indicative of the occurrence of correlation between the RF signal and the generated pseudo-random codes, the microprocessor enters an operational state which slows the receiver code sequence to stay locked with the satellite code sequence. The output of the mixer is provided to a detector which, in turn, controls certain routines of the microprocessor. The microprocessor will output pseudo range information according to an interrupt routine in response detection of correlation. The pseudo range information is to be telemetered to a ground station which determines the position of the global positioning satellite receiver.

  18. Method and Apparatus for Determining Position Using Global Positioning Satellites

    NASA Technical Reports Server (NTRS)

    Ward, John L. (Inventor)

    2001-01-01

    A global positioning satellite receiver having an antenna for receiving a L1 signal from a satellite is presented. The L1 signal is processed by a preamplifier stage including a band pass filter and a low noise amplifier and output as a radio frequency (RF) signal. A mixer receives and de-spreads the RF signal in response to a pseudo-random noise code, i,e., Gold code, generated by an internal pseudo-random noise code generator. A microprocessor enters a code tracking loop, such that during the code tracking loop, it addresses the pseudorandom code generator to cause the pseudo-random code generator to sequentially output pseudo-random codes corresponding to satellite codes used to spread the L1 signal, until correlation occurs. When an output of the mixer is indicative of the occurrence of correlation between the RF signal and the generated pseudo-random codes, the microprocessor caters an operational state which slows the receiver code sequence to stay locked with the satellite cede sequence. The output of the mixer is provided to a detector which, in turn, controls certain routines of the microprocessor. The microprocessor will output pseudo range information according to an interrupt routine in response detection of correlation. The pseudo range information is to be telemetered to a ground station which determines the position of the global positioning satellite receiver.

  19. Positive signs in massive gravity

    DOE PAGES

    Cheung, Clifford; Remmen, Grant N.

    2016-04-01

    Here, we derive new constraints on massive gravity from unitarity and analyticity of scattering amplitudes. Our results apply to a general effective theory defined by Einstein gravity plus the leading soft diffeomorphism-breaking corrections. We calculate scattering amplitudes for all combinations of tensor, vector, and scalar polarizations. Furthermore, the high-energy behavior of these amplitudes prescribes a specific choice of couplings that ameliorates the ultraviolet cutoff, in agreement with existing literature. We then derive consistency conditions from analytic dispersion relations, which dictate positivity of certain combinations of parameters appearing in the forward scattering amplitudes. These constraints exclude all but a small islandmore » in the parameter space of ghost-free massive gravity. And while the theory of the "Galileon" scalar mode alone is known to be inconsistent with positivity constraints, this is remedied in the full massive gravity theory.« less

  20. Position and orientation tracking system

    DOEpatents

    Burks, B.L.; DePiero, F.W.; Armstrong, G.A.; Jansen, J.F.; Muller, R.C.; Gee, T.F.

    1998-05-05

    A position and orientation tracking system presents a laser scanning apparatus having two measurement pods, a control station, and a detector array. The measurement pods can be mounted in the dome of a radioactive waste storage silo. Each measurement pod includes dual orthogonal laser scanner subsystems. The first laser scanner subsystem is oriented to emit a first line laser in the pan direction. The second laser scanner is oriented to emit a second line laser in the tilt direction. Both emitted line lasers scan planes across the radioactive waste surface to encounter the detector array mounted on a target robotic vehicle. The angles of incidence of the planes with the detector array are recorded by the control station. Combining measurements describing each of the four planes provides data for a closed form solution of the algebraic transform describing the position and orientation of the target robotic vehicle. 14 figs.

  1. Position and orientation tracking system

    DOEpatents

    Burks, Barry L.; DePiero, Fred W.; Armstrong, Gary A.; Jansen, John F.; Muller, Richard C.; Gee, Timothy F.

    1998-01-01

    A position and orientation tracking system presents a laser scanning appaus having two measurement pods, a control station, and a detector array. The measurement pods can be mounted in the dome of a radioactive waste storage silo. Each measurement pod includes dual orthogonal laser scanner subsystems. The first laser scanner subsystem is oriented to emit a first line laser in the pan direction. The second laser scanner is oriented to emit a second line laser in the tilt direction. Both emitted line lasers scan planes across the radioactive waste surface to encounter the detector array mounted on a target robotic vehicle. The angles of incidence of the planes with the detector array are recorded by the control station. Combining measurements describing each of the four planes provides data for a closed form solution of the algebraic transform describing the position and orientation of the target robotic vehicle.

  2. Dual optical mechanical position tracker

    NASA Astrophysics Data System (ADS)

    Everett, S. L., Jr.

    1985-06-01

    This patent application describes an apparatus for retaining control of moving carriage impact dot matrix print heads when subjected to strong external forces such as shock and/or vibration. Position and direction of carriage movement is provided by a photo emitter-sensor assembly and a slotted timing wheel or disc having a plurality of equally spaced slots whose slot width is equal to the slot separation. The slot width is sufficient to frame a pair of side-by-side emitters which operate in conjunction with a pair of side-by-side sensors on the other side of the timing wheel. The order or sequence in which the sensors receive photo energy from their respective emitters indicates the direction of rotation of the timing wheel while simultaneous reception of photo energy by the side-by-side sensors provides an indication of valid rest position of the carriage drive motor.

  3. SPLASH: Accurate OH maser positions

    NASA Astrophysics Data System (ADS)

    Walsh, Andrew; Gomez, Jose F.; Jones, Paul; Cunningham, Maria; Green, James; Dawson, Joanne; Ellingsen, Simon; Breen, Shari; Imai, Hiroshi; Lowe, Vicki; Jones, Courtney

    2013-10-01

    The hydroxyl (OH) 18 cm lines are powerful and versatile probes of diffuse molecular gas, that may trace a largely unstudied component of the Galactic ISM. SPLASH (the Southern Parkes Large Area Survey in Hydroxyl) is a large, unbiased and fully-sampled survey of OH emission, absorption and masers in the Galactic Plane that will achieve sensitivities an order of magnitude better than previous work. In this proposal, we request ATCA time to follow up OH maser candidates. This will give us accurate (~10") positions of the masers, which can be compared to other maser positions from HOPS, MMB and MALT-45 and will provide full polarisation measurements towards a sample of OH masers that have not been observed in MAGMO.

  4. Flight representative positive isolation disconnect

    NASA Technical Reports Server (NTRS)

    Rosener, A. A.; Jonkoniec, T. G.

    1977-01-01

    Resolutions were developed for each problem encountered and a tradeoff analysis was performed to select a final configuration for a flight representative PID (Positive Isolation Disconnect) that is reduced in size and comparable in weight and pressure drop to the developmental PID. A 6.35 mm (1/4-inch) line size PID was fabricated and tested. The flight representative PID consists of two coupled disconnect halves, each capable of fluid isolation with essentially zero clearance between them for zero leakage upon disconnect half disengagement. An interlocking foolproofing technique prevents uncoupling of disconnect halves prior to fluid isolation. Future development efforts for the Space Shuttle subsystems that would benefit from the use of the positive isolation disconnect are also recommended. Customary units were utilized for principal measurements and calculations with conversion factors being inserted in equations to convert the results to the international system of units.

  5. Tevatron beam position monitor upgrade

    SciTech Connect

    Wolbers, Stephen; Banerjee, B.; Barker, B.; Bledsoe, S.; Boes, T.; Bowden, M.; Cancelo, G.; Forster, B.; Duerling, G.; Haynes, B.; Hendricks, B.; Kasza, T.; Kutschke, R.; Mahlum, R.; Martens, M.; Mengel, M.; Olson, M.; Pavlicek, V.; Pham, T.; Piccoli, L.; Steimel, J.; /Fermilab

    2005-05-01

    The Tevatron Beam Position Monitor (BPM) readout electronics and software have been upgraded to improve measurement precision, functionality and reliability. The original system, designed and built in the early 1980's, became inadequate for current and future operations of the Tevatron. The upgraded system consists of 960 channels of new electronics to process analog signals from 240 BPMs, new front-end software, new online and controls software, and modified applications to take advantage of the improved measurements and support the new functionality. The new system reads signals from both ends of the existing directional stripline pickups to provide simultaneous proton and antiproton position measurements. Measurements using the new system are presented that demonstrate its improved resolution and overall performance.

  6. Positive signs in massive gravity

    NASA Astrophysics Data System (ADS)

    Cheung, Clifford; Remmen, Grant N.

    2016-04-01

    We derive new constraints on massive gravity from unitarity and analyticity of scattering amplitudes. Our results apply to a general effective theory defined by Einstein gravity plus the leading soft diffeomorphism-breaking corrections. We calculate scattering amplitudes for all combinations of tensor, vector, and scalar polarizations. The high-energy behavior of these amplitudes prescribes a specific choice of couplings that ameliorates the ultraviolet cutoff, in agreement with existing literature. We then derive consistency conditions from analytic dispersion relations, which dictate positivity of certain combinations of parameters appearing in the forward scattering amplitudes. These constraints exclude all but a small island in the parameter space of ghost-free massive gravity. While the theory of the "Galileon" scalar mode alone is known to be inconsistent with positivity constraints, this is remedied in the full massive gravity theory.

  7. Electronic Tag and Position Sensor

    SciTech Connect

    Not Available

    1992-01-20

    The intent of this study phase program was to adequately define the Electronic Tag and Position Sensor chip so as to be able to price and schedule the full design and development culminating in a silicon IC. Therefore, even though Hughes Aircraft Company feels that the approach submitted in this document is what should be developed, it is still considered preliminary and could change as the full design is developed.

  8. Capacitive Position Sensor For Accelerometer

    NASA Technical Reports Server (NTRS)

    Vanzandt, Thomas R.; Kaiser, William J.; Kenny, Thomas W.

    1995-01-01

    Capacitive position sensor measures displacement of proof mass in prototype accelerometer described in "Single-Crystal Springs for Accelerometers" (NPO-18795). Sensor is ultrasensitive, miniature device operating at ultra-high frequency and described in more detail in "Ultra-High-Frequency Capacitive Displacement Sensor," (NPO-18675). Advances in design and fabrication of prototype accelerometer also applicable to magnetometers and other sensors in which sensed quantities measured in terms of deflections of small springs.

  9. Positive psychology and romantic scientism.

    PubMed

    Brown, Nicholas J L; Sokal, Alan D; Friedman, Harris L

    2014-09-01

    Replies to the comments of Nickerson (see record 2014-36500-010), Guastello (see record 2014-36500-011), Musau (see record 2014-36500-013), Hämäläinen et al. (see record 2014-36500-014), and Lefebvre and Schwartz (see record 2014-36500-015) on the authors article (see record 2013-24609-001). Fredrickson and Losada's (2005) article was the subject of over 350 scholarly citations before our critique (Brown et al., 2013) appeared, and its principal "conclusions" have been featured in many lectures and public presentations by senior members of the positive psychology research community, although its deficiencies ought to have been visible to anyone with a modest grasp of mathematics and a little curiosity. Unfortunately- because human behavior is, after all, complex and difficult to understand-we have no way of knowing whether the fact that it took so long for these deficiencies to be recognized was due to an unwarranted degree of optimism about the reliability of the peer-review process, a reluctance to make waves in the face of powerful interests, a general lack of critical thinking within positive psychology, or some other factor. We hope that our revelation of the problems with the critical positivity ratio ultimately demonstrates the success of science as a self-correcting endeavor; however, we would have greatly preferred it if our work had not been necessary in the first place. PMID:25197852

  10. Positive lightning and severe weather

    NASA Astrophysics Data System (ADS)

    Price, C.; Murphy, B.

    2003-04-01

    In recent years researchers have noticed that severe weather (tornados, hail and damaging winds) are closely related to the amount of positive lightning occurring in thunderstorms. On 4 July 1999, a severe derecho (wind storm) caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators for short-term forecasts of severe weather.

  11. Procedure for developing Union position

    NASA Astrophysics Data System (ADS)

    1. Position statements will be restricted to those issues that fall within the guidelines approved by the Council. 2. Requests for position statements are referred immediately to the Public Affairs Committee. 3. If a request seems to fall within Union guidelines, the committee will recommend that the President of the Union appoint an independent panel charged with drafting a statement. The panel will include at least one member nominated by the Public Affairs Committee, the originator of the request, and one member of Council. 4. The Council and the membership will be informed that the panel is working on the issue and that comments are welcome. 5. The panel will prepare a statement for circulation to the Council of the Union. 6. Members of Council (or Executive Committee when timeliness is critical) will be asked to vote or to comment on the proposed statement. This vote is to be taken at regularly scheduled meetings except where timeliness is critical. Concurrence of two thirds is required for adoption. 7. All adopted position statements will be published in Eos as soon as possible. 8. Once a statement has been approved, the Public Affairs Committee will endeavor to apply its expertise to making advocacy of its contents as effective as possible.

  12. Geometrical Positioning Schemes Based on Hybrid Lines of Position

    NASA Astrophysics Data System (ADS)

    Chen, Chien-Sheng; Lin, Jium-Ming; Liu, Wen-Hsiung; Chi, Ching-Lung

    To achieve more accurate measurements of the mobile station (MS) location, it is possible to integrate many kinds of measurements. In this paper we proposed several simpler methods that utilized time of arrival (TOA) at three base stations (BSs) and the angle of arrival (AOA) information at the serving BS to give location estimation of the MS in non-line-of-sight (NLOS) environments. From the viewpoint of geometric approach, for each a TOA value measured at any BS, one can generate a circle. Rather than applying the nonlinear circular lines of position (LOP), the proposed methods are much easier by using linear LOP to determine the MS. Numerical results demonstrate that the calculation time of using linear LOP is much less than employing circular LOP. Although the location precision of using linear LOP is only reduced slightly. However, the proposed efficient methods by using linear LOP can still provide precise solution of MS location and reduce the computational effort greatly. In addition, the proposed methods with less effort can mitigate the NLOS effect, simply by applying the weighted sum of the intersections between different linear LOP and the AOA line, without requiring priori knowledge of NLOS error statistics. Simulation results show that the proposed methods can always yield superior performance in comparison with Taylor series algorithm (TSA) and the hybrid lines of position algorithm (HLOP).

  13. Fluorescent fluid interface position sensor

    DOEpatents

    Weiss, Jonathan D.

    2004-02-17

    A new fluid interface position sensor has been developed, which is capable of optically determining the location of an interface between an upper fluid and a lower fluid, the upper fluid having a larger refractive index than a lower fluid. The sensor functions by measurement, of fluorescence excited by an optical pump beam which is confined within a fluorescent waveguide where that waveguide is in optical contact with the lower fluid, but escapes from the fluorescent waveguide where that waveguide is in optical contact with the upper fluid.

  14. Positional Cloning by Linkage Disequilibrium

    PubMed Central

    Maniatis, Nikolas; Collins, Andrew; Gibson, Jane; Zhang, Weihua; Tapper, William; Morton, Newton E.

    2004-01-01

    Recently, metric linkage disequilibrium (LD) maps that assign an LD unit (LDU) location for each marker have been developed (Maniatis et al. 2002). Here we present a multiple pairwise method for positional cloning by LD within a composite likelihood framework and investigate the operating characteristics of maps in physical units (kb) and LDU for two bodies of data (Daly et al. 2001; Jeffreys et al. 2001) on which current ideas of blocks are based. False-negative indications of a disease locus (type II error) were examined by selecting one single-nucleotide polymorphism (SNP) at a time as causal and taking its allelic count (0, 1, or 2, for the three genotypes) as a pseudophenotype, Y. By use of regression and correlation, association between every pseudophenotype and the allelic count of each SNP locus (X) was based on an adaptation of the Malecot model, which includes a parameter for location of the putative gene. By expressing locations in kb or LDU, greater power for localization was observed when the LDU map was fitted. The efficiency of the kb map, relative to the LDU map, to describe LD varied from a maximum of 0.87 to a minimum of 0.36, with a mean of 0.62. False-positive indications of a disease locus (type I error) were examined by simulating an unlinked causal SNP and the allele count was used as a pseudophenotype. The type I error was in good agreement with Wald’s likelihood theorem for both metrics and all models that were tested. Unlike tests that select only the most significant marker, haplotype, or haploset, these methods are robust to large numbers of markers in a candidate region. Contrary to predictions from tagging SNPs that retain haplotype diversity, the sample with smaller size but greater SNP density gave less error. The locations of causal SNPs were estimated with the same precision in blocks and steps, suggesting that block definition may be less useful than anticipated for mapping a causal SNP. These results provide a guide to

  15. Russian Soyuz in Launch Position

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Soyuz TM-31 launch vehicle is shown in the vertical position for its launch from Baikonur, carrying the first resident crew to the International Space Station. The Russian Soyuz launch vehicle is an expendable spacecraft that evolved out of the original Class A (Sputnik). From the early 1960s until today, the Soyuz launch vehicle has been the backbone of Russia's marned and unmanned space launch fleet. Today, the Soyuz launch vehicle is marketed internationally by a joint Russian/French consortium called STARSEM. As of August 2001, there have been ten Soyuz missions under the STARSEM banner.

  16. Diffraction encoded position measuring apparatus

    DOEpatents

    Tansey, R.J.

    1991-09-24

    When a lightwave passes through a transmission grating, diffracted beams appear at the output or opposite side of the grating that are effectively Doppler shifted in frequency (phase) whereby a detector system can compare the phase of the zero order and higher order beams to obtain an indication of position. Multiple passes through the grating increase resolution for a given wavelength of a laser signal. The resolution can be improved further by using a smaller wavelength laser to generate the grating itself. Since the grating must only have a pitch sufficient to produce diffracted orders, inexpensive, ultraviolet wavelength lasers can be utilized and still obtain high resolution detection. 3 figures.

  17. Diffraction encoded position measuring apparatus

    DOEpatents

    Tansey, Richard J.

    1991-01-01

    When a lightwave passes through a transmission grating, diffracted beams appear at the output or opposite side of the grating that are effectively Doppler shifted in frequency (phase) whereby a detector system can compare the phase of the zero order and higher order beams to obtain an indication of position. Multiple passes through the grating increase resolution for a given wavelength of a laser signal. The resolution can be improved further by using a smaller wavelength laser to generate the grating itself. Since the grating must only have a pitch sufficient to produce diffracted orders, inexpensive, ultraviolet wavelength lasers can be utilized and still obtain high resolution detection.

  18. Ultra-precision positioning assembly

    DOEpatents

    Montesanti, Richard C.; Locke, Stanley F.; Thompson, Samuel L.

    2002-01-01

    An apparatus and method is disclosed for ultra-precision positioning. A slide base provides a foundational support. A slide plate moves with respect to the slide base along a first geometric axis. Either a ball-screw or a piezoelectric actuator working separate or in conjunction displaces the slide plate with respect to the slide base along the first geometric axis. A linking device directs a primary force vector into a center-line of the ball-screw. The linking device consists of a first link which directs a first portion of the primary force vector to an apex point, located along the center-line of the ball-screw, and a second link for directing a second portion of the primary force vector to the apex point. A set of rails, oriented substantially parallel to the center-line of the ball-screw, direct movement of the slide plate with respect to the slide base along the first geometric axis and are positioned such that the apex point falls within a geometric plane formed by the rails. The slide base, the slide plate, the ball-screw, and the linking device together form a slide assembly. Multiple slide assemblies can be distributed about a platform. In such a configuration, the platform may be raised and lowered, or tipped and tilted by jointly or independently displacing the slide plates.

  19. Inertial Pointing and Positioning System

    NASA Technical Reports Server (NTRS)

    Yee, Robert (Inventor); Robbins, Fred (Inventor)

    1998-01-01

    An inertial pointing and control system and method for pointing to a designated target with known coordinates from a platform to provide accurate position, steering, and command information. The system continuously receives GPS signals and corrects Inertial Navigation System (INS) dead reckoning or drift errors. An INS is mounted directly on a pointing instrument rather than in a remote location on the platform for-monitoring the terrestrial position and instrument attitude. and for pointing the instrument at designated celestial targets or ground based landmarks. As a result. the pointing instrument and die INS move independently in inertial space from the platform since the INS is decoupled from the platform. Another important characteristic of the present system is that selected INS measurements are combined with predefined coordinate transformation equations and control logic algorithms under computer control in order to generate inertial pointing commands to the pointing instrument. More specifically. the computer calculates the desired instrument angles (Phi, Theta. Psi). which are then compared to the Euler angles measured by the instrument- mounted INS. and forms the pointing command error angles as a result of the compared difference.

  20. Positive Emotion Facilitates Audiovisual Binding

    PubMed Central

    Kitamura, Miho S.; Watanabe, Katsumi; Kitagawa, Norimichi

    2016-01-01

    It has been shown that positive emotions can facilitate integrative and associative information processing in cognitive functions. The present study examined whether emotions in observers can also enhance perceptual integrative processes. We tested 125 participants in total for revealing the effects of emotional states and traits in observers on the multisensory binding between auditory and visual signals. Participants in Experiment 1 observed two identical visual disks moving toward each other, coinciding, and moving away, presented with a brief sound. We found that for participants with lower depressive tendency, induced happy moods increased the width of the temporal binding window of the sound-induced bounce percept in the stream/bounce display, while no effect was found for the participants with higher depressive tendency. In contrast, no effect of mood was observed for a simple audiovisual simultaneity discrimination task in Experiment 2. These results provide the first empirical evidence of a dependency of multisensory binding upon emotional states and traits, revealing that positive emotions can facilitate the multisensory binding processes at a perceptual level. PMID:26834585

  1. Asympotics with positive cosmological constant

    NASA Astrophysics Data System (ADS)

    Bonga, Beatrice; Ashtekar, Abhay; Kesavan, Aruna

    2014-03-01

    Since observations to date imply that our universe has a positive cosmological constant, one needs an extension of the theory of isolated systems and gravitational radiation in full general relativity from the asymptotically flat to asymptotically de Sitter space-times. In current definitions, one mimics the boundary conditions used in asymptotically AdS context to conclude that the asymptotic symmetry group is the de Sitter group. However, these conditions severely restricts radiation and in fact rules out non-zero flux of energy, momentum and angular momentum carried by gravitational waves. Therefore, these formulations of asymptotically de Sitter space-times are uninteresting beyond non-radiative spacetimes. The situation is compared and contrasted with conserved charges and fluxes at null infinity in asymptotically flat space-times.

  2. Pavlov's position toward American behaviorism.

    PubMed

    Windholz, G

    1983-10-01

    Pavlov's development of the conditional reflex theory coincided with the rise of American behaviorism. Substituting an objective physiology for a subjective psychology, Pavlov saw in the rise of American behaviorism a clear confirmation of his method and theory. But in the early 1930s, Lashley attacked Pavlov's theory of specific cerebral localization of function, proposing instead the concept of an internal cerebral organization; Guthrie objected to Pavlov's centralist interpretation of conditioning, proposing instead a peripheralist interpretation; while Hull challenged Pavlov's theory of sleep and hypnosis as the manifestations of inhibition. Pavlov replied with critiques of Lashley's, Guthrie's, and Hull's views, and, convinced that Lashley and Guthrie misunderstood his position, repeated his method's and theory's basic propositions. Yet, Pavlov never gave up the expectation that American behaviorism would accept his conditional reflex theory and saw in Hunter's 1932 statements a support of his assumptions.

  3. Optical fiber stripper positioning apparatus

    DOEpatents

    Fyfe, Richard W.; Sanchez, Jr., Amadeo

    1990-01-01

    An optical fiber positioning apparatus for an optical fiber stripping device is disclosed which is capable of providing precise axial alignment between an optical fiber to be stripped of its outer jacket and the cutting blades of a stripping device. The apparatus includes a first bore having a width approximately equal to the diameter of an unstripped optical fiber and a counter bore axially aligned with the first bore and dimensioned to precisely receive a portion of the stripping device in axial alignment with notched cutting blades within the stripping device to thereby axially align the notched cutting blades of the stripping device with the axis of the optical fiber to permit the notched cutting blades to sever the jacket on the optical fiber without damaging the cladding on the optical fiber. In a preferred embodiment, the apparatus further includes a fiber stop which permits determination of the length of jacket to be removed from the optical fiber.

  4. NASN position statement: caseload assignments.

    PubMed

    Durant, Bonnie V; Gibbons, Linda J; Poole, Cynthia; Suessmanm, Mary; Wyckoff, Leah

    2011-01-01

    It is the position of the National Association of School Nurses (NASN) that schools should employ professionally prepared Registered Nurses, to conduct and supervise school health programs which address the variety of health problems experienced by school children. NASN recommends a formula-based approach with minimum ratios of nurses-to-students depending on the needs of the student populations as follows: 1:750 for students in the general population, 1:225 in the student populations requiring daily professional school nursing services or interventions, 1:125 in student populations with complex health care needs, and 1:1 may be necessary for individual students who require daily and continuous professional nursing services. Other factors that should be considered in the formula-based approach are number of students on free or reduced lunch, number of students with a medical home, and average number of emergency services per year.

  5. GPS Position Time Series @ JPL

    NASA Technical Reports Server (NTRS)

    Owen, Susan; Moore, Angelyn; Kedar, Sharon; Liu, Zhen; Webb, Frank; Heflin, Mike; Desai, Shailen

    2013-01-01

    Different flavors of GPS time series analysis at JPL - Use same GPS Precise Point Positioning Analysis raw time series - Variations in time series analysis/post-processing driven by different users. center dot JPL Global Time Series/Velocities - researchers studying reference frame, combining with VLBI/SLR/DORIS center dot JPL/SOPAC Combined Time Series/Velocities - crustal deformation for tectonic, volcanic, ground water studies center dot ARIA Time Series/Coseismic Data Products - Hazard monitoring and response focused center dot ARIA data system designed to integrate GPS and InSAR - GPS tropospheric delay used for correcting InSAR - Caltech's GIANT time series analysis uses GPS to correct orbital errors in InSAR - Zhen Liu's talking tomorrow on InSAR Time Series analysis

  6. Natural head position: An overview

    PubMed Central

    Meiyappan, N.; Tamizharasi, S.; Senthilkumar, K. P.; Janardhanan, K.

    2015-01-01

    Cephalometrics has given us a different perspective of interpreting various skeletal problems in the dentofacial complex. Natural head position (NHP) is a reproducible, physiologically determined aspect of function. To determine NHP, a horizontal or vertical reference line outside the crania was used, but preference was given generally to the horizontal. Various intra and extracranial cephalometric horizontal reference planes have been used to formulate diagnosis and plan individualized treatment for an integrated correction of the malocclusion cephalometrics is constantly undergoing refinements in its techniques and analyses to improve the clinical applications. Even though various methods for establishing NHP have been proposed, still it remains a challenge to the clinicians to implement the concept of NHP thoroughly in all the stages of treatment because of practical difficulties in the clinical scenario. PMID:26538891

  7. Natural head position: An overview.

    PubMed

    Meiyappan, N; Tamizharasi, S; Senthilkumar, K P; Janardhanan, K

    2015-08-01

    Cephalometrics has given us a different perspective of interpreting various skeletal problems in the dentofacial complex. Natural head position (NHP) is a reproducible, physiologically determined aspect of function. To determine NHP, a horizontal or vertical reference line outside the crania was used, but preference was given generally to the horizontal. Various intra and extracranial cephalometric horizontal reference planes have been used to formulate diagnosis and plan individualized treatment for an integrated correction of the malocclusion cephalometrics is constantly undergoing refinements in its techniques and analyses to improve the clinical applications. Even though various methods for establishing NHP have been proposed, still it remains a challenge to the clinicians to implement the concept of NHP thoroughly in all the stages of treatment because of practical difficulties in the clinical scenario.

  8. NASN position statement: caseload assignments.

    PubMed

    Durant, Bonnie V; Gibbons, Linda J; Poole, Cynthia; Suessmanm, Mary; Wyckoff, Leah

    2011-01-01

    It is the position of the National Association of School Nurses (NASN) that schools should employ professionally prepared Registered Nurses, to conduct and supervise school health programs which address the variety of health problems experienced by school children. NASN recommends a formula-based approach with minimum ratios of nurses-to-students depending on the needs of the student populations as follows: 1:750 for students in the general population, 1:225 in the student populations requiring daily professional school nursing services or interventions, 1:125 in student populations with complex health care needs, and 1:1 may be necessary for individual students who require daily and continuous professional nursing services. Other factors that should be considered in the formula-based approach are number of students on free or reduced lunch, number of students with a medical home, and average number of emergency services per year. PMID:21291082

  9. Ode to positive constructive daydreaming

    PubMed Central

    McMillan, Rebecca L.; Kaufman, Scott Barry; Singer, Jerome L.

    2013-01-01

    Nearly 60 years ago, Jerome L. Singer launched a groundbreaking research program into daydreaming (Singer, 1955, 1975, 2009) that presaged and laid the foundation for virtually every major strand of mind wandering research active today (Antrobus, 1999; Klinger, 1999, 2009). Here we review Singer’s enormous contribution to the field, which includes insights, methodologies, and tools still in use today, and trace his enduring legacy as revealed in the recent proliferation of mind wandering studies. We then turn to the central theme in Singer’s work, the adaptive nature of positive constructive daydreaming, which was a revolutionary idea when Singer began his work in the 1950s and remains underreported today. Last, we propose a new approach to answering the enduring question: Why does mind wandering persist and occupy so much of our time, as much as 50% of our waking time according to some estimates, if it is as costly as most studies suggest? PMID:24065936

  10. [Empathic leadership: shaping positive change].

    PubMed

    Wetterauer, U; Ruhl, S

    2011-12-01

    This paper explains the concept of empathic leadership in the setting of fundamental organisational changes. It deals with the question of how you can establish a culture of leadership, which motivates employees positively and enthuses them for the upcoming changes. It discusses the basics of empathic leadership and considers the question of how handling of emotions influences change processes and how different management styles can be used supportively during changes. With the help of a practical example the different phases of change are presented from a management point of view. Thereby the theory of different levels of employee motivation is explained inter alia. The article shows that empathic leadership also has a lasting economic effect. This can be seen particularly in the power of motivation for change, in addition to recruitment and long-term employee retention. PMID:22159703

  11. Positively regulated bacterial expression systems

    PubMed Central

    Brautaset, Trygve; Lale, Rahmi; Valla, Svein

    2009-01-01

    Summary Regulated promoters are useful tools for many aspects related to recombinant gene expression in bacteria, including for high‐level expression of heterologous proteins and for expression at physiological levels in metabolic engineering applications. In general, it is common to express the genes of interest from an inducible promoter controlled either by a positive regulator or by a repressor protein. In this review, we discuss established and potentially useful positively regulated bacterial promoter systems, with a particular emphasis on those that are controlled by the AraC‐XylS family of transcriptional activators. The systems function in a wide range of microorganisms, including enterobacteria, soil bacteria, lactic bacteria and streptomycetes. The available systems that have been applied to express heterologous genes are regulated either by sugars (l‐arabinose, l‐rhamnose, xylose and sucrose), substituted benzenes, cyclohexanone‐related compounds, ε‐caprolactam, propionate, thiostrepton, alkanes or peptides. It is of applied interest that some of the inducers require the presence of transport systems, some are more prone than others to become metabolized by the host and some have been applied mainly in one or a limited number of species. Based on bioinformatics analyses, the AraC‐XylS family of regulators contains a large number of different members (currently over 300), but only a small fraction of these, the XylS/Pm, AraC/PBAD, RhaR‐RhaS/rhaBAD, NitR/PnitA and ChnR/Pb regulator/promoter systems, have so far been explored for biotechnological applications. PMID:21261879

  12. Positively regulated bacterial expression systems.

    PubMed

    Brautaset, Trygve; Lale, Rahmi; Valla, Svein

    2009-01-01

    Regulated promoters are useful tools for many aspects related to recombinant gene expression in bacteria, including for high-level expression of heterologous proteins and for expression at physiological levels in metabolic engineering applications. In general, it is common to express the genes of interest from an inducible promoter controlled either by a positive regulator or by a repressor protein. In this review, we discuss established and potentially useful positively regulated bacterial promoter systems, with a particular emphasis on those that are controlled by the AraC-XylS family of transcriptional activators. The systems function in a wide range of microorganisms, including enterobacteria, soil bacteria, lactic bacteria and streptomycetes. The available systems that have been applied to express heterologous genes are regulated either by sugars (L-arabinose, L-rhamnose, xylose and sucrose), substituted benzenes, cyclohexanone-related compounds, ε-caprolactam, propionate, thiostrepton, alkanes or peptides. It is of applied interest that some of the inducers require the presence of transport systems, some are more prone than others to become metabolized by the host and some have been applied mainly in one or a limited number of species. Based on bioinformatics analyses, the AraC-XylS family of regulators contains a large number of different members (currently over 300), but only a small fraction of these, the XylS/Pm, AraC/P(BAD), RhaR-RhaS/rhaBAD, NitR/PnitA and ChnR/Pb regulator/promoter systems, have so far been explored for biotechnological applications.

  13. High Contrast Positive Resist II

    NASA Astrophysics Data System (ADS)

    Grunwald, John; Turner, Edwin J.; Sawoska, David A.; Spencer, Allen C.

    1985-04-01

    The functional performance of ULTRAMAC PR914 positive resist on a 10:1 wafer stepper using monochromatic light at 436 nanometers was described in detail at the last SPIE Conference (March 1984). Submicron resolution capabilities in the order of 0.6 micron with edge wall profiles greater than 85° were shown, using the metal-ion-free developer, ULTRAMAC' MF62. This follow-up paper details the functional performance of ULTRAMAC' PR914 positive resist with a new metal-ion-free developer, ULTRAMAC" MF62A. When used at 1:1 dilution, ULTRAMAC' MF62A reduces the exposure energy necessary to obtain high contrast PR914 images by approximately 50% as compared to a 1:1 dilution of ULTRAMAC' MF62, making it a "fast" photoresist system by accepted industry standards. Data is shown with contact, projection and step-and-repeat alignment equipment. Also, a mechanism is proposed to explain the significant reduction in standing waves when ULTRAMAC' PR914 resist is developed with MF62 or MF62A. New data is shown on a modified version of PR914 resist, designated as ULTRAMAC" PR914 AR, for use on highly reflective surfaces, particularly over nonplanar (stepped) features. Deep UV stabilization of both ULTRAMAC' PR914 and PR914 AR, offering excellent thermal stability of critical dimensions, is also shown. Selectivity data of PR914 resist in plasma/RIE etch conditions is presented in comparison with other resists. The effect of high current ion implant (phosphorus and arsenic) on PR914 resist is also reported.

  14. [Readers' position against induced abortion].

    PubMed

    1981-08-25

    Replies to the request by the Journal of Nursing on readers' positions against induced abortion indicate there is a definite personal position against induced abortion and the assistance in this procedure. Some writers expressed an emotional "no" against induced abortion. Many quoted arguments from the literature, such as a medical dictionary definition as "a premeditated criminally induced abortion." The largest group of writers quoted from the Bible, the tenor always being: "God made man, he made us with his hands; we have no right to make the decision." People with other philosophies also objected. Theosophical viewpoint considers reincarnation and the law of cause and effect (karma). This philosophy holds that induced abortion impedes the appearance of a reincarnated being. The fundamental question in the abortion problem is, "can the fetus be considered a human life?" The German anatomist Professor E. Bleckschmidt points out that from conception there is human life, hence the fertilized cell can only develop into a human being and is not merely a piece of tissue. Professional nursing interpretation is that nursing action directed towards killing of a human being (unborn child) is against the nature and the essence of the nursing profession. A different opinion states that a nurse cares for patients who have decided for the operation. The nurse doesn't judge but respects the individual's decision. Some proabortion viewpoints considered the endangering of the mother's life by the unborn child, and the case of rape. With the arguments against abortion the question arises how to help the woman with unwanted pregnancy. Psychological counseling is emphasized as well as responsible and careful assistance. Referral to the Society for Protection of the Unborn Child (VBOK) is considered as well as other agencies. Further reader comments on this subject are solicited. PMID:6913282

  15. [Childhood peripheral vestibular disorders: a report of three cases].

    PubMed

    Akdoğan, Mehmet Volkan; Tarhan, Erkan; Ozgirgin, Osman Nuri; Ozlüoğlu, Levent Naci

    2006-01-01

    Vertigo is uncommon in childhood. Its etiology is different from that of adults. Both central and peripheral disorders may give rise to vertigo symptoms in pediatric patients. The evaluation of vertigo in children requires a detailed history taking, clinical examination, audiometric assessment, and vestibular function tests. We present three pediatric patients with vertigo symptoms, together with treatment methods and results of treatment. Their ages ranged from 10 to 14 years. The diagnoses were vestibular neuritis in one patient, and benign paroxismal positional vertigo in two patients. Treatment was comprised of vestibular rehabilitation for vestibular neuritis, and canalith repositioning maneuver for benign paroxismal positional vertigo. All the patients benefited well from the procedures applied. PMID:17124444

  16. Research priorities: seating and positioning.

    PubMed

    Sprigle, Stephen

    2007-05-01

    The Mobility Rehabilitation Engineering Research Center at the Georgia Institute of Technology held its State of the Science Conference to address challenges in studying the health, activity and participation of wheelchair users. This article summarizes the discussions of four seating and positioning research topics. Attendees were divided into Breakout Groups and assigned specific research topics that were deemed priorities by the attendees. Breakout Groups were charged with configuring the research topic into a research project and were asked to identify research questions, specific aims or hypotheses, significance, study design possibilities, recruitment considerations, measurement variables and tools, analysis considerations, and anticipated challenges. The four research topics selected for discussion were: Impact of a seating and mobility intervention, Defining a systematic clinical approach to cushion selection, Functional impact of wheelchair cushions, and Long term impact of sitting. Group synopses presented in this paper were compiled from Group notes and presentation. They are presented in sequence and reflect variability in discussion, presentation and content. Some research topics were more amenable to the suggested guidelines than others.

  17. Population policy: major party positions.

    PubMed

    Betts, K

    1998-01-01

    This article identifies the major political party positions on population policy (PP) in Australia. Australia has the Governing Coalition, comprised of the Liberal and National Parties, and the Australian Labor Party (ALP), the main opposition party. The ALP adopted a PP at its national conference in 1998. The Government Minister for Immigration and Multicultural Affairs (DIMA) does not view a PP as a need. The ALP policy identifies the need to decide on a long term sustainable population size as determined within a PP framework. The visa classification system needs to reflect national priorities. Labor will support a fair refugee and humanitarian program. Skilled labor migration must be linked with labor market needs. Business migration is a means of transferring resources and technology to Australia. The DIMA Minister announced the target intake of 80,000 visa immigrants in 1998- 99, which would produce a peak population of about 23 million in 2050. Settler arrivals from New Zealand would increase population size. A group of scientists and scholars published their recommendations about development of a PP. The Minister of DIMA's defense of the lack of a PP is included in this publication. Labor in several publications indicates support for a larger immigration intake, or an adjustment of the intake within the existing numbers. The Prime Minister, who supports the concept of multiculturalism, argues that people must accept immigration policy. Politics today are more divided over the origin and future of the nation than population size issues.

  18. [Psychogenic tremor: a positive diagnosis].

    PubMed

    Redondo, L; Morgado, Y; Durán, E

    2010-01-01

    Psychogenic movement disorders are a daily challenge for the neurologist. A mistake in its recognition may have important consequences for the patients. As a result, the diagnosis must be considered very carefully in clinical practice. However, psychogenic movement disorders are not unusual, are mainly tremors, and a wrong diagnosis is common. Psychogenic is an unspecific term that usually masks the real mental disorder, and should be called somatoform disorders, factitious disorders, malingering, depression, anxiety and histrionic personality disorder, although the absence of a psychiatric diagnosis does not preclude a psychogenic cause. The diagnosis may often be difficult and should be made by an expert neurologist. Organic movement disorders must be excluded after a detailed neurological history, examination, and appropriate diagnostic studies. Psychogenic tremor is not only a diagnosis of exclusion, it can be diagnosed positively by its neurological signs, mainly: variability in frequency and amplitude, bilateral and sudden onset, non-progressive with frequent remissions, absence of finger, tongue or face tremor and coactivation of antagonistic muscles. Several tests can be useful in diagnosis, such as: accelerometry, EMG and response to placebo or suggestion. The treatment requires close cooperation between the medical team and patient. The problem must never be minimised and early diagnosis and treatment must be attempted. PMID:20388461

  19. Postdoctoral Positions and Career Growth

    NASA Astrophysics Data System (ADS)

    Manka, R. H.

    2001-12-01

    Career choices begin to diverge at the time the doctorate is received. A variety of career options are available to pursue including positions in academia, government, and industry as well as non-traditional services. A postdoctoral appointment is worth considering as preparation for a career in academia or basic research. The postdoctoral appointment can expand the recent graduate's background and broaden their scientific perspective and reputation. Postdoctoral experience may even be essential to be competitive for some faculty and research laboratory appointments. However, there is a wide range of postdoctoral choices to consider. There are many opportunities for postdoctoral appointments in universities, and emerging opportunities in some corporate laboratories. We will mention opportunities in federal laboratories such as the National Research Council programs in NASA, NOAA, EPA, and the Dept. of Defense, which are open to U.S. citizens and in some cases to non-U.S. applicants, to pursue research in all areas of the Earth and space sciences. And there are exciting new interdisciplinary programs such as the NASA Astrobiology Institute, as well as international opportunities including the von Humboldt fellowships in Germany and similar programs elsewhere in Europe, Japan, and other countries.

  20. Positional Identity and Science Teacher Professional Development

    ERIC Educational Resources Information Center

    Moore, Felicia M.

    2008-01-01

    The aim of this study was to understand the positional identity of three African American secondary science teachers. Positional identity was operationally defined in terms of race, ethnicity, economic status, gender, religion, and age. Positional identity was posited to inform why diverse teachers with differing knowledge and experiences in…