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Diagnosing persistent postural-perceptual dizziness (PPPD)

The authors, part of an influential committee of experts of the Bárány Society, proposed this consensus document after reviewing 30 years of research on phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. They also reviewed interesting historical...

Vestibular migraine or BPPV?

There are close similarities between benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) as both can be presented by positional nystagmus. Though BPPV remains the commonest cause of pure positional vertigo, VM can mimic this condition. This study is...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

A diagnostic survey of dizziness

The prevalence of self-reported dizziness and that requiring medical consultation is remarkably high. Cardiac and neuropathic comorbidities, often associated with these patients confuse the diagnosis. In this multicentre study, the prevalence and characteristics of various diagnostic groups, for example, Benign...

New diagnostic criteria for Ménière’s disease – an international consensus

Most readers are familiar with the American Academy diagnostic criteria for Ménière’s disease (MD) but a significant minority will be aware of other criteria from Japan and Korea. This new effort is a collaboration between these three bodies and the...

Sham controlled trial: BPPV

I was drawn to this study and it proved an enlightening read; it also is a good example of where recommendations of a Cochrane review for long-term evidence of benefit have been acted upon! The study looked at the efficiency...

Epley Manoeuvre: number of times it is required and its diagnostic value

Benign paroxysmal positional vertigo is a common condition but if inadequately treated or wrongly diagnosed, can prolong the distressing symptoms of momentary dizziness, nausea and visual disturbances which can be due to other causes and deteriorate quality of life. Studies...

ENT emergencies

This Belgian paper reports the epidemiology of 1296 patients attending the emergency department with ENT problems over a five-year period. As expected the most common presentation was epistaxis, but interestingly vertigo seemed to be the second most common presentation to...

Head and Neck Vascular Anomalies: A Practical Case-Based Approach

I was genuinely delighted when this book arrived for review. Usually I get something on vertigo which props up one end of the book case gathering dust. A quick skim through this instantly told me the section editor had blessed...

Diagnostic criteria for superior semicircular canal dehiscence syndrome

The latest Bárány Society’s consensus document on diagnostic criteria for vestibular disorders is one for superior semicircular canal dehiscence syndrome (SCDS). There are three major categories: (A) Symptoms consistent with a third mobile labyrinthine window; (B) Physiologic tests – clinical...

Unravelling the Meniere’s vs. migraine conundrum – what does the mastoid contribute?

This is an interesting observational study that attempts to classify subtypes of Meniere’s disease (MD) in relation to the coexistence of migraine. It is well known that the two conditions share common characteristics, making diagnosis and treatment challenging at times....