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Saturday, 30 November 2013

Vertigo - The Risk Factors

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Risk Factors
1. Endolymphatic hydrops 
In the study to assess the results of treatment for a first episode of benign paroxysmal positional vertigo (BPPV) and risk factors for recurrence at the Kobe University Graduate School of Medicine, showed that  endolymphatic hydrops is a risk factor for recurrence of BPPV and that prevention of recurrent BPPV is important for control of endolymphatic hydrops(10)

2. Vascular risk factors
Vascular risk factors predispose to vertebrobasilar ischemia. Cervical osteophytes can impinge on the vertebral artery causing mechanical occlusion during head turning. Presentation with vertigo in such instances is a common finding(11)


3. Otitis media history
Researchers 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)(12).

4. Gender
If you are women, you at  two to three times higher risk to develop Vertigo

5. Vestibular neuritis (VN) is a condition of an ear disorder that involves irritation and inflammation. The recurrence rate of vertigo due to any cause in patients with vestibular neuritis (VN) was about 26.0(13)

6. Heredity
Genetic loci and clinical features of familial episodic ataxias have been defined in linkage disequilibrium studies with mutations in neuronal genes KCNA1 and CACNA1A. Migrainous vertigo is a clinical disorder with a high comorbidity within families much more common in females with overlapping features with episodic ataxia and migraine. Bilateral vestibular hypofunction is a heterogeneous clinical group defined by episodes of vertigo leading to progressive loss of vestibular function which also can include migraine. Meniere's disease is a clinical syndrome characterized by spontaneous episodes of recurrent vertigo, sensorineural hearing loss, tinnitus and aural fullness and familial Meniere's disease in around 10-20% of cases.(14)

7. Etc. 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(10) http://www.ncbi.nlm.nih.gov/pubmed/19128712
(10) http://www.ncbi.nlm.nih.gov/pubmed/17986375
(11) http://www.ncbi.nlm.nih.gov/pubmed/19300597 
(12) http://www.ncbi.nlm.nih.gov/pubmed/14670144
(13) http://www.ncbi.nlm.nih.gov/pubmed/21728751
(14) http://www.ncbi.nlm.nih.gov/pubmed/22379397