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Skare TL, de Carvalho JF, de Medeiros IRT, Shoenfeld Y. Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review. Autoimmun Rev 2024; 23:103606. [PMID: 39209013 DOI: 10.1016/j.autrev.2024.103606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 05/30/2024] [Indexed: 09/04/2024]
Abstract
Chronic fatigue syndrome (CFS), fibromyalgia (FM), silicone breast implants (SBI), Coronavirus-19 infectious disease (COVID), COVID-19 vaccination (post-COVIDvac-syndrome), Long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/ inflammatory syndrome induced by adjuvants (ASIA) are a cluster of poorly understood medical conditions that have in common a group of ill-defined symptoms and dysautonomic features. Most of the clinical findings of this group of diseases are unspecific, such as fatigue, diffuse pain, cognitive impairment, paresthesia, tachycardia, anxiety, and depression. Hearing disturbances and vertigo have also been described in this context, the underlying pathophysiologic process for these conditions might rely on autonomic autoimmune dysbalance. The authors procced a literature review regarding to hearing and labyrinthic disturbances in CSF, FM, SBI, COVID, post-COVIDvac-syndrome, PCS, SBS, POTS, and ASIA. The PRISMA guidelines were followed, and the literature reviewed encompassed papers from January 1990 to January 2024. After the initial evaluation of the articles found in the search through Pubmed, Scielo and Embase, a total of 172 articles were read and included in this review. The prevalence of hearing loss, dizziness, vertigo and tinnitus was described and correlated with the diseases investigated in this study. There are great variability in the frequencies of symptoms found, but cochlear complaints are the most frequent in most studies. Vestibular symptoms are less reported. The main pathophysiological mechanisms are discussed. Direct effects of the virus in the inner ear or nervous pathways, impaired vascular perfusion, cross-reaction or autoimmune immunoreactivity, oxidative stress, DNA methylation, epigenetic modifications and gene activation were implicated in the generation of the investigated symptoms. In clinical practice, all patients with these autoimmune conditions who have any audiological complaint an ENT consultation followed by an audiometry are needed.
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Affiliation(s)
- Thelma L Skare
- Serviço de Reumatologia, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil
| | - Jozélio Freire de Carvalho
- Núcleo de Pesquisa em Doenças Crônicas não Transmissíveis (NUPEN), School of Nutrition from the Federal University of Bahia, Salvador, Bahia, Brazil.
| | | | - Yehuda Shoenfeld
- Reichman University, Herzelia, Israel; Zabludowicz Center for Autoimmune Diseases (Founder), Sheba Medical Center, Tel-Hashomer, Israel
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Kirovakov Z, Kutsarov A, Todorov S, Penchev P. Vertigo During Pregnancy: A Narrative Review of the Etiology, Pathophysiology, and Treatment. Cureus 2024; 16:e55657. [PMID: 38495964 PMCID: PMC10944550 DOI: 10.7759/cureus.55657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
From the time of conception until the time of labor, a woman's body and mind undergo a variety of hormonal and other changes. Patients may also experience vertigo and a lack of balance during this period. Disabling and physically painful, these symptoms may strike at any moment. Pregnancy-related vertigo has been the focus of several studies. We looked at the research on vertigo in pregnant women in detail. This narrative review aims to examine the causes, pathophysiology, and current treatments for vertigo during pregnancy. Vertigo during pregnancy has a diverse etiology, with typical causes including hormonal changes and modifications in vascular dynamics. Vertigo may start to appear due to pathophysiological mechanisms involving vestibular and central nervous system adaptations. Numerous alternatives for treatment are available, including dietary changes, vestibular therapy, medicines, and surgical procedures. The thorough assessment of the current research on vertigo during pregnancy provided by this narrative review will help medical practitioners make wise clinical decisions.
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Affiliation(s)
- Zlatko Kirovakov
- Department of Obstetrics and Gynaecology, University Hospital for Active Treatment - Burgas, Burgas, BGR
- Faculty of Public Health and Health Care, Prof. Asen Zlatarov University, Burgas, BGR
| | - Asen Kutsarov
- Department of Health Care, Medical University Varna, Affiliate Veliko Tarnovo, Veliko Tarnovo, BGR
| | - Svetoslav Todorov
- Department of Neurological Surgery, University Hospital for Active Treatment - Burgas, Burgas, BGR
- Faculty of Medicine, Prof. Asen Zlatarov University, Burgas, BGR
| | - Plamen Penchev
- Faculty of Medicine, Medical University of Plovdiv, Plovdiv, BGR
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Aedo-Sánchez C, Gutiérrez G, Aguilar-Vidal E. COVID-19 and Vestibular Symptoms and Assessment: A Review. Audiol Neurootol 2023; 29:81-87. [PMID: 37703853 PMCID: PMC11412481 DOI: 10.1159/000533448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 08/03/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The current pandemic of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality primarily associated with respiratory failure. However, it has also been reported that COVID-19 can evolve into a nervous system infection. The direct and indirect mechanisms of damage associated with SARS-CoV-2 neuropathogenesis could affect our sensory functionality, including hearing and balance. SUMMARY In order to investigate a possible association between SARS-CoV-2 viral infection and possible damage to the vestibular system, this review describes the main findings related to diagnosing and evaluating otoneurological pathologies. KEY MESSAGES The clinical evidence shows that SARS-CoV-2 causes acute damage to the vestibular system that would not leave significant sequelae. Recovery is similar to vestibular pathologies such as vestibular neuronitis and benign paroxysmal positional vertigo. Further basic science, clinical, and translational research is needed to verify and understand the short- and long-term effects of COVID-19 on vestibular function.
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Affiliation(s)
- Cristian Aedo-Sánchez
- Departamento Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gabriela Gutiérrez
- Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Enzo Aguilar-Vidal
- Departamento Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Motawea KR, Monib FA, Shaheen N. Acute Vertigo in a Patient Following COVID-19 Infection: A Case Report and Literature Review. Indian J Otolaryngol Head Neck Surg 2023:1-5. [PMID: 37362121 PMCID: PMC10116458 DOI: 10.1007/s12070-023-03745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/27/2023] [Indexed: 06/28/2023] Open
Abstract
COVID-19 has infected millions of people worldwide causing millions of deaths. COVID-19 has many serious effects on organs of the body especially the respiratory system causing pneumonia and acute respiratory distress syndrome (ARDS). The disease also has severe complications on other different organs; kidneys and liver which may end in multi-organ failure. Most common symptoms that have been detected in large section of patients were fever, cough and loss of taste or smell and less commonly sore throat, headache and muscle pain. The incidence of vertigo or dizziness is a rare symptom of COVID-19. In this case report, we introduce a 59-year-old male patient suffering from acute vertigo attack after COVID-19 infection. The patient had negative medical history of vertigo and any ear diseases. The patient received REGEN-COV (casirivimab and imdevimab) for COVID-19 and meclizine for vertigo. Vertigo attacks lasted for the two weeks follow up after disappearance of COVID-19 symptoms despite receiving vertigo medication. In conclusion, vertigo may be the sole neurological manifestation of COVID-19. More observational studies should address this symptom and researchers should also focus on identifying the origin of developing vertigo and the direct or indirect mechanisms that SARS-CoV-2 triggers to develop dizziness in general. This research should deliver a clear message, especially to ER physicians to consider proper referral of these patients without underestimating the risk of developing more serious COVID-19 symptoms as ARDS and multi-organ failure if no proper testing and follow-up are provided.
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Affiliation(s)
| | | | - Nour Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Pazdro-Zastawny K, Dorobisz K, Misiak P, Kruk-Krzemień A, Zatoński T. Vestibular disorders in patients after COVID-19 infection. Front Neurol 2022; 13:956515. [PMID: 36203969 PMCID: PMC9531925 DOI: 10.3389/fneur.2022.956515] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe COVID-19 clinical symptoms are primarily related to the respiratory system but may also be involved in many others, including the nervous system. Recently, vertigo or dizziness has been described as one of the clinical manifestations and possible complications of COVID-19.Materials and methodsThis clinical study was designed to describe the otorhinolaryngological evaluation and videonystagmographic (VNG) findings in patients with an antecedent of COVID-19 infection in the last 6 months. In this study, we sought to investigate the presence of persistent vestibular damage in healed COVID-19 patients and to determine the origin of vertigo by conducting a comprehensive vestibular examination. To evaluate the association precisely, an otoneurological assessement was conducted on all participants. The study group included 58 patients aged 23–75 years with vertigo, who were diagnosed with COVID-19 infection 6 months before the examination. Each participant was submitted to an evaluation consisting of anamnesis, otorhinolaryngological evaluation, and VNG.ResultsSpontaneous nystagmus with closed eyes was reported in 8 patients (13.8%). Positional nystagmus was observed in 15 patients (24.1%). Asymmetrical optokinetic nystagmus was observed in 18 patients (31%). A distorted record in the tracking pendulum test was present in 23 patients (39.7%). Square waves were observed in 34 COVID-19 patients (58.6%). Unilateral weakness (UW) was observed in 23 subjects (39.7%); among those with UW, 22 patients (95.7%) also demonstrated directional preponderance contralateral to the UW. Another 16 patients (27.6%) presented only directional advantage. The post-caloric recruitment was present in 38% patients.ConclusionPatients who had been diagnosed with COVID-19 seem to be more likely to suffer from vertigo/dizziness and to compensate more slowly. COVID-19 infection may cause inner ear damage and lead to vestibular dysfunction. The role of the central nervous system in the onset of equilibrium disorders should be considered. The presence of vertigo of central origin may indicate the neurotropic effect of SARS-CoV-2 following COVID-19. Imbalance may be the only symptom of COVID-19 and may also be a late complication of the disease due to post-infectious inflammation of the nervous tissue. Comprehensive studies are needed to investigate whether COVID-19 can cause long-term vestibular deficits.
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Lee DH, Shin JE, Jung T, Kim CH. Change in Diagnosis of Benign Paroxysmal Positional Vertigo During COVID-19 Pandemic. Int J Gen Med 2022; 15:7029-7037. [PMID: 36090705 PMCID: PMC9462836 DOI: 10.2147/ijgm.s378822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose The present study investigated the impact of coronavirus disease 2019 (COVID-19) pandemic on benign paroxysmal positional vertigo (BPPV). Patients and Methods The medical records of BPPV patients who were evaluated in the outpatient department (OPD) and emergency room (ER) during (435 patients) and before (517 patients) the COVID-19 pandemic were retrospectively reviewed. Dix-Hallpike and supine head-roll tests were used to classify the subtype of BPPV as posterior semicircular canal (PSCC), geotropic lateral semicircular canal (geotropic LSCC), or apogeotropic lateral semicircular canal (apogeotropic LSCC) BPPV. Results More patients with PSCC BPPV were diagnosed at the OPD compared with those who were diagnosed at the ER both before and during the COVID-19 pandemic; however, more patients with LSCC BPPV were diagnosed at the ER compared with those who were diagnosed at the OPD during the same periods. The mean time interval between vertigo onset and initial evaluation was remarkably longer during the pandemic in patients with PSCC BPPV. Conclusion This study demonstrated that the incidences of BPPV subtypes according to hospital visit type were not significantly different before and during the COVID-19 pandemic. Because hospital visits were delayed in patients with PSCC BPPV during the COVID-19 pandemic, telemedicine or e-health could be suitable alternatives to face-to-face medical care for these patients.
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Affiliation(s)
- Dong-Han Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Taesik Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Chang-Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
- Correspondence: Chang-Hee Kim, Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, Republic of Korea, Tel +82-2-2030-7666, Fax +82-2-2030-5299, Email
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Korres G, Kitsos DK, Kaski D, Tsogka A, Giannopoulos S, Giannopapas V, Sideris G, Tyrellis G, Voumvourakis K. The Prevalence of Dizziness and Vertigo in COVID-19 Patients: A Systematic Review. Brain Sci 2022; 12:brainsci12070948. [PMID: 35884754 PMCID: PMC9313303 DOI: 10.3390/brainsci12070948] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/09/2022] [Accepted: 07/18/2022] [Indexed: 12/15/2022] Open
Abstract
Clinical manifestations of COVID-19 include symptoms of vertigo and dizziness, which is rather unsurprising, since SARS-CoV-2 neurotropism may inflict a broad spectrum of neuropathic effects. The widespread nature of central and peripheral audiovestibular pathways suggests that there may be several probable pathophysiological mechanisms. The cytokine storm, CNS infiltration of the virus through ACE 2 receptors, and other systemic factors can be responsible for the significant number of COVID-19 patients reported to experience symptoms of vertigo and dizziness. In this paper, we present a systematic review of clinical studies reporting the detection of dizziness and vertigo as clinical manifestations of COVID-19 and discuss their etiopathogenesis.
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Affiliation(s)
- George Korres
- 2nd ENT Department, Attikon University Hospital, 124 62 Athens, Greece; (G.S.); (G.T.)
- Correspondence:
| | - Dimitrios K. Kitsos
- 2nd Department of Neurology, Attikon University Hospital, 124 62 Athens, Greece; (D.K.K.); (A.T.); (S.G.); (K.V.)
| | - Diego Kaski
- Centre for Vestibular and Behavioural Neuroscience, Department of Clinical and Movement Neurosciences, University College London, 33 Queen Square, London WC1N 3BG, UK;
| | - Anthi Tsogka
- 2nd Department of Neurology, Attikon University Hospital, 124 62 Athens, Greece; (D.K.K.); (A.T.); (S.G.); (K.V.)
| | - Sotirios Giannopoulos
- 2nd Department of Neurology, Attikon University Hospital, 124 62 Athens, Greece; (D.K.K.); (A.T.); (S.G.); (K.V.)
| | - Vasileios Giannopapas
- 2nd Department of Neurology, Laboratory of Neuromuscular & Cardiovascular Study of Motion (LANECASM), Attikon University Hospital, 124 62 Athens, Greece;
| | - Giorgos Sideris
- 2nd ENT Department, Attikon University Hospital, 124 62 Athens, Greece; (G.S.); (G.T.)
| | - Giorgos Tyrellis
- 2nd ENT Department, Attikon University Hospital, 124 62 Athens, Greece; (G.S.); (G.T.)
| | - Konstantine Voumvourakis
- 2nd Department of Neurology, Attikon University Hospital, 124 62 Athens, Greece; (D.K.K.); (A.T.); (S.G.); (K.V.)
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8
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Maleki M, Maarefvand M, Nazeri AR, Akbarzadeh Baghban AR, Borna A. Audio-Vestibular Profile of COVID-19; Systematic Review and Meta-analysis. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2022; 34:145-155. [PMID: 36035653 PMCID: PMC9393004 DOI: 10.22038/ijorl.2022.60404.3079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 05/16/2022] [Indexed: 11/06/2022]
Abstract
Introduction After more than a year of the COVID-19 pandemic, audio-vestibular problems have been reported as consequences. Several limited case report studies with different methodologies were published. This study aimed to describe the impact of COVID-19 on the auditory-vestibular system and communication problems in subjects with hearing impairment. Materials and Methods The current systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. PubMed, Web of Science, and Google Scholar were searched to find relevant articles using combined keywords. Results Out of 26 final studies, 20 studies dealt with the effects of COVID-19 on the auditory and vestibular system, and six articles examined the COVID-19 effects on hearing-impaired people and patients. In these studies, dizziness (17.8%), tinnitus (8.1%), and vertigo (2.8%) were common symptoms. Most studies were case reports (42.30%), and in terms of quality, nine studies (34.61%) were in the suitable quality group. Conclusions COVID-19 might cause auditory-vestibular system problems by directly affecting the structures or functions of the inner ear or by weakening the immune system. The need for taking preventive measures during the COVID-19 pandemic has caused communication and social challenges, particularly for people with hearing loss.
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Affiliation(s)
- Mehri Maleki
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Maarefvand
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Reza Nazeri
- Department of Audiology, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Reza Akbarzadeh Baghban
- Proteomic Research Center Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azadeh Borna
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.,Corresponding Author: School of Rehabilitation Sciences, Iran University of Medical Sciences, Maddadkaran St., Shahid Nazari St., Mother Square, Mirdamad Blvd, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. E-mail:
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Kaliyappan K, Chen YC, Krishnan Muthaiah VP. Vestibular Cochlear Manifestations in COVID-19 Cases. Front Neurol 2022; 13:850337. [PMID: 35370886 PMCID: PMC8971520 DOI: 10.3389/fneur.2022.850337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/15/2022] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a high transmissible infectious disease that primarily impacts the respiratory system and leads to death as it worsens. Ever since the World Health Organization declared the disease as a global pandemic, the pathophysiology, clinical manifestations, and disease prognosis has been discussed in various literature. In addition to impaired respiratory health, the symptoms also indicated the involvement of the cardiovascular and neurological system after SARS-CoV-2 infection. Despite the pulmonary, cardiovascular, and neurological complications, many reports also revealed the prevalence of vestibulocochlear symptoms like dizziness, vertigo, vestibular neuritis, sudden sensorineural hearing loss, and tinnitus. Though many clinical reports and scientific reviews reported the vestibular and cochlear impairments associated with coronavirus disease 2019 (COVID-19) infection, the underlying pathological mechanisms are still unclear and unexplored. In this review, we discussed the published clinical reports, research articles, and literature reviews related to vestibulocochlear manifestations following SARS-CoV-2 infections. We also summarized the current knowledge about the prevalence, epidemiological and clinical features, and potential pathological mechanisms related to vestibular and cochlear manifestations resulting from COVID-19 infections.
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Affiliation(s)
- Kathiravan Kaliyappan
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Yu-Chen Chen
| | - Vijaya Prakash Krishnan Muthaiah
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States
- Vijaya Prakash Krishnan Muthaiah
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Bashir K, Yousuf A, Rauf L, Dewji M, Elmoheen A. Curing Benign Paroxysmal Positional Vertigo (BPPV) Through Telehealth: A Case Series. Cureus 2021; 13:e16363. [PMID: 34395140 PMCID: PMC8360323 DOI: 10.7759/cureus.16363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 01/10/2023] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) is a common medical condition in which the patient feels a spinning sensation when making certain head movements. There is evidence to support those free-floating calcium crystals in the semi-circular canals (the inner ear) may be the cause. BPPV can be a disabling condition. It can be easily diagnosed after taking a careful history and performing bedside examinations. BPPV can be treated successfully through a specific set of physical maneuvers leading to the removal of these crystals from the inner ear. We present three cases of BPPV, living in three different countries, treated successfully using telehealth via Zoom. This approach can be a particularly useful consultation stand during the coronavirus disease 2019 (COVID-19) pandemic.
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Affiliation(s)
- Khalid Bashir
- Medicine, Qatar University, Doha, QAT.,Emergency Medicine, Hamad Medical Corporation, Doha, QAT
| | - Abdulla Yousuf
- Medical Education and Simulation, Hamad General Hospital, Doha, QAT
| | - Lubna Rauf
- Clinical Education, Qatar College of Medicine, Doha, QAT
| | - Mohamed Dewji
- Medical Education, Primary Health Care Corporation, Doha, QAT
| | - Amr Elmoheen
- Emergency Medicine, Hamad Medical Corporation, Doha, QAT
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