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Domínguez-Durán E, Moreno-de-Jesús C, Prieto-Sánchez-de-Puerta L, Mármol-Szombathy I, Sánchez-Gómez S. Identifying Training, Diagnostic and Therapeutic Needs From a Comparison in the Distribution of Vestibular Disorders in Primary Care and in a Neurotology Unit. Front Neurol 2020; 11:605613. [PMID: 33329367 PMCID: PMC7714908 DOI: 10.3389/fneur.2020.605613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Several epidemiological studies in Neurotology have been previously carried out in the general population. This approach is useful for learning about the most common disorders in clinical population, but it may fail when one is trying to help professionals to guide their training, to optimize their resources and to decide on the highest-priority research objectives. Objective: To identify which of the neurotological diseases are most common in two different populations, those who attended a consultation in the Neurotology Unit of a tertiary level hospital and those who did so in Primary Care in order to infer which of them requires more attention in each context and their specific needs. Methods: All the diagnoses made in Hospital Care between October 15, 2017 and October 14, 2018 were reviewed. These diagnoses were coded and classified into syndromes and diseases. Later, the proportions of each category were compared with the proportions of the neurotological diagnoses made in five Primary Care centers over the same period of time. Results: BPPV is the most common cause of vestibular symptoms in both contexts. Vestibular migraine, ischemic vestibular symptoms, orthostatic hypotension and side effects of drugs are common in Primary Care, whereas Ménière's disease and undifferentiated episodic vestibular syndrome are common in specialized centers. Conclusion: The proportion of diagnoses in neurotologic patients is different in the general population and in the specialized center population, and therefore they have different needs. Primary Care professionals would benefit from training on maneuvers for repositioning otoliths, the treatment of headache, the identification of cardiovascular risk factors, the orthostatic hypotension and the side effects of the most commonly used drugs. The professionals who work in specialized centers need strategies for dealing with cases of BPPV associated to other vestibular diseases and refractory cases and their research should focus on the development of new diagnostic tools for the diagnosis of undifferentiated episodic vestibular syndrome and new therapeutic options for Ménière's disease.
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Affiliation(s)
- Emilio Domínguez-Durán
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Carolina Moreno-de-Jesús
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Irene Mármol-Szombathy
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Serafín Sánchez-Gómez
- Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Tanaka A, Hata J, Akamatsu N, Mukai N, Hirakawa Y, Yoshida D, Kishimoto H, Ohara T, Mizuno T, Tsuji S, Kitazono T, Ninomiya T. Prevalence of adult epilepsy in a general Japanese population: The Hisayama study. Epilepsia Open 2019; 4:182-186. [PMID: 30868129 PMCID: PMC6398097 DOI: 10.1002/epi4.12295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/28/2018] [Accepted: 12/09/2018] [Indexed: 11/12/2022] Open
Abstract
The aim of the present study was to examine the prevalence and causes of adult epilepsy in a general Japanese population. We examined a total of 3333 Japanese residents in the town of Hisayama aged ≥40 years in 2012-2013. The examination was performed mainly at the municipal center for health promotion, but some subjects were examined in their homes, hospitals, or nursing homes. Twenty-three subjects had a diagnosis of epilepsy. The prevalence (95% confidence interval [CI]) of epilepsy per 1000 was 6.9 (4.1-9.7) in total, 4.9 (1.3-8.5) in men, and 8.4 (4.3-12.5) in women (P = 0.23 between sexes). The prevalence of epilepsy was significantly higher in the elderly (aged ≥65 years; 10.3 per 1000 [95% CI 5.4-15.1]) than in the middle-aged (aged 40-64 years; 3.6 per 1000 [95% CI 0.7-6.4]; P = 0.02). The major cause of epilepsy was cerebrovascular diseases (n = 11; 48% of the epilepsy patients). More than half of the epilepsy patients experienced the first episode of seizure in older age (≥65 years; n = 13; 57%). The findings of this study suggest the clinical importance of the prevention of cerebrovascular diseases to reduce the burden of epilepsy in the future.
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Affiliation(s)
- Akihiro Tanaka
- Department of NeurologyGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Jun Hata
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Naoki Akamatsu
- Department of NeurologyInternational University of Health and Welfare School of Medical SciencesNaritaJapan
| | - Naoko Mukai
- Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoichiro Hirakawa
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Daigo Yoshida
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiro Kishimoto
- Division for Student Counseling and GuidanceFaculty of Arts and ScienceKyushu UniversityKasugaJapan
| | - Tomoyuki Ohara
- Department of NeuropsychiatryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toshiki Mizuno
- Department of NeurologyGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Sadatoshi Tsuji
- Department of Medical TechnologyInternational University of Health and Welfare School of Medical Sciences at FukuokaOkawaJapan
| | - Takanari Kitazono
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
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Guerra-Jiménez G, Arenas Rodríguez A, Falcón González JC, Pérez Plasencia D, Ramos Macías Á. Epidemiology of Vestibular Disorders in the Otoneurology Unit. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.otoeng.2017.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Epidemiología de los trastornos vestibulares en la consulta de otoneurología. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:317-322. [DOI: 10.1016/j.otorri.2017.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/13/2017] [Accepted: 01/22/2017] [Indexed: 11/18/2022]
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Teggi R, Manfrin M, Balzanelli C, Gatti O, Mura F, Quaglieri S, Pilolli F, Redaelli de Zinis LO, Benazzo M, Bussi M. Point prevalence of vertigo and dizziness in a sample of 2672 subjects and correlation with headaches. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:215-9. [PMID: 27214833 PMCID: PMC4977009 DOI: 10.14639/0392-100x-847] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 12/09/2015] [Indexed: 12/03/2022]
Abstract
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.
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Affiliation(s)
- R Teggi
- ENT Division, San Raffaele Scientific Institute, Milan, Italy
| | - M Manfrin
- UOC of ORL, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, Italy
| | - C Balzanelli
- Divisione di Otorinolaringoiatria, Università degli Studi di Brescia, Italy
| | - O Gatti
- ENT Division, San Raffaele Scientific Institute, Milan, Italy
| | - F Mura
- UOC of ORL, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, Italy
| | - S Quaglieri
- UOC of ORL, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, Italy
| | - F Pilolli
- ENT Division, San Raffaele Scientific Institute, Milan, Italy
| | | | - M Benazzo
- UOC of ORL, Fondazione IRCCS Policlinico San Matteo e Università di Pavia, Italy
| | - M Bussi
- ENT Division, San Raffaele Scientific Institute, Milan, Italy
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Abstract
Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness. Although the disease is often encountered in neurological clinics and is well known by physicians, incidence and prevalence rates are not well known. We searched EMBASE, Medline, Web-of-science, Cochrane, PubMed Publisher, and Google Scholar, for population-based studies investigating the prevalence of polyneuropathy and its risk factors. Out of 5119 papers, we identified 29 eligible studies, consisting of 11 door-to-door survey studies, 7 case-control studies and 11 cohort/database studies. Prevalence of polyneuropathy across these studies varies substantially. This can partly be explained by differences in assessment protocols and study populations. The overall prevalence of polyneuropathy in the general population seems around 1% and rises to up to 7% in the elderly. Polyneuropathy seemed more common in Western countries than in developing countries and there are indications that females are more often affected than males. Risk factor profiles differ across countries. In developing countries communicable diseases, like leprosy, are more common causes of neuropathy, whereas in Western countries especially diabetes, alcohol overconsumption, cytostatic drugs and cardiovascular disease are more commonly associated with polyneuropathy. In all studies a substantial proportion of polyneuropathy cases (20-30%) remains idiopathic. Most of these studies have been performed over 15 years ago. More recent evidence suggests that the prevalence of polyneuropathy in the general population has increased over the years. Future research is necessary to confirm this increase in prevalence and to identify new and potentially modifiable risk factors.
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Abstract
OBJECTIVE To report the nationwide prevalence of dizziness and vestibular dysfunction in the Korean population and determine the associated factors. DESIGN Cross-sectional analysis of a nationwide health survey. METHODS We obtained data from the 2009 to 2010 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the South Korean civilian, non-institutionalised population aged 40 years and older (N=3267). A field survey team performed interviews and physical examinations. Structured questionnaires were handed out and balance function tests using the modified Romberg test of standing balance on firm and compliant support surfaces were performed on participants. Failure on the modified Romberg test was regarded to indicate vestibular dysfunction. RESULTS The prevalence of dizziness during the past year was 16.70% (95% CI 14.65% to 18.76%). The presence of vestibular dysfunction was noted in 1.84% (95% CI 1.18% to 2.51%). In addition, the prevalence of experiencing falls and positional dizziness were 1.46% (95% CI 0.87% to 2.06%) and 1.73% (95% CI 1.17% to 2.29%), respectively. Multivariable analysis revealed that dizziness was associated with increased age, female gender, hearing loss and stress. Vestibular dysfunction was associated with increased age, history of dizziness and hearing loss. CONCLUSIONS Vertigo and dizziness are the greatest contributors to the burden of disability in the aged population. Screening for dizziness and vestibular dysfunction, and management of associated factors might be important for improving compromised quality of life due to postural imbalance caused by vestibular problems.
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Affiliation(s)
- Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Mun Young Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sook-young Woo
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Seonwoo Kim
- Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Yang-Sun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Wada M, Takeshima T, Nakamura Y, Nagasaka S, Kamesaki T, Oki H, Kajii E. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study. Int J Gen Med 2015; 8:149-54. [PMID: 25931828 PMCID: PMC4404935 DOI: 10.2147/ijgm.s82018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.
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Affiliation(s)
- Masaoki Wada
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan ; Oki Clinic, Ibaraki, Japan
| | - Taro Takeshima
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Tochigi, Japan
| | - Shoichiro Nagasaka
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi, Japan
| | - Toyomi Kamesaki
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | | | - Eiji Kajii
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
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Bisdorff A, Bosser G, Gueguen R, Perrin P. The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Front Neurol 2013; 4:29. [PMID: 23526567 PMCID: PMC3605504 DOI: 10.3389/fneur.2013.00029] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 03/06/2013] [Indexed: 02/01/2023] Open
Abstract
Vertigo, dizziness, and unsteadiness (VDU) are common symptoms traditionally considered to result from different kinds of vestibular and non-vestibular dysfunctions. The epidemiology of each symptom and how they relate to each other and to migraine, agoraphobia, motion sickness susceptibility (MSS), vaso-vagal episodes (VVE), and anxiety-depression was the object of this population-based study in north-eastern France. A self-administered questionnaire was returned by 2987 adults (age span 18–86 years, 1471 women). The 1-year prevalence for vertigo was 48.3%, for unsteadiness 39.1%, and for dizziness 35.6%. The three symptoms were correlated with each other, occurred mostly (69.4%) in various combinations rather than in isolation, less than once per month, and 90% of episodes lasted ≤2 min. The three symptoms were similar in terms of female predominance, temporary profile of the episodes, and their link to falls and nausea. Symptom episodes of >1 h increase the risk of falls. VDU are much more common than the known prevalence of vestibular disorders. The number of drugs taken increase VDU even when controlling for age. Each VDU symptom was correlated with each co-morbidity in Chi-squared tests. The data suggest that the three symptoms are more likely to represent a spectrum resulting from a range of similar – rather than from different, unrelated – mechanisms or disorders. Logistic regressions controlling for each vestibular symptom showed that vertigo correlated with each co-morbidity but dizziness and unsteadiness did not, suggesting that vertigo is certainly not a more specific symptom than the other two. A logistic regression using a composite score of VDU, controlling for each co-morbidity showed a correlation of VDU to migraine and VVE but not to MSS and not to agoraphobia in men, only in women.
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Affiliation(s)
- Alexandre Bisdorff
- EA DevAH - Development, Adaption and Disadvantage, Cardio-Respiratory Regulations and Motor Control, Faculty of Medicine and UFR STAPS, Université de Lorraine Nancy, France ; Department of Neurology, Centre Hospitalier Emile Mayrisch Esch-sur-Alzette, Luxembourg
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Dewhurst F, Dewhurst MJ, Gray WK, Aris E, Orega G, Howlett W, Warren N, Walker RW. The prevalence of neurological disorders in older people in Tanzania. Acta Neurol Scand 2013; 127:198-207. [PMID: 22845781 DOI: 10.1111/j.1600-0404.2012.01709.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There are few data on neurological disorders prevalence from low- and middle-income countries, particularly sub-Saharan Africa (SSA) and none specific to the African elderly. We aimed to determined the prevalence of neurological disorders in those aged 70 years and over in a rural African community. MATERIALS AND METHODS This study was a cross-sectional two-phased community epidemiological survey set in the rural Hai district of Tanzania. Screening was performed with a validated screening questionnaire with high sensitivity and specificity. Positive responders to screening underwent full neurological history and examination to confirm or refute the presence of neurological disorders and to classify the disorder using the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). RESULTS Of 2232 participants, there were 384 neurological diagnoses amongst 349 people. The age-adjusted prevalence of people with neurological diagnoses was 154.1 per 1000 (95% CI 139.2-169.1). The age-adjusted prevalence per 1000 of the most common neurological disorders were tremor (48.2), headache (41.8), stroke (23.0), peripheral polyneuropathy (18.6), upper limb mononeuropathy (6.5) and parkinsonism (5.9). CONCLUSIONS This is the first published community-based neurological disorders prevalence study specifically in the elderly in SSA. It reveals a high prevalence of neurological morbidity and demonstrates the contribution neurological disorders make to the non-communicable disease epidemic. This is likely to increase as the population of low-income countries ages constituting a public health dilemma.
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Affiliation(s)
| | | | - W. K. Gray
- Northumbria Healthcare NHS Foundation Trust; North Tyneside General Hospital; North Shields; UK
| | - E. Aris
- Department of Medicine; Muhimbili University College Hospital; Dar-es-Salaam; Tanzania
| | - G. Orega
- Kilimanjaro Christian Medical Centre; Moshi; Tanzania
| | - W. Howlett
- Kilimanjaro Christian Medical Centre; Moshi; Tanzania
| | - N. Warren
- Newcastle-upon-Tyne Hospitals NHS Foundation Trust; Royal Victoria Infirmary; Newcastle-upon-Tyne; UK
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Muangpaisan W, Hori H, Brayne C. Systematic review of the prevalence and incidence of Parkinson's disease in Asia. J Epidemiol 2009; 19:281-93. [PMID: 19801887 PMCID: PMC3924097 DOI: 10.2188/jea.je20081034] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative disorder in older people, and half of the world's older population lives in Asia. However, the epidemiology of PD in Asian countries is poorly understood. This review assembles evidence on the prevalence and incidence of PD in Asian countries and identifies gaps in our present knowledge. METHODS A systematic search of studies published from 1965 to October 2008 was conducted using MEDLINE and EMBASE. The selection criteria were defined a priori. Prevalence and incidence were standardized to the WHO World Standard Population 2000. Twenty-one original studies were selected for the review. Two studies that described the ethnic origin of participants and contained Asian populations were also included in the analysis. RESULTS Excluding one study with questionably low prevalence and incidence, the remaining studies reported a standardized all-age prevalence of 51.3 to 176.9 per 100,000 in door-to-door surveys; prevalence in record-based studies ranged from 35.8 to 68.3 per 100,000. The standardized incidence rates were 8.7 per 100,000 person-years in door-to-door surveys and 6.7 to 8.3 per 100,000 person-years in record-based surveys. CONCLUSIONS The prevalence of PD in Asian countries was slightly lower than that in Western countries. However, comparison of incidence was difficult because of the small number of studies. Varying methodologies, diagnostic criteria, and case-finding strategies contributed to the considerable variation in the reported prevalence and incidence of PD.
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Affiliation(s)
- Weerasak Muangpaisan
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Picot MC, Baldy-Moulinier M, Daurs JP, Dujols P, Crespel A. The prevalence of epilepsy and pharmacoresistant epilepsy in adults: A population-based study in a Western European country. Epilepsia 2008; 49:1230-8. [DOI: 10.1111/j.1528-1167.2008.01579.x] [Citation(s) in RCA: 305] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Garrigues HP, Andres C, Arbaizar A, Cerdan C, Meneu V, Oltra JA, Santonja J, Pérez A. Epidemiological aspects of vertigo in the general population of the Autonomic Region of Valencia, Spain. Acta Otolaryngol 2008; 128:43-7. [PMID: 17851953 DOI: 10.1080/00016480701387090] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION Vertigo, defined as an illusion of unequivocal rotatory motion, is a common symptom in the general population that frequently requires individuals to seek medical attention in a primary care centre. OBJECTIVES To evaluate the annual incidence of patients who suffer vertigo, and to examine some of the variables associated, in a sample of the general population of the Autonomic Region of Valencia, Spain. SUBJECTS AND METHODS The study was designed as an observational, incidence study. The study area included six primary care centres with a total population of 10760 inhabitants. The parameters studied were age, sex, working status, de novo presentation or recurrent vertigo crisis. RESULTS A total of 191 patients (17.8 patients per 1000 inhabitants) sought medical attention because of vertigo over the year of the study. Of these, 82 patients (7.6 per 1000 inhabitants) experienced vertigo for the first time, a de novo crisis. Women were more often affected and the crises occurred more frequently in individuals between 50 and 60 years of age. The work status had influence on the results obtained.
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Affiliation(s)
- H Pérez Garrigues
- Unit of Otoneurology, Department of Otorhinolaryngology, La Fe University Hospital (Tertiary Referral Center), Valencia, Spain.
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Takeshima T, Ishizaki K, Fukuhara Y, Ijiri T, Kusumi M, Wakutani Y, Mori M, Kawashima M, Kowa H, Adachi Y, Urakami K, Nakashima K. Population-based door-to-door survey of migraine in Japan: the Daisen study. Headache 2004; 44:8-19. [PMID: 14979878 DOI: 10.1111/j.1526-4610.2004.04004.x] [Citation(s) in RCA: 189] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To determine prevalence and characteristics of migraine in Japan, and to investigate use of medical care and whether food preference is associated with risk of migraine. METHODS Structured questionnaires were given to all adult residents (N = 5758; 2681 men and 3077 women) in Daisen, a rural community in western Japan. Second questionnaires, specific to headache, were given to 1628 residents with headache. A telephone survey was also carried out. Statistical Packages for the Social Sciences analyzed the data. RESULTS The 1-year prevalence of migraine was 2.3% (migraine with aura, 0.4% and without aura, 1.9%) in men and 9.1% (migraine with aura, 1.0% and migraine without aura, 8.1%) in women. Overall prevalence of migraine in Daisen was 6.0% (95% confidence interval [CI], 5.4% to 6.6%). Women observed a 5.9-fold higher risk of migraine than men (odds ratio, 5.9; 95% CI, 4.5 to 8.0; P <.0001, after age adjustment, by logistic analysis). Fatigue and loss of vigor were predominant premonitory symptoms of migraine. Fatigue, mental stress, and lack of sleep were the main headache triggers. Over a 3-month period, 20.3% of migraineurs experienced time or days off work due to headache. Only 7.3% of those with migraine with aura and 5.3% of those with migraine without aura had consulted a physician, and of those with migraine, 61.0% with aura and 71.8% without aura had never visited a medical doctor for their headache. Consumption of alcohol and cigarette smoking did not influence the risk for migraine or tension-type headache, after age and gender adjustment (logistic analysis). Migraineurs consume significantly more fatty/oily foods, coffee, and tea than nonheadache subjects of the same community. Migraineurs consume significantly fewer fish than nonheadache residents. CONCLUSIONS Only a few Japanese migraineurs receive benefits of medical services and recent advances of headache medicine. Public education concerning headaches is one of the most urgent issues in Japan.
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Affiliation(s)
- Takao Takeshima
- Department of Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Yonago, Japan
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Yamasoba T, Yagi M, Roessler BJ, Miller JM, Raphael Y. Inner ear transgene expression after adenoviral vector inoculation in the endolymphatic sac. Hum Gene Ther 1999; 10:769-74. [PMID: 10210144 DOI: 10.1089/10430349950018526] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Gene transfer has been performed in a variety of organs. In the mammalian inner ear, viral vectors have been used to introduce exogenous reporter genes via the scala tympani into the cochlea. While scala tympani inoculation is clinically feasible, it is not without risks. Moreover, transgene expression has so far been restricted to the cochlear tissues in the perilymphatic spaces that are contiguous with the scala tympani. To achieve gene transfer of vestibular organs and cells surrounding the endolymphatic space, and to extend the clinical utility of inner ear gene therapy, we developed a new surgical approach for vector inoculation. A replication-deficient adenoviral vector, Ad.RSVntlacZ, was injected into the guinea pig endolymphatic sac. A large number of blue (LacZ-positive) cells was observed in the endolymphatic sac and duct, the vestibule, and the ampulla. Blue cells were also detected in the cochlea, mainly in cells bordering the endolymphatic space: marginal cells in the stria vascularis and supporting cells in the organ of Corti. These findings indicate that inoculation of viral vectors into the endolymphatic sac can provide efficient gene transfer into a variety of cell types that are not accessible via scala tympani inoculation.
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Affiliation(s)
- T Yamasoba
- Kresge Hearing Research Institute, University of Michigan, Ann Arbor 48109-0648, USA
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