Repositório Institucional - Unifesp :: Navegando por Palavras-chave "vertigem"

Navegando por Palavras-chave "vertigem"

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Active head rotation in benign positional paroxysmal vertigo
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2009-08-01) Ganança, Fernando Freitas [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Mangabeira-Albernaz, Pedro Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN Program on Vestibular Rehabilitation and Social Inclusion; Bandeirante University in São Paulo Graduate Program on Vestibular Rehabilitation and Social Inclusion
Benign Positional Paroxysmal Vertigo (BPPV) is one of the most common vestibular diseases and the active head rotation test one of the most modern methods of vestibular function assessment. AIM: this study aims to verify if the active head rotation test may reveal signs of horizontal and/or vertical vestibulo-ocular reflex dysfunction in vertigo patients suspected for BPPV. STUDY DESIGN: retrospective series study. MATERIALS AND METHOD: Neurotological evaluation including computerized electronystagmography and active head rotation on the horizontal and vertical axes were conducted in 100 patients suspected for BPPV patients. Results: Isolated or associated abnormalities of the horizontal and/or vertical vestibulo-ocular reflex gain, phase and symmetry were indicative of vestibular involvement and found in 77.0% of the BPPV patients. CONCLUSION: the active head rotation test revealed horizontal and/or vertical vestibulo-ocular reflex dysfunctions in a relevant number of BPPV patients.
Acesso aberto (Open Access)
Avaliação oculomotora em pacientes com disfunção vestibular periférica
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-06-01) Tuma, Vanessa Costa [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
AIM: To assess whether or not the parameters of fixed and randomized saccadic movements, of pendular tracking and of optokinetic nystagmus in the digital vectonystagmography may show abnormalities in patients with possible diagnosis of peripheral vestibular dysfunction. METHOD: 60 patients with dizziness of peripheral vestibular origin, from 12 to 82 years of age, males and females, were evaluated in the Universidade Federal de São Paulo (UNIFESP). Ocular movement parameter findings were compared to a normal pattern. RESULTS: Fixed saccadic movements were altered in 100% of the cases as to latency, and in 35.0% of the cases as to speed; the randomized saccadic movements were altered in 100% of the cases as to latency, in 78.3% as to precision, and in 1.7% as to speed; the pendular tracking showed a gain alteration in the frequencies of 0.1 Hz in 15% of the cases, 0.2 Hz in 21.7%, and 0.4 Hz in 13.3%; the optokinetic nystagmus showed an alteration of the angular speed in the slow component in 1.7% of the cases, and in gain in 5.0%. CONCLUSION: Fixed saccadic movement latency and speed, randomized saccadic movement latency, precision and speed, pendular tracking gain, slow component angular speed, and optokinetic nystagmus gain in the digital vectonystagmography may show abnormalities in patients with possible diagnosis of peripheral vestibular dysfunction.
Acesso aberto (Open Access)
Benign paroxysmal positional vertigo recurrence and persistence
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2009-08-01) Dorigueto, Ricardo Schaffeln [UNIFESP]; Mazzetti, Karen R; Gabilan, Yeda Pereira Lima [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); UNICID; UNIBAN Program in Vestibular Rehabilitation and Social Inclusion
Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR) protocol was applied in cases of persistent BPPV. RESULTS: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.
Acesso aberto (Open Access)
Blood glucose and insulin levels in patients with peripheral vestibular disease
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2009-10-01) Serra, Ana Paula; Lopes, Karen de Carvalho [UNIFESP]; Dorigueto, Ricardo Schaffeln [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Metabolic disorders can cause dizziness. AIM: to study the prevalence of glucose and glucose-insulin alterations in patients with peripheral vestibular disorders by studying the four-hour glucose-insulin curve; to check at what time there was the highest prevalence of altered cases and whether the glucose and insulin curves together are better than the isolate glucose curve and fasting glucose curve. MATERIALS AND METHODS: retrospective study, analyzing 81 four-hour glucose-insulin curves in patients with peripheral vestibular dizziness. RESULTS: Four-hour glucose-insulin curve alterations happened in 87.7% of the patients. Hypoglycemia was seen in 61.7% of the cases, hyperinsulinemia in 55.5%, hyperglycemia in 27.2%, glucose intolerance in 12.3% and hypoinsulinemia in 1.2%. Normal tests were seen in 12.3 % of the cases and altered fasting glucose in 23.5%. CONCLUSIONS: The four-hour glucose-insulin curve analysis showed that 87.7% of the patients with dizziness and suspicion of peripheral vestibular disorder had glucose or insulin metabolism disorders. The highest number of alterations was seen up to the third and fourth hour of the glucose-insulin curve. The glucose and insulin curves together overcame the glucose curve alone and fasting glucose curve in regards of the prevalence of altered cases.
Acesso aberto (Open Access)
Clinical features of benign paroxysmal positional vertigo
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2009-08-01) Caldas, Mariana Azevedo [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN program in vestibular rehabilitation and social inclusion
Benign paroxysmal positioning vertigo (BPPV) is considered as the most common vestibular disease. AIM: to evaluate the age, gender, type and site of the lesion, association with other vestibular diseases, progression, and recurrence in these patients. MATERIAL AND METHOD: A retrospective series study. Data from medical reports of BPPV patients examined in series during the past six years were analyzed. RESULTS: prevalences of BPPV were: at age 41-60 years (42.2 %); in females (62.8 %), wit nystagmus and positioning vertigo (81.3%); affecting the posterior canal (87%), unilateral (91.8 %), the right labyrinth (60.2%) - p<0.001). Due to canalithiasis (97.5%), idiopathic (74.8%), association with Menière's disease compared to other affections (55.4%); healing or recovery by means of the particle repositioning maneuver (77.9%); and possible recurrence (21.8% in a one-year follow-up period). CONCLUSION: BPPV is characterized by its prevalence at age 41 to 60 years, in females, with nystagmus and positioning vertigo, involving mostly the posterior canal of the right labyrinth, associated with canalithiasis or idiopathic, associated with Menière's disease compared to other affections, healing or recovery by means of particle repositioning maneuver, and possible recurrence.
Acesso aberto (Open Access)
É importante restringir a movimentação cefálica após a manobra de Epley?
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2005-12-01) Ganança, Fernando Freitas [UNIFESP]; Simas, Ricardo [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Korn, Gustavo Polacow [UNIFESP]; Dorigueto, Ricardo Schaffeln [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The effectiveness of postmaneuver postural restrictions is controversial in patients with benign paroxysmal positional vertigo. AIM: To verify the role of postural restrictions in patients with benign paroxysmal positional vertigo of posterior canal, submitted to a single Epley maneuver. STUDY DESIGN: clinical prospective. MATERIAL AND METHOD: Fifty eight patients with benign paroxysmal positional vertigo of posterior canal were randomly divided in two groups following the application of a unique Epley maneuver. The patients from group 1 were informed to restrict their head movements and to use a cervical collar and group 2 patients were not informed about these postmaneuver restrictions. The patients from both groups were reevaluated one week after Epley maneuver, regarding the presence of symptoms and positional nystagmus. RESULTS: One week after Epley maneuver 82.1% of the patients from group 1 and 73.3% from group 2 didn't present positional nystagmus (p=0.421). There was a clinical improvement in 96.0% of the patients from group 1 and in 94.0% from group 2 (p=0.781). CONCLUSION: The use of postural restrictions in patients with benign paroxysmal positional vertigo of posterior canal didn't interfere in their clinical evaluation, one week after a unique Epley maneuver.
Acesso aberto (Open Access)
Evolução clínica de pacientes com doença de Ménière
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-06-01) Chaves, Adriana Gonzaga [UNIFESP]; Boari, Letícia [UNIFESP]; Munhoz, Mário Sérgio Lei [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Misericórdia de São Paulo
Ménière`s disease is a frequent vestibular disease that occurs predominantly in the fourth decade of life. Diagnosis is mostly medical and is based on findings of vertigo, sensorineural hearing loss, tinnitus and aural fullness. AIM: To study the clinical findings of Ménière`s disease: age, duration of vertigo, tinnitus, hearing loss and aural fullness, and unilateral or bilateral involvement. METHOD: a retrospective study included 39 patients with a diagnosis of Ménière`s disease confirmed by electrocochleography, who were seen at a neuro-otology referral centre. Patients underwent a clinical examination, audiometry and bilateral transtympanic electrocochleography. Patients were separated into 2 groups: bilateral Ménière`s disease and unilateral Ménière`s disease. RESULTS: The mean age was 42.9 years; 72.5% were female. Fluctuation of hearing loss occurred in 54.5% of cases, and 65.7% had frequent attacks of vertigo. Bilateral disease was observed in 33.3%. The onset of the disease was earlier in the bilateral group (33.7 years) compared to the unilateral group (p= 0.0013). Duration of disease, tinnitus, hearing loss and aural fullness were similar between groups. CONCLUSION: Patients with bilateral Ménière`s disease had symptoms earlier than patients with unilateral disease. There was no difference between the groups in duration of disease and associated symptoms.
Acesso aberto (Open Access)
Manobra de Epley repetida em uma mesma sessão na vertigem posicional paroxística benigna
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-08-01) Korn, Gustavo Polacow [UNIFESP]; Dorigueto, Ricardo Schaffeln [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
AIM: To assess whether more than one Epley s maneuver in the same session, compared to a single one, decreases the number of sessions necessary to suppress positional nystagmus. METHOS: Epley s maneuver was done in 123 patients with BPPV due to unilateral posterior semicircular canal canalolithiasis. The number of sessions for positional nystagmus suppression was compared in two groups of patients. Group I consisted of 75 patients submitted to a single Epley s maneuver on weekly sessions and group II consisted of 48 patients that were submitted to four Epley s maneuvers during the first session. RESULTS: Group II showed greater nystagmus latency and duration than group I (p<0.05). The number of sessions and standard deviation showed by group I was greater than in group II (p=0.008). We observed a significant association between number of sessions and group (p=0.039) studied. Group II had 21.4% more nystagmus-free patients following only one session (CI95% [7.7% - 35.1%]). CONCLUSION: Repeated Epley s maneuvers in less sessions rendered more positional nystagmus-free patients when compared to those submitted to more sessions of single maneuvers.
Acesso aberto (Open Access)
Neurotological symptoms and academic performance of university students
(Academia Brasileira de Neurologia - ABNEURO, 2010-02-01) Marques, Marcia Mattos; Ganança, Mauricio Malavasi [UNIFESP]; Marques, Carolina Mattos; Ganança, Fernando Freitas [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To compare the academic performance of university students with or without neurotological symptoms. METHOD: 100 students enrolled in the Biomedical Sciences Graduate School - Medical Modality of UNIFESP-EPM in 2007 and answered a neurotological screening questionnaire. RESULTS: The symptoms presented once, sometimes, many times or always, in a decreasing order of prevalence, were headache (74.0%), difficulty with concentration (57.0%), lack of memory (45.0%), physical indisposition, nausea /dizziness when in moving vehicle (37.0%), fainting (27.0%), nausea (26.0%), sensation of fullness in the ear (26.0%), hypersensitivity to sounds (26.0%), tinnitus (22.0%), vertigo and other kinds of dizziness (21.0%), imbalance when walking (21.0%), difficulty in hearing (21.0%), imminent sensation of fainting (11.0%) and vomiting (8.0%), alone or in different associations; convulsion was not mentioned. The final academic performance score ranged from 5.1 to 10.0. CONCLUSION: University students with or without neurotological symptoms have manifested similar academic performance.
Acesso aberto (Open Access)
Otimizando o componente farmacológico da terapia integrada da vertigem
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-02-01) Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Munhoz, Mário Sérgio Lei [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Silva, Maria Leonor Garcia da [UNIFESP]; Serafini, Flavio [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Bandeirante de São Paulo Programa de Mestrado em Ciências do Movimento Corporal; UNIBAN
Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for Ménière s disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with Ménière s disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In Ménière s disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-Ménière s disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with Ménière s disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with Ménière s disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.
Acesso aberto (Open Access)
Posturografia do Balance Rehabilitation Unit (BRU TM) na vertigem posicional paroxística benigna
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-06-01) Monteiro, Silvia Roberta Gesteira; Ganança, Mauricio Malavasi [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Posturography has been used in the evaluation of patients with vestibular disorders. AIM: To evaluate balance control with the Balance Rehabilitation Unit (BRU TM) posturography in patients with Benign Paroxysmal Positional Vertigo. Study design: Prospective case-control. MATERIALS AND METHODS: A cross-sectional controlled study was carried out in 45 patients with BPPV, and a homogeneous control group consisting of 45 healthy individuals. Patients were submitted to a balance function evaluation by means of the Balance Rehabilitation Unit (BRU TM) posturography. RESULTS: The mean values of the ellipse area and the sway velocity in a firm surface and saccadic stimulation (p = 0.060). CONCLUSION: The Balance Rehabilitation Unit (BRU TM) posturography enables to identify postural control abnormalities in patients with BPPV.
Acesso aberto (Open Access)
Qualidade de vida de idosos com tontura
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-12-01) Takano, Nancy Akemi; Cavalli, Silvia Sper; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Santos, Mônica Alcantara de Oliveira; Peluso, Érica de Toledo Piza [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN Programa de Mestrado em Reabilitação do Equilíbrio Corporal e Inclusão Social
Dizziness is frequent in elderly people. AIMS: To evaluate the Quality of Life (QoL) in elderly subjects with dizziness, relate it with gender and age. MATERIAL AND METHOD: A prospective study comprising 120 elderly patients with dizziness evaluated with Brazilian versions of the Whoqol-bref and the dizziness handicap inventory (DHI). The factor analysis (FA), the Mann Whitney and Kruskal Wallis tests, and the Spearman correlation were applied to study the results. RESULTS: The most compromised domains were the DHI physical domain and the Whoqol-bref physical and environment domains. FA resulted in 3 factors in the DHI and 5 factors in the Whoqol-bref. There was a moderate correlation (-0.596) in the total scores of both instruments. Males had a better QoL in the environment perception and introspectivity and health perception factors of the Whoqol-bref test. Females had a better QoL in the functionality perception factor of the Whoqol-bref test. There were no significant age differences. CONCLUSIONS: Elderly patients with dizziness have a worse QoL. Elderly females with dizziness have worse QoL scores in environment perception and introspectivity and health perception and better QoL in the functionality perception factor compared to elderly males.
Acesso aberto (Open Access)
Qualidade de vida em pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2005-12-01) Handa, Patrícia Rumi [UNIFESP]; Kuhn, Ana Maria Baccari [UNIFESP]; Cunha, Fabiana [UNIFESP]; Schaffleln, Ricardo [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Patients with benign paroxysmal positional vertigo and/or Ménière's disease relate damages in quality of life. AIM: To compare the impact of dizziness on quality of life, in patients with benign paroxysmal positional vertigo and/or Ménière's disease, in crisis and out of crisis, and to evaluate the influence of gender, age and impaired semicircular canal. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: The prospective study was realized in 2003/04 at Federal University of São Paulo. The Dizziness Handicap Inventory was applied in seventy patients with positional vertigo, seventy with Ménière's disease and fifteen with both. Two-proportion equality test and the Analysis of variance were employed in this study. RESULTS: When comparing the groups, Dizziness Handicap Inventory results evidenced higher averages in crisis and out of crisis for Ménière's disease group than for positional vertigo group. The same occurred only during the crisis period in the group when comparing with both disorders (p<0,05). No significant statistical differences were observed, when comparing the results considering age, gender and, in the group with positional vertigo, affection of posterior semicircular canal as variables. CONCLUSIONS: Ménière's disease patients presented worse quality of life when compared to BPPV patients, in and out of crisis, and during the crisis when regarding the patients with association of both disorders. The damage on quality of life was independent of gender, age and in the BPPV cases it was independent of posterior canal affection.
Acesso aberto (Open Access)
Quality of life of individuals submitted to vestibular rehabilitation
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2009-06-01) Patatas, Olívia Helena Gomes [UNIFESP]; Ganança, Cristina Freitas [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN Social Inclusion and Vestibular Rehabilitation Program
Balance disorders affect social, family and professional activities. Vestibular rehabilitation can reduce the impact of these disorders on the quality of life of individuals with vertigo. AIM: to study the influence of vestibular rehabilitation on the quality of life of individuals, correlating it with gender, age, results from computerized vectoelectronystagmography and vertigo. Study type: Retrospective. MATERIALS AND METHODS:Twenty-two individuals were submitted to customized vestibular rehabilitation and the Brazilian Dizziness Handicap Inventory - DHI before and after vestibular rehabilitation. Results from this questionnaire were correlated with gender, age, vestibular assessment and the presence of vertigo. RESULTS: all the DHI scores reduced significantly after vestibular rehabilitation. There were no differences among genders; adults and elderly patients; irritative peripheral vestibular syndromes; deficiency syndromes and normal exams; the presence or absence of vertigo. CONCLUSION: all the individuals had improvements in their quality of life after customized vestibular rehabilitation.
Acesso aberto (Open Access)
Quantas manobras são necessárias para abolir o nistagmo na vertigem posicional paroxística benigna?
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2005-12-01) Dorigueto, Ricardo Schaffeln [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
AIM: To evaluate the number of weekly canalith repositioning procedures needed to eliminate positioning nystagmus in patients with benign paroxysmal positional vertigo and to verify influences of canalithiasis or cupulolithiasis and/or semicircular canal involvement. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: Sixty patients with benign paroxysmal positional vertigo were consecutively selected according to each combination of canalithiasis or cupulolithiasis with semicircular canal involvement. Patients were treated by means of canalith repositioning procedures repeated weekly until the elimination of the positioning nystagmus. Analysis of Variance was used to verify differences between the variables. RESULTS: An average of 2.13 procedures (from 1 to 8) was needed to eliminate the positioning nystagmus. Canalithiasis required an average of 1.53 procedures, while cupulolithiasis needed 2.92 procedures (p=0.0002). An average of two procedures was needed to eliminate the positioning nystagmus in cases with posterior canal involvement, 2.39 procedures in cases with anterior canal involvement and 2.07 procedures in cases with lateral canal involvement (p=0.5213). CONCLUSIONS: From one to eight weekly canalith repositioning procedures were needed, with an average of two, to eliminate positioning nystagmus in benign paroxysmal positional vertigo. Cupulolithiasis requires a greater number of procedures than canalithiasis to eliminate positioning nystagmus. Semicircular canal involvement didn't influence the number of therapeutic maneuvers.
Acesso aberto (Open Access)
Reabilitação vestibular em pacientes com esclerose múltipla remitente-recorrente
(Academia Brasileira de Neurologia - ABNEURO, 2007-06-01) Pavan, Karina; Marangoni, Bruna E.m.; Schmidt, Kizi B.; Cobe, Fernanda A.; Matuti, Gabriela S.; Nishino, Lúcia K.; Thomaz, Rodrigo B.; Mendes, Maria Fernanda [UNIFESP]; Lianza, Sérgio; Tilbery, Charles Peter; ISCMSP; ISCMSP Setor Otorrinolaringologia; ISCMSP Centro de Atendimento Tratamento da Esclerose Múltipla; Universidade Federal de São Paulo (UNIFESP); Santa Casa de Misericórdia de São Paulo Faculdade de Ciências Médicas; Santa Casa de Misericórdia de São Paulo Centro de Atendimento e Tratamento de Esclerose Múltipla
Multiple sclerosis (MS) is a demyelinating, inflammatory illness, that attack the white matter of the central nervous system, and abnormal vestibular sensations (vertigo, disequilibrium) are frequent. The vestibular rehabilitation (VR) is determined by mechanisms of adaptations, neural substitutions and compensations. This study evaluated the improvement of the central or peripheral vertigo in patients with relapsing-remitting MS submitted to the VR (exercises of Cawthorne-Cooksey), through the scale of Berg and Dizziness Handicap Inventory (DHI). In this sample of 4 cases the VR, carried through in a period of 2 months, demonstrated the improvement in 3 patients according to the Berg scale and in 2 patients considering that of the DHI.
Acesso aberto (Open Access)
Reabilitação vestibular em um hospital universitário
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-04-01) Tavares, Flávia da Silva [UNIFESP]; Colella-Santos, Maria Francisca [UNIFESP]; Knobel, Keila Alessandra Baraldi; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP); Universidade de São Paulo (USP)
The aim of vestibular rehabilitation is to improve total balance, quality of life and spatial orientation of patients with dizziness. AIMS: To determine the characteristics of the patients who underwent the Vestibular Rehabilitation program of the Neurotology Ward of a University Hospital, and to verify the results obtained between November/2000 and December/2004. MATERIALS AND METHODS: analysis of 93 files from patients under Vestibular Rehabilitation during the studied period. STUDY DESIGN: Retrospective clinical. RESULTS: the mean age of patients was 52.82 years, 56 females and 37 males. The average number of therapy sessions was 4.3, higher for patients with central neurotological disorders (average of 5.9). Among the patients who concluded the treatment, 37 (60.7%) had significant improvement, 14 (22.9%) presented partial improvement and 10 (16.4%) did not report significant benefits. Patients with peripheral neurotological disorders were the ones who most benefited from Vestibular Rehabilitation. CONCLUSION: Most of the patients were female, with a mean age of 52.8 years. Fifty one patients (83.6%) benefited from the therapy, confirming treatment efficacy.
Acesso aberto (Open Access)
Sintomas psicológicos concomitantes à queixa de vertigem em 846 prontuários de pacientes otoneurológicos do Ambulatório de Otoneurologia da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2004-08-01) Paiva, Angela Daou; Kuhn, Ana Maria Baccari [UNIFESP]; Universidade Presbiteriana Mackenzie; Universidade Federal de São Paulo (UNIFESP)
AIM: To report the psychological symptoms associated to dizziness complaint in neurootological patients. STUDY DESIGN: Chart review. METHOD: A total of 846 medical reports of neurootological patients with dizziness complaint were quantified, concerning to gender, age and psychological symptoms associated to dizziness complaint. RESULTS: The psychological symptoms associated to dizziness complaint were anguish (47,38%), anxiety (19,71%), fear (13,42%), depression (12,58%), and memory disturbances (6,92%). CONCLUSION: Anguish (47,38%) was the most prevalent psychological symptom associated to dizziness complaints in neurootological patients.
Acesso aberto (Open Access)
Versão brasileira do Dynamic Gait Index
(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-12-01) De Castro, Sandra Meirelles; Perracini, Monica Rodrigues [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; UNIBAN; Universidade Federal de São Paulo (UNIFESP); Universidade Cidade de São Paulo
The Dynamic Gait Index (DGI) is a useful test to evaluate balance and gait. AIMS: The objectives of this study were to culturally adjust the DGI to the Portuguese language and to assess its reliability. METHODS: The method proposed by Guillemin et al. (1993) was used for a cultural adaptation of this tool. A prospective study was performed with 46 patients that were assessed in the cultural adaptation phase. The items that not understood by 20% or more patients were reworded and reapplied. The final Portuguese version of DGI was applied to 35 elderly in order to check intra and interobserver reliability. The Spearman rank coefficient was used to correlate intra and interobserver scores and the Wilcoxon test was applied to compare these scores. Internal consistency was analyzed by the Cronbach alpha coefficient. RESULTS: There were statistically significant correlations among the scores for intra and interobserver assessments for all items (p<0.001), which were classified as good and very strong correlations (ranging from r=0.655 to r=0.951). The DGI demonstrated high internal consistency in intra and interobserver assessments (varying from µ or = 0.820 to µ or = 0.894). CONCLUSION: The DGI was culturally adjusted to Brazilian Portuguese and proved to be a reliable tool.

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