Claim: Newly Identified Form of Vertigo Responds to Treatment
Verdict: REFUTES

Retrieved passages:
title: Benign paroxysmal positional vertigo
text: underlying mechanism involves a small calcified otolith moving around loose in the inner ear. It is a type of balance disorder along with labyrinthitis and Ménière's disease. Diagnosis is typically made when the Dix–Hallpike test results in nystagmus (a specific movement pattern of the eyes) and other possible causes have been ruled out. In typical cases, medical imaging is not needed. BPPV is often treated with a number of simple movements such as the Epley maneuver or Brandt–Daroff exercises. Medications may be used to help with nausea. There is tentative evidence that betahistine may help with vertigo but its use

title: Benign paroxysmal positional vertigo
text: variations are used, and involve rolling the patient 360 degrees in a series of steps to reposition the particles. This maneuver is generally performed by a trained clinician who begins seated at the head of the examination table with the patient supine There are four stages, each a minute apart, and at the third position the horizontal canal is oriented in a vertical position with the patient's neck flexed and on forearm and elbows. When all four stages are completed, the head roll test is repeated, and if negative, treatment ceases. Medical treatment with anti-vertigo medications may be considered in

title: Vestibular rehabilitation
text: For example, phobic postural vertigo (PPV) occurs when an individual with obsessive-compulsive characteristics experiences a sense of imbalance, despite the absence of balance issues. Chronic subjective dizziness (CSD) is a similar condition characterized by persistent vertigo, hypersensitivity to motion stimuli, and difficult with precise visual tasks. Both phobic postural vertigo and chronic subjective dizziness may be treated with vestibular rehabilitation therapy or other therapeutic methods such as cognitive behavioral therapy and conditioning. Vestibular rehabilitation is specific to the dysfunction that a patient experiences. Some treatment methods seek to eliminate the cause of vestibular dysfunction, while others allow the brain to

title: Benign paroxysmal positional vertigo
text: the ampulla) with the direction of gravity. This test will reproduce vertigo and nystagmus characteristic of posterior canal BPPV. When performing the Dix–Hallpike test, patients are lowered quickly to a supine position, with the neck extended by the clinician performing the maneuver. For some patients, this maneuver may not be indicated, and a modification may be needed that also targets the posterior semicircular canal. Such patients include those who are too anxious about eliciting the uncomfortable symptoms of vertigo and those who may not have the range of motion necessary to comfortably be in a supine position. The modification involves

title: Benign paroxysmal positional vertigo
text: acute, severe exacerbation of BPPV, but in most cases are not indicated. These primarily include drugs of the anti-histamine and anti-cholinergic class, such as meclizine and hyoscine butylbromide (scopolamine), respectively. The medical management of vestibular syndromes has become increasingly popular over the last decade, and numerous novel drug therapies (including existing drugs with new indications) have emerged for the treatment of vertigo/dizziness syndromes. These drugs vary considerably in their mechanisms of action, with many of them being receptor- or ion channel-specific. Among them are betahistine or dexamethasone/gentamicin for the treatment of Ménière's disease, carbamazepine/oxcarbazepine for the treatment of paroxysmal dysarthria

title: Vertigo
text: histamine, serotonin, and acetylcholine are neurotransmitters thought to produce vomiting. It is known that centrally acting antihistamines modulate the symptoms of acute symptomatic vertigo. Tests for vertigo often attempt to elicit nystagmus and to differentiate vertigo from other causes of dizziness such as presyncope, hyperventilation syndrome, disequilibrium, or psychiatric causes of lightheadedness. Tests of vestibular system (balance) function include electronystagmography (ENG), Dix-Hallpike maneuver, rotation tests, head-thrust test, caloric reflex test, and computerized dynamic posturography (CDP). The HINTS test, which is a combination of three physical exam tests that may be performed by physicians at the bedside has been deemed helpful

title: Hitachi Magic Wand
text: each leg. In a 2011 article for the "International Journal of Otolaryngology", Jeremy Hornibrook discussed the inner ear disorder Benign paroxysmal positional vertigo (BPPV). BPPV is the most common cause of vertigo, a problem attributed to a detached otoconia in one of the semicircular canals. Hornibrook recommended a repositioning treatment for patients with BPPV from the posterior canal location. He wrote that the procedure most often performed for this purpose was a slightly transformed version of the Epley maneuver, and afterwards recommended carrying out a Dix–Hallpike test to assess the status of BPPV. If such a test was positive, Hornibrook

title: Vertigo
text: vascular risk factors. Presentation may more often involve headache or neck pain, additionally, those who have had multiple episodes of dizziness in the months leading up to presentation are suggestive of stroke with prodromal TIAs. The HINTS exam as well as imaging studies of the brain (CT, CT angiogram, and/or MRI) are helpful in diagnosis of posterior fossa stroke. Definitive treatment depends on the underlying cause of vertigo. Ménière's disease patients have a variety of treatment options to consider when receiving treatment for vertigo and tinnitus including: a low-salt diet and intratympanic injections of the antibiotic gentamicin or surgical measures

title: Benign paroxysmal positional vertigo
text: other types of nystagmus. Although rare, CNS disorders can sometimes present as BPPV. A practitioner should be aware that if a patient whose symptoms are consistent with BPPV, but does not show improvement or resolution after undergoing different particle repositioning maneuvers — detailed in the Treatment section below — need to have a detailed neurological assessment and imaging performed to help identify the pathological condition. Vertigo, a distinct process sometimes confused with the broader term, dizziness, accounts for about six million clinic visits in the United States every year; between 17 and 42% of these patients are eventually diagnosed with

title: Vertigo
text: in differentiating between central and peripheral causes of vertigo. The HINTS test involves the horizontal head impulse test, observation of nystagmus on primary gaze, and the test of skew. CT scans or MRIs are sometimes used by physicians when diagnosing vertigo. Tests of auditory system (hearing) function include pure tone audiometry, speech audiometry, acoustic reflex, electrocochleography (ECoG), otoacoustic emissions (OAE), and the auditory brainstem response test. A number of specific conditions can cause vertigo. In the elderly, however, the condition is often multifactorial. A recent history of underwater diving can indicate a possibility of barotrauma or decompression sickness involvement but

title: Benign paroxysmal positional vertigo
text: performed as follows: Some patients will only need one treatment, but others may need multiple treatments, depending on the severity of their BPPV. In the Semont maneuver, as with the Epley maneuver, patients themselves are able to achieve canalith repositioning. The Brandt–Daroff exercises may be prescribed by the clinician as a home treatment method, usually in conjunction with particle-repositioning maneuvers or in lieu of the particle-repositioning maneuver. The exercise is a form of habituation exercise, designed to allow the patient to become accustomed to the position which causes the vertigo symptoms. The Brandt–Daroff exercises are performed in a similar fashion

title: Vertigo
text: moving. The third type is known as pseudovertigo, an intensive sensation of rotation inside the person's head. While this classification appears in textbooks, it has little to do with the pathophysiology or treatment of vertigo. Vertigo that is caused by problems with the inner ear or vestibular system, which is composed of the semicircular canals, the vestibule (utricle and saccule), and the vestibular nerve is called "peripheral", "otologic" or "vestibular" vertigo. The most common cause is benign paroxysmal positional vertigo (BPPV), which accounts for 32% of all peripheral vertigo. Other causes include Ménière's disease (12%), superior canal dehiscence syndrome, labyrinthitis,

title: Vertigo
text: a peripheral lesion tends to improve in a short period of time (days to weeks). Vertigo that arises from injury to the balance centers of the central nervous system (CNS), often from a lesion in the brainstem or cerebellum, is called "central" vertigo and is generally associated with less prominent movement illusion and nausea than vertigo of peripheral origin. Central vertigo may have accompanying neurologic deficits (such as slurred speech and double vision), and pathologic nystagmus (which is pure vertical/torsional). Central pathology can cause disequilibrium which is the sensation of being off balance. The balance disorder associated with central lesions

title: Benign paroxysmal positional vertigo
text: structure in the inner ear includes the otolith organs which contain crystals that are sensitive to gravity. These crystals are responsible for sensitivity to head positions, and can also be dislocated, causing them to lodge inside one of the semicircular canals, which causes dizziness. The condition is diagnosed by the patient's history, and by performing the Dix–Hallpike test or the roll test, or both. The Dix–Hallpike test is a common test performed by examiners to determine whether the posterior semicircular canal is involved. It involves a reorientation of the head to align the posterior semicircular canal (at its entrance to

title: Migraine-associated vertigo
text: clear-cut history, no vestibular tests are required. Other historical criteria which are helpful in making the diagnosis of migraine-associated vertigo are vertiginous symptoms throughout the patient’s entire life, a long history of motion intolerance, sensitivity to environmental stimuli, illusions of motion of the environment, and vertigo that awakens the patient. Treatment of migraine-associated vertigo is the same as the treatment for migraine in general. The prevalence of migraine and vertigo is 1.6 times higher in 200 dizziness clinic patients than in 200 age- and sex-matched controls from an orthopaedic clinic. Among the patients with unclassified or idiopathic vertigo, the prevalence

title: Benign paroxysmal positional vertigo
text: and ataxia in multiple sclerosis, metoprolol/topiramate or valproic acid/tricyclic antidepressant for the treatment of vestibular migraine, and 4-aminopyridine for the treatment of episodic ataxia type 2 and both downbeat and upbeat nystagmus. These drug therapies offer symptomatic treatment, and do not affect the disease process or resolution rate. Medications may be used to suppress symptoms during the positioning maneuvers if the patient's symptoms are severe and intolerable. More dose-specific studies are required, however, in order to determine the most effective drug(s) for both acute symptom relief and long-term remission of the condition. Surgical treatments, such as a semi-circular canal occlusion,

title: Vestibulocerebellar syndrome
text: sensory input responsible for the dizziness. Treatment is presently focused on addressing specific symptoms to alleviate the nausea that often accompanies attacks and to make daily life more manageable. There have been very few studies on the effectiveness of drugs that are used for the management of other ataxias on vestibulocerebellar syndrome. Trials with acetazolamide achieved some success, while amitriptyline hydrochloride was unsuccessful. Acetazolamide therapy proved effective in treating episodic vertigo. In trials with patients afflicted with vestibulocerebellar syndrome, acetazolamide either eliminated or significantly decreased the frequency and severity of vertigo episodes. Dramamine (Dimenhydrinate) and antihistamine drugs have also been

title: Migraine-associated vertigo
text: of patients with BAM with a noticeable change in hearing just before the onset of a migraine headache. The attacks of vertigo are usually concurrent with a headache and the family history is usually positive. The diagnostician must rule out: TIAs, and paroxysmal vestibular disorder accompanied by headache. There is also a familial vestibulopathy, familial benign recurrent vertigo (fBRV), where episodes of vertigo occur with or without a migraine headache. Testing may show profound vestibular loss. The syndrome responds to acetazolamide. Familial hemiplegic migraine (FHM) has been linked to mutations in the calcium channel gene. (Ophoff et al. 1966 cf.

title: Benign paroxysmal positional vertigo
text: exact head movements that provoke their vertigo. Purely horizontal nystagmus and symptoms of vertigo lasting more than one minute can also indicate BPPV occurring in the horizontal semicircular canal. Patients do not experience other neurological deficits such as numbness or weakness, and if these symptoms are present, a more serious etiology, such as posterior circulation stroke or ischemia, must be considered. The spinning sensation experienced from BPPV is usually triggered by movement of the head, will have a sudden onset, and can last anywhere from a few seconds to several minutes. The most common movements patients report triggering a spinning

title: Benign paroxysmal positional vertigo
text: the patient moving from a seated position to side-lying "without" their head extending off the examination table, such as with Dix–Hallpike. The head is rotated 45 degrees away from the side being tested, and the eyes are examined for nystagmus. A positive test is indicated by the patient report of a reproduction of vertigo and clinician observation of nystagmus. Both the Dix–Hallpike and the side-lying testing position have yielded similar results, and as such the side-lying position can be used if the Dix–Hallpike cannot be performed easily. The roll test can determine whether the horizontal semicircular canal is involved. The