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Criterios Diagnóstico para Vértigo Posicional Paroxístico Benigno

Diagnostic Criteria for Benign Paroxysmal Positional Vertigo

  • Vertigo associated with a characteristic mixed torsional and vertical nystagmus provoked by the Dix-Hallpike test
  • A latency (typically of 1 to 2 seconds) between the completion of the Dix-Hallpike test and the onset of vertigo and nystagmus
  • Paroxysmal nature of the provoked vertigo and nystagmus (i.e., an increase and then a decline over a period of 10 to 20 seconds)
  • Fatigability (i.e., a reduction in vertigo and nystagmus if the Dix-Hallpike test is repeated)

Common Causes of Vertigo

Otologic disorders

  • Benign paroxysmal positional vertigo
  • Meniere´s disease (hydrops endolymphayic)
  • Vestibular neuronitis (labyrinthitis)

Neurologic disorders

  • Migraine-associated dizziness
  • Vertebrobasilar insufficiency
  • Panic disorders

Dix-Hallpike Maneover for Positional Nystagmus

Peripheral disorder Central disorder
Latent period before onset of positional nystagmus 2 to 20 seconds None
Duration of nystagmus Less than 1 minute Greater than 1 minute
Fatigability Fatiguing with repetition Nonfatiguing
Direction of nystagmus Only one type, usually horizontal/rotatory May change direction with a given head position
Intensity of vertigo Severe Less severe, sometimes none

 

References:

  1. Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999 Nov 18;341(21):1590-6. [Medline]

 

Created: Dic 23, 2005

 

Causes of Syncope

Cardiac causes

  • Structural cardiac or cardiopulmonary disease (aortic stenosis, mitral stenosis, pulmonary stenosis, left atrial myxoma, aortic dissection, acute myocardial infarction, cardiac tamponade, pulmonary embolism, obstructive cardiomyopathy)

  • Cardiac arrhythmias (tachyarrhythmias, bradyarrhythmias)

  • Neurally mediated syncopal syndrome (includes neurocardiogenic or vasovagal syncope, carotid sinus syncope, and situational syncope)

  • Orthostatic (or postural) hypotension

Continue reading “Causes of Syncope”

Diagnostic Criteria of Infarction in MRI of the Brain in Acute Stroke

Acute: Subtle low signal (hypointense) on T1, often difficult to see at this stage, and high signal (hyperintense) on spin density and/or T2-weighted and proton density-weighted images starting 8 h after onset; should follow vascular distribution. Mass effect maximal at 24 h, sometimes starting 2 h after onset, even in the absence of parenchymal signal changes. No parenchymal enhancement with paramagnetic contrast agent. Territorial intravascular paramagnetic contrast enhancement of “slow-flow” arteries in hyperacute infarcts; at 48 h, parenchymal and meningeal enhancement can be expected.

Continue reading “Diagnostic Criteria of Infarction in MRI of the Brain in Acute Stroke”

Diagnostic Criteria of Infarction in CT Imaging of the Brain in Acute Stroke

Computed tomography (CT) is widely used for early evaluation of acute strokes. Most importantly, CT excludes acute hemorrhage or other diseases mimicking ischemia. Continue reading “Diagnostic Criteria of Infarction in CT Imaging of the Brain in Acute Stroke”

Diagnostic Criteria for Tuberous Sclerosis Complex (TSC)

The diagnostic criteria for tuberous sclerosis complex (TSC) were revised at the Tuberous Sclerosis Complex Consensus Conference, July 1998.

Definite TSC: Two major features or one major feature plus two minor features

Probable TSC: One major feature plus one minor feature

Possible TSC: One major feature or two or more minor features

Continue reading “Diagnostic Criteria for Tuberous Sclerosis Complex (TSC)”

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