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- Postprandial Dizziness/Syncope Relieved by Alfa-Glucosidase Inhibitor: A Case Report
- Hakyeu An, Seong-Hae Jeong, Hyun Jin Kim, Eun Hee Sohn, Ae Young Lee, Jae Moon Kim
- Res Vestib Sci. 2018;17(2):67-70. Published online June 15, 2018
- DOI: https://doi.org/10.21790/rvs.2018.17.2.67
- 5,978 View
- 119 Download
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Abstract
PDF - A 74-year-old man presented with positional vertigo and prandial dizziness and syncope. He had experienced episodes of frequent dizziness and loss of consciousness for several months. He underwent total gastrectomy with esophagojejunostomy and brown anastomosis 30 years ago. Thirteen years ago, subtotal colectomy with ileo-descending colostomy was done due to colon cancer. And he also had mitral valve replacement and maze operation due to severe mitral valve stenosis and atrial fibrillation. After cardiac operation, he has suffered from sudden dizziness with diaphoresis and chalky face, which usually occurs especially within 30 minutes from the onset of eating. Sometimes, this event was followed by several seconds of loss of consciousness, which caused recurrent events of falling. Neurological examination showed positional nystagmus compatible with benign paroxysmal positional vertigo arising from posterior semicircular canal of the right ear. The positional vertigo disappeared immediately after canalith repositioning maneuver. We tried to monitor vital signs and serum level of glucose during eating. Hyperglycemia (range, 210–466 mg/dL) was noted during eating, which was accompanied by postprandial and prandial hypotension, up to 60/40 mmHg. The patient was prescribed 100 mg of the alfa-glucosidase, acarbose to be taken half an hour before each meal. Eventually, the treatment with acarbose ameliorated the prandial dizziness and hypotension associated with hyperglycemia. Our patient suggests the acarbose could prevent postprandial dizziness and hypotension.
- Recording of Ictal Nystagmus in a Case of Syncope Presenting Vertigo
- Jin Woo Maeng, Sung Kwang Hong, Hyung Jong Kim, Hyo Jeong Lee
- Res Vestib Sci. 2011;10(3):103-106.
- 1,718 View
- 10 Download
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Abstract
PDF
- Prevalence of dizziness has been reported to be as high as nearly twenty percent and one half of these population had social handicap to some degree. The diagnostic approach of dizziness heavily relies on the premise that dizziness type predicts the underlying etiology-e.g, vertigo with vestibular causes and presyncope with cardiovascular causes. However, such symptomatological approach sometimes delays correct diagnosis as the presenting symptom of individual patient is typically vague to designate the type. In this paper, a case of a 57-year-old woman who has experienced recurrent rotatory vertigo of cardiovascular origin was discussed. When her head were turned to the left, a fast downbeat nystagmus following a slow upward eye deviation was recorded using video nystagmogram. Hence, we report this single case of syncope presented as peripheral vertigo type with literature review.
- Recurrent Dizziness of Cardiac Origin Confirmed by Holter Monitoring
- Seung Ho Shin, Kyu Sung Kim, Hoseok Choi, Seong Hye Choi
- J Korean Bal Soc. 2008;7(2):218-221.
- 1,762 View
- 9 Download
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Abstract
PDF
- Ineffective cerebral perfusion by low cardiac output may cause various types of dizziness like mild lightheadedness, vertigo or presyncope, and sometimes it can be the only heralding symptom. Differential diagnosis with other causes of dizziness is important because the symptom may progress into life-threatening bradyarrythmia and loss of consciousness. There are several literatures that reporting the association between cardiac disease and dizziness and their improvement with treatment of cardiac problem including pacemaker placement. But these are only indirect evidences to explain the cause-symptom relationship. We experienced 48-year old woman who has had recurrent dizziness of rotatory type lasting for about 5 seconds since first year, and then diagnosed atrioventricular block after. She has been having anti-hypertension medications for 2 years. She didn’t have any abnormalities in electrocardiography, chest x-ray, or routine blood tests. There were no abnormalities in vestibular function test and electronystgmography. Her result of 24-hour Holter monitoring clearly elucidated temporal relationship between arrhythmia and her episodic symptoms of dizziness. The authors report a case with review of literatures about cardiogenic dizziness. Key words: Dizziness, Syncope, Arrhythmias, Cardiac, Electrocardiography, Ambulatory
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