Research in Vestibular Science

Review Article

Treatment of hemodynamic orthostatic dizziness/vertigo: Hyun Ah Kim; Res Vestib Sci. 2024;23(3):79-88. Published online September 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.017

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Abstract PDF: Orthostatic dizziness occurs when a person feels dizzy or lightheaded upon standing up. Hemodynamic orthostatic dizziness can result from autonomic dysfunction, such as orthostatic hypotension or postural tachycardia syndrome. The International Classification of Vestibular Disorders has established diagnostic criteria for hemodynamic orthostatic dizziness/vertigo. These criteria help clinicians understand the terminology associated with orthostatic dizziness/vertigo and differentiate it from dizziness caused by global brain hypoperfusion and other etiologies. Effective treatment involves interpreting the results of autonomic function tests, which can lead to improvements in orthostatic dizziness and help prevent falls related to this condition. This paper discusses general management strategies and specific treatments for orthostatic hypotension and postural tachycardia syndrome, highlighting the importance of tailored care based on the most recent clinical insights.

Review

Autonomic Dysfunction in Dizziness Clinic: Eun Bin Cho, Ki-Jong Park; Res Vestib Sci. 2018;17(2):37-43. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.37

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2 Crossref

Orthostatic dizziness is a common type of dizziness. In general, orthostatic dizziness is provoked by standing or tilting, and subsided by supine position. The patient with orthostatic intolerance complains multiple symptoms such as dizziness, palpitation, lightheadness, fatigue and rarely syncope. Common orthostatic intolerance is orthostatic hypotension (classic, initial, transient, and delayed orthostatic hypotension) and postural orthostatic tachycardia syndrome. Transcranial Doppler is a noninvasive technique that provides real-time measurement of cerebral blood flow velocity. It can be useful for understanding the relationship between orthostatic symptoms and cerebral autoregulatory function. The reciprocal causal relationship between vestibular and autonomic dysfunction should always be kept in mind.

Citations

Citations to this article as recorded by

A Study on the Characteristics of Patients Treated for Dizziness with Jeoreongchajeonja-tang: A Retrospective Analysis of 63 Cases
Nu-ri Jung, Ki-tae Kim, Seon-mi Shin, Heung Ko
The Journal of Internal Korean Medicine.2019; 40(6): 1122. CrossRef
Pitfalls in the Diagnosis of Vertigo
Hyun Ah Kim, Hyung Lee
Journal of the Korean Neurological Association.2018; 36(4): 280. CrossRef

Original Article

Classification of Chronic Dizziness in Elderly People and Relation with Falls: Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park; Res Vestib Sci. 2018;17(1):13-17. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.13

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Abstract PDF: Objectives
Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness.
Methods
We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or out patient department follow-up for 6 months.
Results
Thirty-four patients were enrolled and all completed follow-up for 6 months. Nine patients classified as the falling groups and 34 patients as nonfalling group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%), and vestibular migraine (n=3, 9%) were more frequent in nonfall group.
Conclusions
The presence of dizziness in the elderly is a strong predictor of fall, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.

Review

Positional Dizziness and Vertigo without Nystagmus and Orthostatic Hypotension: Jae Han Park; Res Vestib Sci. 2016;15(4):107-111. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.107

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Abstract PDF: According to the Barany Society classification of vestibular symptoms, positional dizziness or vertigo is defined as dizziness or vertigo triggered by and occurring after a change of head position in space relative to gravity. Thus, positional dizziness or vertigo should be differentiated from orthostatic dizziness or vertigo, which is triggered by and occurs upon rising. Benign paroxysmal positional vertigo (BPPV) is the most common positional vertigo and accompanied by a characteristic paroxysmal positional nystagmus. But a problem occasionally encountered in clinical practice is the presence of a positive history of BPPV with a negative diagnostic maneuver for positional nystagmus. Orthostatic hypotension may be dependent upon various neurogenic and non-neurogenic disorders and conditions. Combination of non-pharmacological and pharmacological treatment improve orthostatic tolerance.

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