ABSTRACT
Many of the dizziness patients annually visit ENT (ear, nose, throat) clinics because the vestibular function is the major organ to keep body balance and belongs to the Otorhinolaryngology. Nevertheless, many otolaryngologists feel that it is not easy to access the dizziness patients. The reason is that dizziness is not a final diagnosis and it is necessary to start the diagnosis of dizziness and find out the cause. Also, the causes of dizziness belong to multiple medical departments. That is why we need to pay more attention. Among them, traumatic vertigo can be manifested in various ways depending on the injury site and mechanism, and it is often difficult to predict the medical prognosis. Therefore, this review article focuses on traumatic vertigo. In this paper, we discussed its epidemiology and mechanism to help clinicians to treat patients with traumatic vertigo.
Subject(s)
Humans , Craniocerebral Trauma , Diagnosis , Dizziness , Epidemiology , Nose , Otolaryngology , Prognosis , VertigoABSTRACT
Objective To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph.Methods The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. The application of acid-base balance coordinate graph in the cases was introduced.Results The method of four parameters-four steps analysis was put forward to analyze the acid-base balance disorders completely. Four parameters included pH, arterial partial pressure of carbon dioxide (PaCO2), HCO3- and anion gap (AG). Four steps were outlined by following aspects: ① according to the pH, PaCO2 and HCO3-, the primary or main types of acid-base balance disorder was determined; ② primary or main types of acid-base disorder were used to choose the appropriate compensation formula and to determine the presence of double mixed acid-base balance disorder; ③ the primary acid-base balance disorders were divided into two parts: respiratory acidosis or respiratory alkalosis, at the same time, the potential HCO3- should be calculated, the measured HCO3- should be replaced with potential HCO3-, to determine whether there were three mixed acid-base disorders; ④ based on the above analysis the data judged as the simple AG increased-metabolic acidosis was needed to be further analyzed. The ratio of ΔAG↑/ΔHCO3-↓ was also needed to be calculated, to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. In the clinical practice, PaCO2 (as the abscissa) and HCO3- (as the ordinate) were used to establish a rectangular coordinate system, through origin (0, 0) and coordinate point (40, 24) could be a straight line, and all points on the straight line pH were equal to 7.40. The acid-base balance coordinate graph could be divided into seven areas by three straight lines [namely pH = 7.40 isoline, PaCO2 = 40 mmHg (1 mmHg = 0.133 kPa) line and HCO3- = 24 mmol/L line]: main respiratory alkalosis area, main metabolic alkalosis area, respiratory+ metabolic alkalosis area, main respiratory acidosis area, main metabolic acidosis area, respiratory+ metabolic acidosis area and normal area. It was easier to determine the type of acid-base balance disorders by identifying the location of the (PaCO2, HCO3-) or (PaCO2, potential HCO3-) point on the acid-base balance coordinate graph.Conclusions Four parameters-four steps method is systematic and comprehensive. At the same time, by using the acid-base balance coordinate graph, it is simpler to estimate the types of acid-base balance disorders. It is worthy of popularizing and generalizing.
ABSTRACT
Objective To investigate the effects of therapeutic equipment that aimed to improve cerebrovascular func?tion combined with electric standing bed on balance disorder following cerebellar infarction. Methods Fifty patients with balance disorder after cerebellar infarction were randomized into study and control groups. Agreed routine rehabilitation ther?apy including automatic standing bed and medication were given to both groups. In addition, therapeutic equipment that aim to improve cerebrovascular function were delivered to patients in study group. The effects were assessed using Fugl-Meyer balance function scale and Barthel index (BI) before and after 4 weeks of treatment. Results Study group and control group did not present difference between FM-B grade and BI before treatment (P>0.05). Both FM-B and BI were improved after treatment (P<0.05), but it improved more in study group than in control group (P<0.05). The total efficiency in treatment group is higher than that in control group (P<0.05). In the process of treatment, no obvious adverse reactions was observed. Conclusion The therapeutic equitment that aim to improve cerebrovascular function combined with automatic standing bed can improve balance disorder and daily activity after cerebellar infarction.
ABSTRACT
Ability to control postural balance is a prerequisite for standing and gait training during the period of rehabilitation in patients with balance disorder. Precise and quantitative assessment of balance deficit as well as development of effective training methods are the important areas of research in the field. The purposes of this study are (1) to assess the test-retest reliability and clinical feasibility of Computerized Balance Evaluation and Training System (COBETS) developed by Department of Medical Engineering and Department. of Rehabilitation Medicine at Chonbuk National University and (2) to quantitatively assess the static and dynamic postural control ability of the patients with balance disorders due to various causes using COBETS and compare them with the results of normal control subjects. The subjects consist of 21 patients with brain damage by stroke, head injury, or surgical procedure to control intractable epilepsy, 5 patients with lower extremity amputation, 6 patients with unilateral total hip replacement, and 50 normal control subjects, Fifteen out of 50 normal control subjects performed subsequent two trials to evaluate the test-retest reliability of the COBETS. There was no statistically significant difference between the results of first and second trials in static and dynamic postural sway measured by the patients with brain damage, amputation, and hip joint replacement, static postural sways during comfortable, narrow, and affected one-leg stance were significantly increased than normal control subjects. Abnormal results in somatosensory evoked potential study and presence of motor weakness were negatively influenced to the results of static postural-sway. In all the patients groups. The movement time, path error, and peripheral sway were markedly increased in forward and affected lateral directions compared with normal subjects. Abnormal sensory and motor findings also negatively influenced to some parameters of dynamic postural control. However, there was no difference in the postural sway among the patients groups divided by the causes of balance disorder. The COBETS is considered as a reliable and clinically useful too for quantitative as sessment of static and dynamic postural control in the patients with balance disorders. Its usefulness for the training of balance control is subject to be defined in future.