[Arterial blood gas abnormalities during attacks of dizziness]. / Bas dönmesi ataklari sirasinda arteryel kan gazi anormallikleri.

OBJECTIVES: We investigated arterial blood gas abnormalities in patients presenting with dizziness. PATIENTS AND METHODS: The study included 58 patients (39 females, 19 males; mean age 46 years; range 22 to 74 years) who presented during attacks of dizziness. The duration of vertigo complaints ranged from one day to 30 years. Arterial gas measurements were performed at presentation and one month after treatment. The patients were examined in five groups according to the diagnoses: Meniere's disease (n=14), benign paroxysmal positional vertigo (n=13), vertebrobasilar insufficiency (n=12), vestibular neuritis (n=4), and craniocervical myofascial syndromes (n=15). RESULTS: At presentation, pH was low (acidosis) in two patients (3.5%), and high (alkalosis) in 15 patients (25.9%). After treatment, all abnormal pH values returned to normal. Twenty-four patients had high or low HCO3- values. High HCO3- values persisted in three patients together with dizziness. Patients with vestibular neuritis had significantly higher PO2 values compared to those with craniocervical myofascial syndrome and vertebrobasilar insufficiency (p<0.05). However, one month after treatment, there were no significant differences between five groups with respect to PO2 levels (p>0.05). Consecutive blood gas measurements did not differ significantly within each diagnosis group (p>0.05). CONCLUSION: Our results suggest that arterial blood gas abnormalities may be related to vertigo attacks.

A pilot study of nitric oxide blood levels in patients with chronic orofacial pain.

BACKGROUND: Control of pain is the major goal in the management of chronic orofacial pain (COP) patients. The pathogenesis of COP is currently not well understood. Consequently, the treatment of COP may be suboptimal or even harmful. Based on independent observations, we propose that local elevated levels of nitric oxide (NO) may have a central role in the pathogenesis of COP. HYPOTHESIS: NO level in the orofacial region of COP patients is elevated. A regional increased level of NO causes excessive vasodilatation. This hyperperfusion is manifested by hyperthermia of the overlying skin, while NO enhances nociception, aggravating orofacial pain. An alternative mechanism involving NO as a neurotransmitter at the CNS level may contribute to orofacial pain, but seems not to account for all the known clinical observations. METHODS: Two groups of subjects were studied: 5 patients with COP and 59 control subjects. For each subject we collected blood samples for analysis of nitrite\nitrate (or NOx). RESULTS: (1) NOx blood levels for 5 patients diagnosed with COP was 65.9 microM (SD of 10.4) verses 42.7 microM (SD of 24.2) for 59 control subjects, the difference being statistically significant, t-statistic = -2.12 (P > .05). (2) No statistical difference was found for NOx blood levels for 59 control subjects divided by gender (male vs female), with 23 female controls having NOx blood levels of 42.6 microM (SD of 25.2) and male controls having NOx blood levels of 42.8 microM (SD of 24.0), t-statistic = -0.03, P = .98. CONCLUSION: This pilot study suggests that NO blood levels may have an association with COP. A better understanding of the mechanism of chronic orofacial pain is expected to lead to more precise diagnostic staging and management of this disorder.

[Changes in hemostasis and vagal tonus in healthy individuals and patients with facial neuropathy by micro-dose heparin stimulation of nasal receptors]. / Izmenenie gemostaza i vagotonii u zdorovykh i bol'nykh nevropatieí litsevogo nerva, putem stimuliatsii retseptorov nosa mikrodozami geparina.

The effects of heparin microdoses on vagal tone (the Bayevsky heart rate variability index) and blood coagulation time were examined in 15 healthy men and women and in 14 patients with acute facial neuropathy. Nasal inhalation of heparin solution vapour (thrice every 30 sec, interrupted by a 60-80 sec interval) without changes in olfactory sensation or nasal secretion prolongs the onset and completion of blood clotting and decreased heart rate (vagal activation) in normotony volunteers. The similar procedure of distilled water nasal inhalation appears to be ineffective.