wylee
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« on: December 20, 2011, 12:18:34 PM » |
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It's official. The research project conducted by the DUKE Docs is ready for presentation to the medical community. The presentation will be at the Spring meeting of the American Neurotology Society on April 21, 2012, in San Diego, CA. Below is the abstract from their website:
Cerebrospinal Fluid Pressure Abnormalities as a Cause of Chronic Subjective Vertigo with Migraine or Head Pressure H. Wolfgang Beumer, MD; David M. Kaylie, MD Linda Gray, MD; Peter Kranz, MD Objective: The normal range of CSF pressure is poorly defined. Abnormal pressure for some may be normal for others. The objective is to determine if altering the CSF pressure in patients within “normal” range can relieve symptoms of chronic subjective vertigo with migraine headache or head pressure, with or without other otologic complaints Study Design: Prospective, IRB approved study Setting: Tertiary center Patients: Patients with chronic subjective vertigo, migraine or head pressure, with or without other otologic complaints and clouded mentation Intervention: Diagnostic lumbar puncture with opening pressure measurement and addition or removal of CSF Outcome measure: Self-reported symptom score immediately after lumbar puncture Results: 46 patients met entrance criteria. Average opening pressure was 270 mmH20 ranging from 110 to 265mmH20. 27 patients had immediate symptom improvement with removal of CSF - opening pressure for this group averaged 217mmH20. Eight had complete resolution of symptoms, 14 had significant improvement and 5 had mild improvement. Eleven patients had improvement with addition of CSF, 3 with complete resolution of symptoms, 4 with significant improvement and 3 with mild improvement with CSF pressure averaging 157mmH20. The opening pressure was significantly higher in group that improved with CSF removal. Eight patients had no improvement with addition or removal of CSF. 7 reported no change, one reported significant worsening. Conclusion: Chronic subjective vertigo with migraine or head pressure, clouded mentation with or without other otologic complaints is often caused by abnormal CSF pressure. Removing or adding CSF in many of these patients provided immediate relief of their symptoms. Lumbar puncture should be considered in these patients. Define Professional Practice Gap & Educational Need: Lack of contemporary knowledge of treatment for chronic subjective vertigo and migraine headache leads to many patients receiving suboptimal care Learning Objective: To learn about potential causes of chronic subjective vertigo with migraine and how to treat it Desired Result: Attendees will be able to apply the knowledge they gain in the treatment of patients with chronic subjective vertigo IRB or IACUC Approval: yes
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