After headache, vertigo and dizziness is the second most common complaint of patients. Vertigo is not a disease entity, but rather an unspecific syndrome consisting of various disorders with different causes. Most syndromes of vertigo can only be correctly diagnosed by means of a careful medical history and physical examination of the patient. The majority of these cases have a benign cause, a favorable natural course, and a positive response to therapy. This short and concise, clinically-oriented book is for physicians of different specializations who treat patients with vertigo including neurologists and ENT specialists. Easy-to-use, it has an overview of the most important syndromes of vertigo, each with explanatory clinical descriptions and illustrations. Target market: Physicians of different specializations who treat patients with vertigo including neurologists, neurootologic specialists, neuroophthalmology, otolaryngology, head and neck surgery, ophthalmology and ENT specialists, and general medicine practitioners.

Schwindel ist keine Diagnose, sondern ein unspezifisches Symptom für unterschiedliche Erkrankungen. Das Buch unterstützt Fachärzte, die an Schwindel leidende Patienten behandeln. Die wichtigsten Schwindelsyndrome werden dargestellt, Untersuchungen ausführlich geschildert und mit Bildern illustriert. Die Kapitelstruktur folgt der Praxis: Anamnese, Klinik, Pathophysiologie und therapeutische Prinzipien, Therapie, Wirksamkeit sowie Differenzialdiagnose und klinische Probleme. Die 2. Auflage wurde aktualisiert und um neue Untersuchungsmethoden ergänzt.

Abstract: Parkinson's disease (PD) is known to involve the peripheral nervous system (PNS) and the enteric nervous system (ENS). Functional changes in PNS and ENS appear early in the course of the disease and are responsible for some of the non-motor symptoms observed in PD patients like constipation, that can precede the appearance of motor symptoms by years. Here we analyzed the effect of the pesticide rotenone, a mitochondrial Complex I inhibitor, on the function and neuronal composition of the ENS by measuring intestinal contractility in a tissue bath and by analyzing related protein expression. Our results show that rotenone changes the normal physiological response of the intestine to carbachol, dopamine and electric field stimulation (EFS). Changes in the reaction to EFS seem to be related to the reduction in the cholinergic input but also related to the noradrenergic input, as suggested by the non-adrenergic non-cholinergic (NANC) reaction to the EFS in rotenone-exposed mice. The magnitude and direction of these alterations varies between intestinal regions and exposure times and is associated with an early up-regulation of dopaminergic, cholinergic and adrenergic receptors and an irregular reduction in the amount of enteric neurons in rotenone-exposed mice. The early appearance of these alterations, that start occurring before the substantia nigra is affected in this mouse model, suggests that these alterations could be also observed in patients before the onset of motor symptoms and makes them ideal potential candidates to be used as radiological markers for the detection of Parkinson's disease in its early stages

Abstract: Background There is increasing evidence for close interrelations between vestibular and emotional brain networks. A study in patients with bilateral peripheral vestibulopathy (BVP) showed relatively low vertigo-related anxiety (VRA), despite high physical impairment. The current working hypothesis proposes the integrity of the peripheral vestibular system as a prerequisite for development of VRA. Here we contribute by evaluating VRA and vestibular-related handicap in central vestibular disorders. Methods Of 6396 patients presenting in a tertiary vertigo centre, 306 were identified with four clear central vestibular disorders: pure cerebellar ocular motor disorder (COD; 61), cerebellar ataxia (CA; 63), atypical parkinsonian syndromes (APS; 28), vestibular migraine (VM; 154). Their results of the Vertigo Handicap Questionnaire (VHQ), with its subscales for anxiety and handicapped activity, were compared to those of 65 BVP patients. Postural instability was measured on a force-plate. Multivariate linear regression was used to adjust for patient demographics. Results Patients with chronic central vestibular disorders (COD, CA, APS) had relatively low VRA levels comparable to those in BVP, independent of increased handicapped activity or postural instability. Only VM patients showed significantly higher VRA, although their activity impairment and postural instability were lowest. No significant differences within chronic central vestibular disorders were found for VRA and subjective activity impairment. Conclusions Subjective and objective vestibular-related impairment are not necessarily correlated with vestibular-related anxiety in central vestibular disorders. Our findings rather support the hypothesis that, in addition to an intact peripheral, an intact central vestibular system could also serve as a prerequisite to develop specific VRA