Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms
| Autor: | Khodayar Goshtasbi, Mehdi Abouzari, Harrison W. Lin, Hamid R. Djalilian, Brooke Sarna |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male Pediatrics Havana Medical and Health Sciences Neurotology 0302 clinical medicine Migraines Vertigo Medicine Brain injury Vestibular system biology Headaches Pain Research Headache Cuba Neurological symptom General Medicine Middle Aged Vestibular Diseases Neurology U.S. diplomats Cohort Female Vestibule Labyrinth medicine.symptom Chronic Pain Adult Vestibule medicine.medical_specialty Migraine Disorders Dizziness Article 03 medical and health sciences Government Employees Clinical Research otorhinolaryngologic diseases Vestibular migraine Humans Labyrinth Migraine Retrospective Studies Neurology & Neurosurgery business.industry US diplomats Neurosciences biology.organism_classification medicine.disease Vestibular symptom United States Brain Disorders 030104 developmental biology Etiology International Classification of Headache Disorders Nervous System Diseases business 030217 neurology & neurosurgery Tinnitus |
| Zdroj: | Med Hypotheses |
| Popis: | Between 2016 and 2017, several U.S. Diplomats in Havana, Cuba, experienced perplexing vestibular and neurological symptoms attributed to an unknown source. They presented with significant vestibular and headache symptoms similar to individuals who experience vestibular migraine (VM). As such, we hypothesize that VM may be a possible explanation for the Havana cohort's presenting symptoms. To evaluate this hypothesis, we compared symptoms reported by the affected individuals in Havana, Cuba, to symptoms reported by corresponding patients from a tertiary academic neurotology clinic with a chief complaint of vertigo or disequilibrium, who met the International Classification of Headache Disorders criteria for VM. The prevalence of the Havana subjects experiencing various symptomatic domains was compared with the VM cohort, leading to 26 unique domains and statistical comparisons between the cohorts. Of the 26 domains compared between the two cohorts, 18 were not significantly different. This included the two most important components of meeting criteria for VM, namely the co-existence of headache and vestibular symptoms. On regression analysis, the only feature which kept its significant difference between the two cohorts was acute intense head pressure (P=0.007). The domains with similar occurrence ratios included dizziness, headache, light sensitivity, hearing reduction, and tinnitus. In other words, multiple headache and vestibular symptoms, consistent with VM criteria, were similar between the two cohorts. The considerable similarities across various domains between VM patients and Havana subjects could be due to migraine as a possible common etiology for both groups. We propose VM as a potential etiology for the symptomatology in the U.S. diplomats in Cuba. |
| Databáze: | OpenAIRE |
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