THE FOLLOWING POST WAS ORIGINALLY POSTED BY JAMES. I JUST COPIED IT AND PASTED IT AS A NEW TOPIC BC I WANTED TO MAKE SURE EVERYONE COULD SEE IT. THANK YOU SO MUCH FOR POSTING THIS JAMES!
Wendy posted this at m.org thought I would cut and paste it here.
As an update, the results of the DUKE research project are being presented in April, 2012, at the Spring meeting of the American Neurotology Society.
Below is the abstract:
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
complaints and clouded mentation
Intervention: Diagnostic lumbar puncture with opening pressure measurement and addition or removal
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