Evidence map›Paper›PMID 25795644›Full record

SynthesisNeurology2015

Clinical and electrographic findings in epileptic vertigo and dizziness: a systematic review.

Alexander A Tarnutzer, Seung-Han Lee, Karen A Robinson, Peter W Kaplan, David E Newman-Toker

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.

  1. Pooled it
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  16. Genes important for otoneurological diagnostic purposes - current status and future prospects.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2018
    Review
  17. Review
  18. Vestibular paroxysmia: Diagnostic criteria.Journal of vestibular research : equilibrium & orientation · 2016
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Alexander A TarnutzerFrom the Department of Neurology (A.A.T.), University Hospital Zurich and the University of Zurich, Switzerland; the Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju, South Korea; the Departments of Medicine (K.A.R.), Neurology (D.E.N.-T.), and Otolaryngology Head & Neck Surgery (D.E.N.-T.), The Johns Hopkins University School of Medicine; and the Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD. alexander.tarnutzer@access.uzh.ch.
Seung-Han LeeFrom the Department of Neurology (A.A.T.), University Hospital Zurich and the University of Zurich, Switzerland; the Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju, South Korea; the Departments of Medicine (K.A.R.), Neurology (D.E.N.-T.), and Otolaryngology Head & Neck Surgery (D.E.N.-T.), The Johns Hopkins University School of Medicine; and the Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD.
Karen A RobinsonFrom the Department of Neurology (A.A.T.), University Hospital Zurich and the University of Zurich, Switzerland; the Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju, South Korea; the Departments of Medicine (K.A.R.), Neurology (D.E.N.-T.), and Otolaryngology Head & Neck Surgery (D.E.N.-T.), The Johns Hopkins University School of Medicine; and the Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD.
Peter W KaplanFrom the Department of Neurology (A.A.T.), University Hospital Zurich and the University of Zurich, Switzerland; the Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju, South Korea; the Departments of Medicine (K.A.R.), Neurology (D.E.N.-T.), and Otolaryngology Head & Neck Surgery (D.E.N.-T.), The Johns Hopkins University School of Medicine; and the Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD.
David E Newman-TokerFrom the Department of Neurology (A.A.T.), University Hospital Zurich and the University of Zurich, Switzerland; the Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju, South Korea; the Departments of Medicine (K.A.R.), Neurology (D.E.N.-T.), and Otolaryngology Head & Neck Surgery (D.E.N.-T.), The Johns Hopkins University School of Medicine; and the Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD.
Chonnam National University · KRUniversity Hospital of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSeizures can cause vestibular symptoms, even without obvious epileptic features. We sought to characterize epileptic vertigo or dizziness (EVD) to improve differentiation from nonepileptic causes, particularly when vestibular symptoms are the sole manifestation.

methodsWe conducted a systematic review with electronic (Medline) and manual search for English-language studies (1955-2014). Two independent reviewers selected studies. Study/patient characteristics were abstracted. We defined 3 study population types: (1) seizures, some experiencing vertigo/dizziness (disease cohort); (2) vertigo/dizziness, some due to seizures (symptom cohort); (3) vertigo/dizziness due to seizures in all patients (EVD-only cohort).

resultsWe identified 84 studies describing 11,354 patients (disease cohort = 8,129; symptom cohort = 2,965; EVD-only cohort = 260). Among 1,055 EVD patients in whom a distinction could be made, non-isolated EVD was present in 8.5%, isolated EVD in 0.8%. Thorough diagnostic workups (ictal EEG, vestibular testing, and brain MRI to exclude other causes) were rare (<0.1%). Ictal EEG was reported in 487 (4.3%), formal neuro-otologic assessment in 1,107 (9.7%). Localized EEG abnormalities (n = 350) were most frequently temporal (79.8%) and uncommonly parietal (11.8%). Duration of episodic vestibular symptoms varied, but was very brief (<30 seconds) in 69.6% of isolated EVD and 6.9% of non-isolated EVD.

conclusionsNon-isolated EVD is much more prevalent than isolated EVD, which appears to be rare. Diagnostic evaluations for EVD are often incomplete. EVD is primarily associated with temporal lobe seizures; whether this reflects greater epidemiologic prevalence of temporal lobe seizures or a tighter association with dizziness/vertigo presentations than with other brain regions remains unknown. Consistent with clinical wisdom, isolated EVD spells often last just seconds, although many patients experience longer spells.

Indexed as

DizzinessEpilepsyHumansVertigo

Identifiers

PMID25795644
PMCPMC4408281
OpenAlexW2138874576

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.