Vertigo Research Today is a free monthly online journal that collates and summarizes the latest research about Vertigo, including details on causes, symptoms, treatment, dizziness. | ||||||
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Suicidal death after injection of a castor bean extract (Ricinus communis L.).Coopman V, De Leeuw M, Cordonnier J, Jacobs W Department of Analytical Toxicology, Chemiphar N.V., Lieven Bauwensstraat 4, B-8200 Brugge, Belgium. The castor bean plant (Ricinus communis L.) or wonder tree is cultivated in many countries as an ornamental annual plant in gardens. The highest concentration of the lectin ricin is present in the seeds and pods. Ricin is considered as one of the most toxic natural poisons. Ricinine is a piperidine alkaloidal toxin present in castor bean and is described as a biomarker for the exposure to ricin. A case report is presented of a 49-year-old man who committed suicide by intravenous and subcutaneous injection of a castor bean extract. He was brought to the emergency department 24 h after injecting himself. On admission, the patient was conscious and he presented with a history of nausea, vomiting, diarrhoea, dyspnoea, vertigo and muscular pain. Despite symptomatic and supportive intensive care, the man died 9 h after admission due to multiorgan failure. A body external examination was performed. Blood, urine, vitreous humour and the castor bean extract were submitted to the laboratory for toxicological analysis. The identification of ricinine in the extract was performed by solid phase extraction in combination with full-scan gas chromatography/mass spectrometry, high-performance liquid chromatography with photodiode array detection and liquid chromatography/mass spectrometry operated in the full-scan mode, respectively. An extraction procedure with Oasis HLB solid phase extraction cartridges was applied. Chromatography was achieved using a Symmetry C18 column using a gradient mode with 0.15% formic acid and 0.15% formic acid in acetonitrile as mobile phase. Exposure to the castor bean extract was confirmed by identification of the biomarker ricinine in blood, urine and vitreous humour using solid phase extraction and liquid chromatography tandem mass spectrometry with electro spray source in positive ionization mode. Multiple reaction monitoring was used for specific detection. To the authors' knowledge, it is the first time that ricinine has been identified in vitreous humour in a case of castor bean poisoning. Based on the clinical symptoms and the results of the toxicological analysis, we concluded that death was caused by intoxication with plant toxins originated from R. communis L. Published 22 June 2009 in Forensic Sci Int, 189(1): e13-20. Articles on Vertigo published 22 June 2009: Chiropractic management of a patient with benign paroxysmal positional vertigo: a case report. J Manipulative Physiol Ther, 32(5): 387-90. OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the ... [Abstract] [Full-text] Articles on Vertigo published 18 June 2009: New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo. J Neurol. This article describes the clinical features of anterior semicircular canal benign paroxysmal positional vertigo (AC-BPPV) and a new therapeutic maneuver for its management. Our study was a retrospective review of cases from an ambulatory tertiary referral center. Thirteen patients afflicted with positional paroxysmal vertigo exhibiting brief positional down-beating nystagmus in positional tests (Dix-Hallpike and head-hanging position) were treated with a maneuver comprised of the following ... [Abstract] [Full-text] Articles on Vertigo published 9 June 2009: Migration of an aneurysm clip to the sacral subarachnoid space. Acta Neurochir (Wien), 151(6): 699-700. CASE REPORT: A 33-year-old woman was admitted for evaluation of vertigo. An unruptured fusiform aneurysm of left distal posterior inferior cerebellar artery was found and presumed to be the cause of her vertigo. The aneurysm was clipped using three clips and then the vertigo was relieved. However, she developed low back pain 53 months after the operation. On plain radiographic examination, a right-angled clip was found at the sacral level. Cerebral angiography revealed two clips remaining at ... [Abstract] [Full-text] Long-term symptoms in dizzy patients examined in a university clinic. BMC Ear Nose Throat Disord, 9: 2. ABSTRACT: BACKGROUND: The long-term course of dizziness was investigated combining medical chart and survey data. The survey was undertaken median (interquartile range (IQR)) 4.6 (4.3) years after the initial medical examination. METHODS: Chart data comprised sex, age, diagnosis, symptom duration, postural sway and neck pain. Survey data comprised symptom severity assessed by the Vertigo Symptom Scale - Short Form (VSS-SF), and data regarding current state of dizziness, medication, neck pain ... [Abstract] [Full-text] Sudden hearing loss from PDE-5 inhibitors: A possible cellular stress etiology. Laryngoscope. OBJECTIVES:: Phosphodiesterase-5 (PDE) inhibitors are a relatively new class of drugs introduced in 1998 for the treatment of erectile dysfunction and pulmonary artery hypertension. Recent concerns regarding these drugs and sudden sensorineural hearing loss (SSHL) have resulted in an FDA requirement for more stringent labeling. In this report, we further investigate the potential link between SSHL and use of these drugs. STUDY DESIGN:: Report of two cases and review of FDA postmarketing data. ... [Abstract] [Full-text] Articles on Vertigo published 8 June 2009: Middle Ear Exploration in Patients With Ménière's Disease Who Have Failed Outpatient Intratympanic Gentamicin Therapy. Otol Neurotol. OBJECTIVE:: Treatment of medically refractory Ménière's disease (MD) with intratympanic (IT) gentamicin has now become a standard therapy. This procedure is effective in controlling vertigo attacks, but approximately 10% of patients do not have an adequate response. The objective of the current study was to evaluate the option of middle ear exploration with direct application of gentamicin to the round window (MEE-G) in patients with persistent MD after transtympanic injection of gentamicin. ... [Abstract] [Full-text] Articles on Vertigo published 4 June 2009: Management of benign paroxysmal positional vertigo. Drug Ther Bull, 47(6): 62-6. In vertigo, people experience an illusion of movement of the environment about them, or of themselves with respect to the environment. Vertigo usually originates in the peripheral nervous system (e.g. due to a disorder of the inner ear) but can, rarely, have a CNS origin (e.g. an intracranial tumour or brainstem lesion). It is commonly due to a peripheral disorder known as 'benign paroxysmal positional vertigo' (BPPV).1 Here we discuss BPPV and the management of patients with the condition, ... [Abstract] [Full-text] Use of canakinumab in the cryopyrin-associated periodic syndrome. N Engl J Med, 360(23): 2416-25. BACKGROUND: The cryopyrin-associated periodic syndrome (CAPS) is a rare inherited inflammatory disease associated with overproduction of interleukin-1. Canakinumab is a human anti-interleukin-1beta monoclonal antibody. METHODS: We performed a three-part, 48-week, double-blind, placebo-controlled, randomized withdrawal study of canakinumab in patients with CAPS. In part 1, 35 patients received 150 mg of canakinumab subcutaneously. Those with a complete response to treatment entered part 2 and ... [Abstract] [Full-text] © 2005-2009 Vertigo Research Today. All Rights Reserved. |
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