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Proposal for a new diagnosis for U.S. diplomats in Havana, Cuba, experiencing vestibular and neurological symptoms
- Source :
- Med Hypotheses
- Publication Year :
- 2020
- Publisher :
- eScholarship, University of California, 2020.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Med Hypotheses
- Accession number :
- edsair.doi.dedup.....0fefb95dd059a3da2d216214446187cf