Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder characterized by intense dizziness often triggered by sudden head movements. Certain dental and maxillofacial surgeries may induce BPPV due to vibrational trauma from instrumentation, extended hyperflexion of the head, and existing vestibular conditions. This study aimed to analyze certain oral and maxillofacial surgical procedures associated with BPPV and evaluate prevention and treatment strategies. A review of relevant literature was conducted through Google Scholar and an extensive search on PubMed for the period 2005-2020 using the keywords "BPPV" and "benign paroxysmal positional vertigo." Articles were screened up to the 2564th listing, focusing on cases of postsurgical BPPV. Eight studies were included and analyzed, including case reports, retrospective analyses, and literature reviews. The procedures that led to BPPV in these studies include sinus floor elevation, maxillary implant placement, third molar extractions, and orthognathic surgery. Factors that contributed to the development of BPPV include surgical trauma, use of osteotomes, abnormal head positioning, and preexisting vestibular conditions. Although postoperative BPPV is typically self-limiting, treatment may involve physical rehabilitation (Epley maneuver) or pharmacotherapy (benzodiazepines, antihistamines). Analysis of the studies revealed that treatment considerations may include referral to an ear, nose, and throat practitioner for management; careful review of the patient's medical history; proper patient positioning; and cautious use of osteotomes. Although BPPV is a rare complication, surgeons should be aware of its potential implications to mitigate unnecessary development of BPPV and management of the condition. Further research is needed on the optimal prevention, treatment, and patient management strategies.

The National Institutes of Health Stroke Scale is the most widely used bedside scale for assessing neurological deficit severity in acute stroke and guiding early clinical decision-making. However, it has important limitations in posterior circulation stroke, particularly in cases involving the brainstem and cerebellum. Because posterior circulation ischemic stroke often presents with vertigo, nystagmus, truncal ataxia, bulbar dysfunction, and other cranial nerve-related symptoms, the conventional National Institutes of Health Stroke Scale may underestimate the initial severity of neurological impairment. This under-recognition can delay escalation of diagnostic evaluation and compromise prognostic stratification. This review specifically focuses on posterior circulation ischemic stroke because currently available posterior circulation-oriented derivatives of the National Institutes of Health Stroke Scale have been developed and clinically evaluated mainly in ischemic stroke cohorts. Recent studies suggest that the expanded National Institutes of Health Stroke Scale improves sensitivity to posterior circulation deficits missed by the conventional scale, whereas posterior circulation-specific tools such as the Posterior National Institutes of Health Stroke Scale and the Peoria Posterior Fossa Stroke Scale may further improve structured bedside assessment and prognostic stratification. Nevertheless, the evidence base remains limited by the small number of validation studies, lack of large multicenter external validation, and incomplete standardization of item definitions and scoring procedures. Future studies should focus on rigorous validation, standardization, and integration of these scales with imaging and clinical workflow to improve recognition and risk assessment in posterior circulation ischemic stroke.

A 77 year old female smoker with history of Polymyalgia Rheumatica and Sarcoidosis presented to hospital with a two day history of fever, nausea, gait ataxia, and new bilateral intention tremor. After admission, she was noted to become rigid with features of parkinsonism and subsequently developed worsening weakness with inability to follow appendicular commands. MRI brain showed midbrain and thalamic infiltration, with CSF findings of markedly elevated WBC, elevated protein, and West Nile IgM. Her condition worsened over the following eleven days to include fulminant flaccid paralysis and neurogenic shock requiring ICU transfer despite empiric treatment with standard of care therapies. Worsening shock refractory to vasopressors, persisting GCS of 3, and rising lactate with acute renal failure prompted family and clinicians to pursue palliative measures. She died with family at bedside 13 days after admission.

Headache, dizziness and vertigo are non-specific but frequently reported symptoms in patients with hypertension. When evaluating headache, clinicians must systematically exclude primary headache disorders - such as migraine, tension-type headache and trigeminal autonomic cephalalgias - before attributing symptoms to hypertension. If a primary headache is suspected, referral to a neurologist is essential for specialized management. Hypertension-related headache must fulfil specific diagnostic criteria, including a high blood pressure level (≥180/120mmHg), a demonstrated causal relationship through temporal association and symptom relief following antihypertensive treatment. Whereas severe hypertension combined with headache (e.g. malignant or accelerated hypertension, grade 3 or 4 hypertensive retinopathy) requires urgent attention, the long-term prognosis of patients with recurrent symptoms does not appear to be negatively impacted. Dizziness, often described as lightheadedness, unsteadiness or a floating sensation, must be distinguished from vertigo, which is characterized by an illusion of movement, typically rotatory. In patients with hypertension, vertigo necessitates a thorough evaluation to rule out neurological and vestibular aetiologies, in collaboration with neurologists and ear, nose and throat specialists. These patients require meticulous blood pressure monitoring because of their increased risk of cardiovascular death, particularly from stroke.

Vestibular disorders are common conditions requiring specialized evaluation. This pilot study aimed to assess the feasibility of a rule-based mobile screening classifier for six ICVD-defined vestibular disorders and to compare its top-two candidate outputs with clinical diagnoses made by an experienced otologist. In this prospective, single-center pilot evaluation, 86 participants (65 females, mean age 59.9 ± 15.7 years) presenting with vestibular symptoms at a specialized clinic completed a 47-item questionnaire using a tablet device and underwent a comprehensive clinical evaluation including history taking and otologic and neurologic examination by an experienced otologist. The performance of the mobile classifier was measured by comparing its top two candidate outputs against the expert reference diagnoses. The mobile classifier demonstrated an overall classification accuracy of 82.1%, with 51.2% of cases completely correct and 30.9% partially correct. For vascular vertigo specifically, the screening branch showed an accuracy of 82.7%. Participants completed the questionnaire in an average time of 7.24 minutes. These pilot findings support the feasibility of the rule-based mobile classifier as an initial screening aid for prevalent vestibular disorders. External multi-center validation in independent cohorts will be required before the tool can be regarded as a clinically validated screening instrument.

Vertigo is a debilitating vestibular disorder affecting approximately 10-30% of the global population, yet no dedicated computational chemistry study has systematically characterised the properties of its pharmacological agents using machine learning. In this study, we present the first Quantitative Structure-Property Relationship (QSPR) analysis of 47 clinically established anti-vertigo drugs using nine Neighborhood degree-based topological indices, combined with three machine learning algorithms such as Ridge Regression, Random Forest (RF) and Gradient Boosting Regression (GBM). The topological indices were correlated with five key properties like Molecular Weight, Complexity, Molar Refractivity, Polarizability, and Molar Volume, using Pearson correlation analysis. All 47 index-property correlations were statistically significant at p < 0.0001. Molecular weight (MW) had the highest correlation with ND5 index (R = 0.9684), while molar refractivity (MR) and polarizability had their strongest correlations with NH index (R = 0.9672, R = 0.9673), respectively. Complexity had the highest correlation with the forgotten index (R=0.9477), where Molar Volume had highest correlation with the index NH (R= 0.9152). Within the machine-learning model analysis, GBM achieved the most accurate predictions for MW(R[2]=0.9757), complexity(R[2]=0.7975), polarizability(R[2]=0.9652), and molar volume (R[2]=0.9456), while RF was superior to other models in terms of the accuracy of the prediction of MR (R[2]=0.9648). Additionally, LOO-CV was used to evaluate model validity and returned Q[2] above the minimum level for each of the Molecular Weight (Q[2]=0.9283), Polarizability (Q[2]=0.9192), Molar Refractivity (Q[2]=0.9189), Complexity (Q[2]=0.8753), and Molar Volume (Q[2]=0.7633) models. This study provides a validated computational framework for rapid predictions of physicochemical properties and drug discovery for future vestibular drugs.