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Objective To explore the clinical features of benign paroxysmal positional vertigo (BPPV) in patients of 40 years old or younger. Methods The clinical features of 40 patients (age ≤40 years) with BPPV admitted from August 2009 to July 2011 were retrospectively analyzed, and compared with that of 286 middle and old-aged patients (age >40 years) with BPPV admitted in the same period. Results The incidence of BPPV in young patients showed a relatively higher incidence (12.3%), with the sex ratio of male to female 1:3 and a mean age of 32.1±6.2 years. The mean latent period of vertigo attack was 1.2±1.3 seconds, and 10 patients (25%) showed no obvious latent period. The median duration of vertigo was 10s. The posterior semicircular canal was involved in 27 patients (67.5%). Cupulolithiasis was found in 6 patients, and all the otolithiasis was found to involve the posterior semicircular canal. The proportion of BPPV with no obvious latency was higher in the young patients than in the middle and old-aged patients (25.0% vs 11.5%, χ2=5.554, P=0.018), but no significant difference in sex ratio, the course of disease, the ratio of involved semicircular canal, the latency and the duration of vertigo attack was found between two groups (P>0.05). Conclusions The incidence of BPPV is relatively higher in youth, more common in females, and the posterior semicircular canal is commonly involved. Compared with the middle and old-aged patients with BPPV, the proportion patients with no obvious latency of vertigo attack in young patients is higher, and the incidence of cupulolithiasis involving posterior semicircular canal is higher in the youth.

Objective To assess the clinical application of Loewenstein Occupational Therapy Cognitive Assessment(LOTCA) in evaluating the impairment of cognition in elderly patients with type 2 diabetes(DM2).Methods Community based 58 elderly patients with DM2 in a community in Shanghai(60 years and older,having received education for 9 years or longer) were enrolled and screened by Mini-Mental State Examination(MMSE).According to the MMSE scores,21 subjects were assigned to case group(MMSE score < 24,implying cognition impairment),and 37 to control group(MMSE score ≥ 24,implying normal cognition).Meanwhile,a group of community-based 40 elderly subjects without DM2(60 years or older,having received education for 9 years or longer,and MMSE score ≥ 24) were enrolled as the blank control.Difference among the baseline data(age,sex ratio and incidence of hypertension) among the 3 groups mentioned above was negligible.The cognition function was assessed with the LOTCA,and the scores acquired were then compared among the 3 groups.Results The total LOTCA scores showed significant difference among the 3 groups.Each LOTCA score,except the score of perception subtest(object identification),was lower in case group than in control and blank group.In control group,the scores were lower than in blank group of the subtest of perception(object constancy),visual-motor organization test and the subtests thereof(reproduction of two-dimensional models,colored and plain block design construction,and reproduction of a puzzle),thinking operation test and the subtests thereof(ROC unstructured,pictorial sequence B,and geometrical sequence),and of concentration test.Conclusions Cognitive impairment may occur in the early stage of elderly patients with DM2.In comparison with MMSE scale,LOTCA is superior in measuring the cognitive impairment during the early stage of elderly DM2 patients and stratifying the severity of the impairment.