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bilateral otolithic

Andreas Sprenger, Jann F Wojak, Nico M Jandl, Christoph Helmchen
Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance...
2017: Frontiers in Neurology
Catherine de Waele, Qiwen Shen, Christophe Magnani, Ian S Curthoys
OBJECTIVE: We examined the eye movement response patterns of a group of patients with bilateral vestibular loss (BVL) during suppression head impulse testing. Some showed a new saccadic strategy that may have potential for explaining how patients use saccades to recover from vestibular loss. METHODS: Eight patients with severe BVL [vestibulo-ocular reflex (VOR) gains less than 0.35 and absent otolithic function] were tested. All patients were given the Dizziness Handicap Inventory and questioned about oscillopsia during abrupt head movements...
2017: Frontiers in Neurology
Elie Hammam, Vaughan G Macefield
We review the existence of vestibulosympathetic reflexes in humans. While several methods to activate the human vestibular apparatus have been used, galvanic vestibular stimulation (GVS) is a means of selectively modulating vestibular afferent activity via electrodes over the mastoid processes, causing robust vestibular illusions of side-to-side movement. Sinusoidal GVS (sGVS) causes partial entrainment of sympathetic outflow to muscle and skin. Modulation of muscle sympathetic nerve activity (MSNA) from vestibular inputs competes with baroreceptor inputs, with stronger temporal coupling to the vestibular stimulus being observed at frequencies remote from the cardiac frequency; "super entrainment" was observed in some individuals...
2017: Frontiers in Neurology
Yu-Juan Zhou, Yong-Zhen Wu, Ning Cong, Jing Yu, Jun Gu, Jing Wang, Fang-Lu Chi
OBJECTIVE: To analyze and summarize the effect of bilateral large vestibular aqueducts in peripheral vestibular organ function. METHODS: Eighteen patients with bilateral large vestibular aqueduct syndrome (LVAS; Study Group) and 18 healthy volunteers (Control Group) were investigated using audiometry, caloric test, sensory organization test (SOT), and vestibular-evoked myogenic potential (VEMP) tests. RESULTS: All 18 patients (36 ears) exhibited sensorineural hearing loss...
August 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Michel Toupet, Christian Van Nechel, Charlotte Hautefort, Ulla Duquesne, Sylvie Heuschen, Alexis Bozorg Grayeli
INTRODUCTION: We aimed to study the participation of proprioceptive and visual inputs in subjective visual vertical (SVV) in bilateral vestibular hypofunction and in normal subjects. STUDY DESIGN: Prospective case-control study. SETTING: Tertiary referral center. MATERIALS AND METHODS: SVV (six replicates) was measured on a tiltable rehabilitation seat in 26 adult patients with idiopathic bilateral vestibular hypofunction (IBVH) and 33 adult controls...
August 2017: Otology & Neurotology
Koeun Lim, Faisal Karmali, Keyvan Nicoucar, Daniel M Merfeld
When making perceptual decisions, humans have been shown to optimally integrate independent noisy multisensory information, matching maximum-likelihood (ML) limits. Such ML estimators provide a theoretic limit to perceptual precision (i.e., minimal thresholds). However, how the brain combines two interacting (i.e., not independent) sensory cues remains an open question. To study the precision achieved when combining interacting sensory signals, we measured perceptual roll tilt and roll rotation thresholds between 0 and 5 Hz in six normal human subjects...
May 1, 2017: Journal of Neurophysiology
M Strupp, K Feil, M Dieterich, T Brandt
The leading symptoms of bilateral vestibulopathy (BVP) are postural imbalance and unsteadiness of gait that worsens in darkness and on uneven ground. There are typically no symptoms while sitting or lying under static conditions. A minority of patients also have movement-induced oscillopsia, in particular while walking. The diagnosis of BVP is based on a bilaterally reduced or absent function of the vestibulo-ocular reflex (VOR). This deficit is diagnosed for the high-frequency range of the angular VOR by a bilaterally pathologic bedside head impulse test (HIT) and for the low-frequency range by a bilaterally reduced or absent caloric response...
2016: Handbook of Clinical Neurology
J M Furman
The natural stimulus for the semicircular canals is rotation of the head, which also might stimulate the otolith organs. Vestibular stimulation usually induces eye movements via the vestibulo-ocular reflex (VOR). The orientation of the subject with respect to the axis of rotation and the orientation of the axis of rotation with respect to gravity together determine which labyrinthine receptors are stimulated for particular motion trajectories. Rotational testing usually includes the measurement of eye movements via a video system but might use a subject's perception of motion...
2016: Handbook of Clinical Neurology
B Devroede, I Pauwels, S-D Le Bon, J Monstrey, A-L Mansbach
INTRODUCTION: An early acquired or congenital absence of sensory input of the vestibule will lead to severe delayed posturomotor milestones. Previous studies have proven modifications and even complete ipsilateral loss of vestibular function after unilateral cochlear implantation. The objective of this study was to evaluate whether sequential cochlear implantation has an impact on vestibular function. METHODS: Retrospective study from January 2012 to January 2015 including 26 patients...
June 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Modupe Oyewumi, Nikolaus E Wolter, Elise Heon, Karen A Gordon, Blake C Papsin, Sharon L Cushing
OBJECTIVES: 1) To determine if bilateral vestibular dysfunction can be predicted by performance on standardized balance tasks in children with sensorineural hearing loss (SNHL) and cochlear implants (CI). 2) To provide clinical recommendations for screening for vestibular impairment in children with SNHL. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary care pediatric implant center. PATIENTS: Pediatric patients (4...
August 2016: Otology & Neurotology
Bart B G T Alberts, Luc P J Selen, Giovanni Bertolini, Dominik Straumann, W Pieter Medendorp, Alexander A Tarnutzer
Inferring object orientation in the surroundings heavily depends on our internal sense of direction of gravity. Previous research showed that this sense is based on the integration of multiple information sources, including visual, vestibular (otolithic), and somatosensory signals. The individual noise characteristics and contributions of these sensors can be studied using spatial orientation tasks, such as the subjective visual vertical (SVV) task. A recent study reported that patients with complete bilateral vestibular loss perform similar as healthy controls on these tasks, from which it was conjectured that the noise levels of both otoliths and body somatosensors are roll-tilt dependent...
July 1, 2016: Journal of Neurophysiology
Derek M Miller, James F Baker, W Zev Rymer
OBJECTIVE: Aberrant vestibular nuclear function is proposed to be a principle driver of limb muscle spasticity after stroke. Although spasticity does not manifest in ocular muscles, we sought to determine whether altered cortical modulation of ascending vestibuloocular pathways post-stroke could impact the excitability of ocular motoneurons. METHODS: Nineteen chronic stroke survivors, aged 49-68 yrs. were enrolled. Vestibular evoked myogenic potentials (VEMPs) were recorded from the inferior oblique muscles of the eye using surface EMG electrodes...
April 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Mehti Salviz, Turgut Yuce, Hurtan Acar, Isil Taylan, Gulsah Acar Yuceant, Abdullah Karatas
Overlaps can be seen between vestibular migraine (VM) Ménière's Disease (MD) and diagnosis is difficult if hearing is normal. We aimed to investigate the sacculo-collic pathway in VM patients, MD patients, and healthy controls to define the diagnostic role of cervical VEMP (cVEMP). VEMP testing in response to 500 Hz and 1000 Hz air-conducted tone burst (TB) stimulation was studied prospectively in 22 subjects with definite VM (according to Bárány nomenclature), 30 subjects with unilateral definite MD, and 18 volunteers matched healthy controls...
2016: Journal of Vestibular Research: Equilibrium & Orientation
Xiaowei Zhou, Youjun Yu, Ziming Wu, Xinjian Liu, Xianbing Chen
OBJECTIVE: To explore the roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo (BPPV) by vestibular evoked myogenic potential (VEMP) test. METHOD: We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMP tests, including cervical vestibular evoked myogenic potential (cVEMP and ocular vestibular evoked myogenic potential (oVEMP) tests...
September 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Eui-Joong Kim, Sun-Young Oh, Ji Soo Kim, Tae-Ho Yang, Si-Young Yang
To evaluate utricular and saccular function during the acute and resolved phases of BPPV, ocular and cervical vestibular evoked myogenic potentials (VEMPs) were studied in 112 patients with BPPV and 50 normal controls in a referral-based University Hospital. Ocular (oVEMPs) and cervical VEMPs (cVEMPs) were induced using air-conducted sound (1000Hz tone burst, 100dB normal hearing level) at the time of initial diagnosis and 2 months after successful repositioning in patients with BPPV, and the results were compared with those of the controls...
November 15, 2015: Journal of the Neurological Sciences
Rodrigo Souza Ribeiro, Melissa Marques Pereira, José Luiz Pedroso, Pedro Braga-Neto, Orlando Graziani Povoas Barsottini, Gilberto Mastrocola Manzano
INTRODUCTION: Machado-Joseph disease is defined as an autosomal dominant ataxic disorder caused by degeneration of the cerebellum and its connections and is associated with a broad range of clinical symptoms. The involvement of the vestibular system is responsible for several symptoms and signs observed in the individuals affected by the disease. We measured cervical and ocular vestibular evoked myogenic potentials in a sample of Machado-Joseph disease patients in order to assess functional pathways involved...
November 15, 2015: Journal of the Neurological Sciences
Qing Zhang, Xinda Xu, Min Xu, Juan Hu, Jianmin Liang, Kimitaka Kaga
OBJECTIVE: To observe the ocular vestibular evoked myogenic potential (oVEMP) and the cervical vestibular evoked myogenic potential (cVEMP) in patients with vestibular diseases. METHOD: From March, 2011 to March, 2012, 13 patients (14 ears) with peripheral vestibular diseases were recruited. Each patient underwent conventional oVEMP and cVEMP examinations elicited by intensive air conducted sound (short tone burst, 500 Hz) in bilateral ears. RESULT: Thirteen cases (14 ears) were included in this study...
January 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Nikolaus E Wolter, Karen A Gordon, Blake C Papsin, Sharon L Cushing
OBJECTIVE: To determine the role of vestibular and balance dysfunction in children with cochlear implant (CI) failure. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty-five children with CI failure were compared to 165 children who did not experience CI failure. MAIN OUTCOME MEASURES: Vestibular function was compared between groups by horizontal canal function (measured by caloric, rotational, video Head Impulse Testing [vHIT]), saccular function (vestibular evoked myogenic potentials [VEMP]), and balance (measured by Bruininks-Oseretsky Test [BOT-2])...
July 2015: Otology & Neurotology
Daniel Q Sun, Mohamed Lehar, Chenkai Dai, Lani Swarthout, Amanda M Lauer, John P Carey, Diana E Mitchell, Kathleen E Cullen, Charles C Della Santina
Bilateral vestibular deficiency (BVD) due to gentamicin ototoxicity can significantly impact quality of life and result in large socioeconomic burdens. Restoring sensation of head rotation using an implantable multichannel vestibular prosthesis (MVP) is a promising treatment approach that has been tested in animals and humans. However, uncertainty remains regarding the histopathologic effects of gentamicin ototoxicity alone or in combination with electrode implantation. Understanding these histological changes is important because selective MVP-driven stimulation of semicircular canals (SCCs) depends on persistence of primary afferent innervation in each SCC crista despite both the primary cause of BVD (e...
June 2015: Journal of the Association for Research in Otolaryngology: JARO
Simon I Angeli, Hillary Snapp, Sandra Velandia, Kari Morgenstein
CONCLUSIONS: Although combined utricular and canal paresis has been described previously, this is the first report of canal hyperactivity associated with utricular hypofunction. Unsteadiness and swaying were the most common symptoms, and patients with shorter duration of symptoms also had positional vertigo. We propose that this syndrome is a variant of utricular dysfunction and should be considered in the differential diagnosis of peripheral vestibular disorders. OBJECTIVE: To describe a syndrome of instability associated with utricular dysfunction and hyperactive caloric responses...
April 2015: Acta Oto-laryngologica
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