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Vestibulopathy

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https://www.readbyqxmd.com/read/27878442/clinical-and-neurophysiological-risk-factors-for-falls-in-patients-with-bilateral-vestibulopathy
#1
Roman Schniepp, Cornelia Schlick, Fabian Schenkel, Cauchy Pradhan, Klaus Jahn, Thomas Brandt, Max Wuehr
Patients with bilateral vestibular failure (BVF) exhibit imbalance when standing and walking that is linked to a higher fall risk. The purpose of this study was to identify risk factors for falls in BVF. We therefore systematically investigated the interrelationship of clinical and demographic characteristics, gait impairments, and the fall frequency of these patients. Clinical and demographic characteristics as well as quantitative measures of gait performance on a pressure-sensitive gait carpet were collected from 55 patients with different etiologies of BVF...
November 22, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27871453/chasing-dizzy-chimera-diagnosis-of-combined-peripheral-and-central-vestibulopathy
#2
Seo-Young Choi, Hyo-Jung Kim, Ji-Soo Kim
Diagnosis of combined peripheral and central vestibulopathy remains a challenge since the findings from peripheral vestibular involvements may overshadow those from central vestibular disorders or vice versa. The aim of this study was to enhance detection of these intriguing disorders by characterizing the clinical features and underlying etiologies. We had recruited 55 patients with combined peripheral and central vestibulopathy at the Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2013...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27869225/noisy-galvanic-vestibular-stimulation-induces-a-sustained-improvement-in-body-balance-in-elderly-adults
#3
Chisato Fujimoto, Yoshiharu Yamamoto, Teru Kamogashira, Makoto Kinoshita, Naoya Egami, Yukari Uemura, Fumiharu Togo, Tatsuya Yamasoba, Shinichi Iwasaki
Vestibular dysfunction causes postural instability, which is prevalent in the elderly. We previously showed that an imperceptible level of noisy galvanic vestibular stimulation (nGVS) can improve postural stability in patients with bilateral vestibulopathy during the stimulus, presumably by enhancing vestibular information processing. In this study, we investigated the after-effects of an imperceptible long-duration nGVS on body balance in elderly adults. Thirty elderly participants underwent two nGVS sessions in a randomised order...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27845944/the-vestibular-system-and-cognition
#4
Paul F Smith
PURPOSE OF REVIEW: The last year has seen a great deal of new information published relating vestibular dysfunction to cognitive impairment in humans, especially in the elderly. The objective of this review is to summarize and critically evaluate this new evidence in the context of the previous literature. RECENT FINDINGS: This review will address the recent epidemiological/survey studies that link vestibular dysfunction with cognitive impairment in the elderly; recent clinical investigations into cognitive impairment in the context of vestibular dysfunction, both in the elderly and in the cases of otic capsule dehiscence and partial bilateral vestibulopathy; recent evidence that vestibular impairment is associated with hippocampal atrophy; and finally recent evidence relating to the hypothesis that vestibular dysfunction could be a risk factor for dementia...
November 10, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27814315/compensatory-saccades-in-head-impulse-testing-influence-the-dynamic-visual-acuity-of-patients-with-unilateral-peripheral-vestibulopathy1
#5
V G Wettstein, K P Weber, C J Bockisch, S C Hegemann
BACKGROUND: Both the dynamic visual acuity (DVA) test and the video head-impulse test (vHIT) are fast and simple ways to assess peripheral vestibulopathy. After losing peripheral vestibular function, some patients show better DVA performance than others, suggesting good compensatory mechanisms. It seems possible that compensatory covert saccades could be responsible for improved DVA. OBJECTIVE: To investigate VOR gain and compensatory saccades with vHIT and compare them to the DVA of patients with unilateral peripheral vestibulopathy...
November 3, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27766472/delayed-vestibulopathy-after-heat-exposure
#6
Ileok Jung, Seo-Young Choi, Hyo-Jung Kim, Ji-Soo Kim
Even though dizziness is a common symptom of heat illness, comprehensive evaluation of the vestibular function has not been available in this potentially life-threatening disorder. Three patients developed vertigo about a week after heat exposure. Evaluation showed bilateral impairments of the vestibulo-ocular reflex during head impulses and the signs of vestibulocerebellar dysfunction that included spontaneous downbeat nystagmus, gaze-evoked nystagmus, and positional downbeat nystagmus. Exposure to excessive heat may give rise to delayed vestibulopathy by damaging the vestibulocerebellum...
October 20, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27747687/prolonged-neuropsychiatric-symptoms-in-a-military-service-member-exposed-to-mefloquine
#7
Jeffrey Livezey, Thomas Oliver, Louis Cantilena
A 32-year-old male developed neuropsychiatric symptoms 2 weeks after starting mefloquine 250 mg/week for malaria prophylaxis. He continued to take the medication for the next 4 months. Initial symptoms included vivid dreams and anxiety, as well as balance problems. These symptoms persisted and progressed over the next 4 years to include vertigo, emotional lability, and poor short-term memory, which have greatly affected his personal and professional life. An extensive evaluation revealed objective evidence supporting a central vestibulopathy...
December 2016: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27735223/associations-between-bipedal-stance-stability-and-locomotor-stability-following-a-trip-in-unilateral-vestibulopathy
#8
Christopher McCrum, Katrin Eysel-Gosepath, Gaspar Epro, Kenneth Meijer, Hans H C M Savelberg, Gert-Peter Brüggemann, Kiros Karamanidis
Posturography is used to assess balance in clinical settings, but its relationship to gait stability is unclear. We assessed if dynamic gait stability is associated with standing balance in 12 patients with unilateral vestibulopathy. Participants were unexpectedly tripped during treadmill walking and the change in the margin of stability (MoSchange) and base of support (BoSchange) relative to non-perturbed walking was calculated for the perturbed and first recovery steps. The centre of pressure (COP) path during 30s stance with eyes open and closed, and the distance between the most anterior point of the COP and the anterior BoS boundary during forward leaning (ADist) were assessed using a force plate...
October 13, 2016: Journal of Applied Biomechanics
https://www.readbyqxmd.com/read/27673096/poster-343-posterior-circulation-stroke-with-secondary-vestibulopathy-a-case-report
#9
Jared R Levin, Olivera D Pekovic
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27638075/bilateral-vestibulopathy
#10
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
https://www.readbyqxmd.com/read/27624122/altered-processing-of-otolithic-information-in-isolated-lateral-medullary-infarction
#11
Hyo-Jung Kim, Seoyeon Kim, Jae Han Park, Ji-Soo Kim
Ocular and cervical vestibular-evoked myogenic potentials (VEMPs) evaluate the function of otolithic pathways in central as well as peripheral vestibular disorders. This study aimed to determine the associations and dissociations of otolithic dysfunction in lateral medullary infarction (LMI), the most well-known disorder of central vestibulopathy. At the Dizziness Clinic of a referral-based University Hospital, 45 patients with isolated LMI (28 men, mean age = 55.6 ± 12.5) had evaluation of the ocular tilt reaction (OTR), tilt of the subjective visual vertical (SVV), and ocular and cervical VEMPs from Janurary 2011 to August 2015 during the acute phase, 1-11 days from the symptom onset (median = 2 days)...
December 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27576326/cerebellar-infarction-and-factors-associated-with-delayed-presentation-and-misdiagnosis
#12
Zeljka Calic, Cecilia Cappelen-Smith, Craig S Anderson, Wei Xuan, Dennis J Cordato
BACKGROUND AND PURPOSE: The diagnosis of cerebellar infarction (CBI) is often challenging due to non-specific or subtle presenting symptoms and signs. We aimed to determine whether a common syndromic cluster of symptoms, signs or vascular risk factors were associated with delayed presentation or misdiagnosis to an Emergency Department (ED). The degree of misdiagnosis between ED and neurology physicians and the influence of delayed presentation or misdiagnosis on outcome were also investigated...
2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27552387/bilateral-vestibulopathy-aggravates-balance-and-gait-disturbances-in-sensory-ataxic-neuropathy-dysarthria-and-ophthalmoparesis-a-case-report
#13
Roeland B van Leeuwen, Bart W Smits, Richard J Rodenburg, Baziel G van Engelen
In patients with a triad of sensory ataxic neuropathy, dysarthria, and ophthalmoparesis (SANDO), the presenting features are mainly ataxia or ptosis. SANDO patients often have impaired balance and gait, which is not surprising considering the combination of sensory ataxic neuropathy, and additional symptoms like cerebellar ataxia and limb girdle weakness. We describe a SANDO patient who noticed an increasingly impaired balance and gait, without any dizziness. Neurological investigation revealed an external ophthalmeplegia and a cerebellar ataxia; the head impulse test was not reliable because of eye movement disorders...
September 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27417055/disease-specific-sparing-of-the-anterior-semicircular-canals-in-bilateral-vestibulopathy
#14
Alexander A Tarnutzer, Christopher J Bockisch, Elena Buffone, Stefan Weiler, Lucas M Bachmann, Konrad P Weber
OBJECTIVE: Bilateral vestibular loss (BVL) is often diagnosed with great delay and an underlying cause is only identified in 50-80%. We measured horizontal and vertical semicircular canal function using the video-head-impulse test (vHIT) and hypothesized that specific vHIT-patterns may be linked to certain etiologies. METHODS: We retrospectively analyzed 109 BVL-patients linked to aminoglycoside vestibulotoxicity (n=16), Menière's disease (n=10), infectious inner-ear disorders (n=11), sensorineural hearing-loss (n=11), cerebellar-ataxia-neuropathy-vestibular-areflexia-syndrome (CANVAS, n=5), other causes (n=19) as well as those with unknown origin (n=47)...
August 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27392835/about-the-pathophysiology-of-acute-unilateral-vestibular-deficit-vestibular-neuritis-vn-or-peripheral-vestibulopathy-pvp
#15
Denis S Uffer, Stefan C A Hegemann
OBJECTIVE: To determine whether patients with acute unilateral peripheral vestibulopathy (PVP), often called "vestibular neuritis/neuronitis or neuropathy" (VN) have a vestibular lesion pattern consistent with the distribution of the neurological afferents. BACKGROUND: Much is known about the clinical nature of PVP, however less so about its etiology and pathogenesis. Due to the frequency with which VN is used to describe the syndrome, an inflammation of the vestibular nerve or of one of its branches is often assumed to be the cause of PVP, though there is insufficient data so far to support this assumption...
July 2, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27374754/discrepancies-between-video-head-impulse-and-caloric-tests-in-patients-with-enlarged-vestibular-aqueduct
#16
Jinsei Jung, Michelle J Suh, Sung Huhn Kim
OBJECTIVE: We performed the video head impulse test (vHIT) and caloric test in patients with enlarged vestibular aqueducts (EVA). We compared the results with those found in Ménière's disease (MD) and acute vestibular neuritis to clarify the characteristics of vestibular dysfunction in EVA and to suggest reasons for the discrepancy between the vHIT and caloric tests in endolymphatic hydrops. STUDY DESIGN: Retrospective analysis. METHODS: Ten patients with EVA and confirmed biallelic SLC26A4 genetic mutations were enrolled...
July 4, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27251884/a-new-saccadic-indicator-of-peripheral-vestibular-function-based-on-the-video-head-impulse-test
#17
Hamish G MacDougall, Leigh A McGarvie, G Michael Halmagyi, Stephen J Rogers, Leonardo Manzari, Ann M Burgess, Ian S Curthoys, Konrad P Weber
OBJECTIVE: While compensatory saccades indicate vestibular loss in the conventional head impulse test paradigm (HIMP), in which the participant fixates an earth-fixed target, we investigated a complementary suppression head impulse paradigm (SHIMP), in which the participant is fixating a head-fixed target to elicit anticompensatory saccades as a sign of vestibular function. METHODS: HIMP and SHIMP eye movement responses were measured with the horizontal video head impulse test in patients with unilateral vestibular loss, patients with bilateral vestibular loss, and in healthy controls...
July 26, 2016: Neurology
https://www.readbyqxmd.com/read/27234349/m%C3%A3-ni%C3%A3-re-s-disease-and-underlying-medical-and-mental-conditions-towards-factors-contributing-to-the-disease
#18
Shwan Mohamed, Imran Khan, Stamatina Iliodromiti, Margaret Gaggini, Georgios Kontorinis
PURPOSE OF THE STUDY: To investigate the relation of Ménière's disease (MD) with medical comorbidity or mental conditions. PROCEDURES: Demographic data, medical and mental comorbidities were retrospectively collected and compared from 3 groups of 30 patients each: a group with patients with definite MD, a second one with patients with vestibulopathies other than MD (non-Ménière's vertigo, NMV) and a third one with patients without any vestibular symptoms (control)...
2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/27166786/visual-and-proprioceptive-contributions-to-postural-control-of-upright-stance-in-unilateral-vestibulopathy
#19
Katrin Eysel-Gosepath, Christopher McCrum, Gaspar Epro, Gert-Peter Brüggemann, Kiros Karamanidis
Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support. Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesized that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects...
June 2016: Somatosensory & Motor Research
https://www.readbyqxmd.com/read/27164706/noisy-vestibular-stimulation-improves-dynamic-walking-stability-in-bilateral-vestibulopathy
#20
Max Wuehr, Eva Nusser, Julian Decker, Siegbert Krafczyk, Andreas Straube, Thomas Brandt, Klaus Jahn, Roman Schniepp
OBJECTIVE: To examine the effects of imperceptible levels of white noise galvanic vestibular stimulation (nGVS) on dynamic walking stability in patients with bilateral vestibulopathy (BVP). METHODS: Walking performance of 13 patients with confirmed BVP (mean age 50.1 ± 5.5 years) at slow, preferred, and fast speeds was examined during walking with zero-amplitude nGVS (sham trial) and nonzero-amplitude nGVS set to 80% of the individual cutaneous threshold for GVS (nGVS trial)...
June 7, 2016: Neurology
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