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Vestibulopathy

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https://www.readbyqxmd.com/read/29301160/-pharmacotherapy-of-vestibular-disorders-nystagmus-and-cerebellar-disorders
#1
K Feil, N Böttcher, O Kremmyda, C Muth, J Teufel, A Zwergal, T Brandt, M Strupp
There are currently different groups of drugs for the pharmacotherapy of vertigo, nystagmus and cerebellar disorders: antiemetics; anti-inflammatories, antimenieres, and antimigraineous medications and antidepressants, anticonvulsants, aminopyridines as well as acetyl-DL-leucine. In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but currently there is not sufficient evidence for a general recommendation. There is insufficient evidence to support the view that 16 mg t...
January 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29298741/-posterior-fossa-infarct-misdiagnosed-as-acute-peripheral-vestibulopathy
#2
Karen Stepanidis, Mads Klokker
Patients with acute central vestibular syndrome (AVS) can mimic acute peripheral vestibulopathy, which can mislead to a diagnosis of posterior fossa infarcts. Delayed diagnosis will prevent relevant treatment and may lead to severe disability and in worst case death. Understanding of AVS is extremely relevant for physicians in hospital and prehospital care to insure the right treatment. I this case report of a 35-year-old male patient with AVS the correct diagnosis was made relatively late.
January 1, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29282702/treatment-of-dizziness-an-interdisciplinary-update
#3
Rainer Spiegel, Heiko Rust, Thomas Baumann, Hergen Friedrich, Raoul Sutter, Martina Göldlin, Christiane Rosin, René Müri, Georgios Mantokoudis, Roland Bingisser, Michael Strupp, Roger Kalla
This review provides an update on interdisciplinary treatment for dizziness. Dizziness can have various causes and the treatment offered should depend on the cause. After reading this article, the clinician will have an overview of current treatment recommendations. Recommendations are made for the most prevalent causes of dizziness including acute and chronic vestibular syndromes, vestibular neuritis, benign paroxysmal positional vertigo, endolymphatic hydrops and Menière's disease, vestibular paroxysmia and vestibular migraine, cardiac causes, transient ischaemic attacks and strokes, episodic ataxia type 2, persistent postural-perceptual dizziness, bilateral vestibulopathy, degenerative, autoimmune and neoplastic diseases, upbeat- and downbeat nystagmus...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29282523/amiodarone-associated-bilateral-vestibulopathy
#4
Robert Gürkov, Leonardo Manzari, Alexander Blödow, Angela Wenzel, Dusan Pavlovic, Leonal Luis
BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating disorder characterized by the hypofunction of both vestibular end organs or nerves. The most frequent identifiable causes of BVP are ototoxic drug effects, infectious and autoimmune disorders. The majority of cases, however, remain idiopathic. METHODS: Medical records of patients diagnosed with idiopathic BVP were examined in five dizziness clinics. RESULTS: We identified 126 patients with "idiopathic" BVP...
December 27, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29194214/prediction-of-vestibular-imbalance-in-acute-peripheral-vestibulopathy-by-measuring-horizontal-ocular-deviation-on-magnetic-resonance-imaging
#5
Yeon-Jun Yang, Kun Woo Kim, Ji Eun Choi, Min Young Lee, Dong Soo Yoo, Jae Yun Jung
OBJECTIVES: The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls. STUDY DESIGN: Retrospective review. PATIENTS AND METHODS: A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Horizontal OD was quantified by using the axial T2-weighted fast-spin echo (FSE) images of the brain at 1...
November 29, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29184530/the-video-head-impulse-test-to-assess-the-efficacy-of-vestibular-implants-in-humans
#6
Nils Guinand, Raymond Van de Berg, Samuel Cavuscens, Maurizio Ranieri, Erich Schneider, Floor Lucieer, Herman Kingma, Jean-Philippe Guyot, Angélica Pérez Fornos
The purpose of this study was to evaluate whether it is possible to restore the high-frequency angular vestibulo-ocular reflex (aVOR) in patients suffering from a severe bilateral vestibulopathy (BV) and implanted with a vestibular implant prototype. Three patients (S1-3) participated in the study. They received a prototype vestibular implant with one to three electrode branches implanted in the proximity of the ampullary branches of the vestibular nerve. Five electrodes were available for electrical stimulation: one implanted in proximity of the left posterior ampullary nerve in S1, one in the left lateral and another one in the superior ampullary nerves in S2, and one in the right lateral and another one in the superior ampullary nerves in S3...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29110566/predicting-the-outcome-after-acute-unilateral-vestibulopathy-analysis-of-vestibulo-ocular-reflex-gain-and-catch-up-saccades
#7
Niccolò Cerchiai, Elena Navari, Stefano Sellari-Franceschini, Chiara Re, Augusto Pietro Casani
Objectives (1) To describe the relationships among the main instrumental features characterizing an acute unilateral vestibulopathy and (2) to clarify the role of the video head impulse test in predicting the development of chronic vestibular insufficiency. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Sixty patients suffering from acute unilateral vestibulopathy were retrospectively analyzed: 30 who recovered spontaneously (group 1) and 30 who needed a vestibular rehabilitation program (group 2)...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29089158/cerebellar-ataxia-with-neuropathy-and-vestibular-areflexia-syndrome-canvas
#8
Masakatsu Taki, Takashi Nakamura, Hiraku Matsuura, Tatsuhisa Hasegawa, Hirofumi Sakaguchi, Kanako Morita, Ryotaro Ishii, Ikuko Mizuta, Takashi Kasai, Toshiki Mizuno, Shigeru Hirano
Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS) is a novel ataxic disorder consisting of the triad of cerebellar impairment, bilateral vestibular hypofunction, and a somatosensory deficit. We report the first Japanese case of CANVAS. The patient is a 68-year-old Japanese male. He was referred to our university for further evaluation of progressive gait disturbance and ataxia. He exhibited horizontal gaze-evoked nystagmus and sensory deficit. Nerve conduction studies showed sensory neuronopathy...
October 28, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29084063/central-vertigo
#9
Jeong-Yoon Choi, Seung-Han Lee, Ji-Soo Kim
PURPOSE OF REVIEW: This review considers recent advances in central vertigo in terms of clinical and laboratory features and pathophysiology. RECENT FINDINGS: Strokes presenting dizziness-vertigo are more likely to be associated with a misdiagnosis in the emergency setting. The risk of future strokes after discharge is higher in patients diagnosed with peripheral vertigo than in control patients. Strokes and transient ischemic attacks account for one-quarter of acute transient vestibular syndrome...
February 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29081426/bilateral-vestibulopathy-diagnostic-criteria-consensus-document-of-the-classification-committee-of-the-b%C3%A3-r%C3%A3-ny-society
#10
Michael Strupp, Ji-Soo Kim, Toshihisa Murofushi, Dominik Straumann, Joanna C Jen, Sally M Rosengren, Charles C Della Santina, Herman Kingma
This paper describes the diagnostic criteria for bilateral vestibulopathy (BVP) by the Classification Committee of the Bárány Society. The diagnosis of BVP is based on the patient history, bedside examination and laboratory evaluation. Bilateral vestibulopathy is a chronic vestibular syndrome which is characterized by unsteadiness when walking or standing, which worsen in darkness and/or on uneven ground, or during head motion. Additionally, patients may describe head or body movement-induced blurred vision or oscillopsia...
2017: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/28985517/effect-of-common-antivertiginous-agents-on-the-high-velocity-vestibulo-ocular-reflex
#11
E Anagnostou, P Koutsoudaki, A Stavropoulos, I Evdokimidis
OBJECTIVE: It has long been suggested that antivertiginous medications exert their symptomatic effect through inhibition of the vestibulo-ocular reflex (VOR). We tested this hypothesis by directly measuring the VOR after administration of three agents from different substance classes: an antihistamine, a benzodiazepine and a calcium channel antagonist. METHODS: The gain and the variability of the high velocity VOR was assessed using video head impulses (vHIT) under the following conditions: baseline, after dimenhydrinate, after diazepam and after cinnarizine...
September 19, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28919878/postural-control-in-bilateral-vestibular-failure-its-relation-to-visual-proprioceptive-vestibular-and-cognitive-input
#12
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
https://www.readbyqxmd.com/read/28894988/how-tandem-gait-stumbled-into-the-neurological-exam-a-review
#13
Jason Margolesky, Carlos Singer
Tandem gait testing is an integral part of the neurological exam. It is informative in a wide variety of disorders ranging from cerebellar disease to vestibular and peripheral neuropathies, parkinsonism, and other neurodegenerative conditions. We discuss the history and development of tandem gait testing as well as its technique, utility, and limitations in the assessment of neurological conditions. Tandem gait has emerged as a tool in the assessment of cerebellar disease, Huntington disease, idiopathic Parkinson's disease, atypical parkinsonism, peripheral neuropathies, and vestibulopathies...
September 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28853245/treatment-of-peripheral-vestibular-dysfunction-using-photobiomodulation
#14
Min Young Lee, Jai-Hwan Hyun, Myung-Whan Suh, Jin-Chul Ahn, Phil-Sang Chung, Jae Yun Jung, Chung Ku Rhee
Gentamicin, which is still used in modern medicine, is a known vestibular toxic agent, and various degrees of balance problems have been observed after exposure to this pharmacologic agent. Photobiomodulation is a candidate therapy for vertigo due to its ability to reach deep inner ear organs such as the cochlea. Previous reports have suggested that photobiomodulation can improve hearing and cochlea function. However, few studies have examined the effect of photobiomodulation on balance dysfunction. We used a rat model to mimic human vestibulopathy resulting from gentamicin treatment and evaluated the effect of photobiomodulation on vestibular toxicity...
August 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/28834943/clinical-characteristics-of-benign-recurrent-vestibulopathy-clearly-distinctive-from-vestibular-migraine-and-meni%C3%A3-re-s-disease
#15
Babette F van Esch, Erik van Wensen, Hester J van der Zaag-Loonen, Peter Paul G van Benthem, Roeland B van Leeuwen
OBJECTIVE: We aimed to systematically investigate the clinical characteristics of benign recurrent vestibulopathy (BRV), vestibular migraine (VM), and Menière's disease (MD) and to assess whether clinical symptoms exist that are unique to BRV. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. METHODS: Between January 2015 and November 2016, patients were prospectively recruited at a specialized dizziness clinic...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28806326/recurrent-vestibular-migraine-vertigo-attacks-associated-with-the-development-of-profound-bilateral-vestibulopathy-a-case-series
#16
Jacob L Wester, Akira Ishiyama, Gail Ishiyama
BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating condition characterized by gait ataxia, oscillopsia, and imbalance. OBJECTIVE: Case series of patients with migraine-linked vertigo spells and profound BVP. PATIENT 1:: A 69-year-old man presented with a history of recurrent severe vertigo spells lasting up to 3 days in duration associated with prostrating migraine headaches starting at age 60. His symptoms were misdiagnosed as an anxiety syndrome. At age 68, electronystagmography (ENG) revealed bilaterally absent caloric responses and complete BVP...
September 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28777127/antivertiginous-drug-therapy-does-not-hinder-the-efficacy-of-individualized-vibrotactile-neurofeedback-training-for-vestibular-rehabilitation-a-randomized-trial
#17
Dietmar Basta, Liliana Borsellino, Arne Ernst
Vestibular rehabilitation using individualized vibrotactile neurofeedback training (IVNT) can lead to significant improvement in the postural stability of patients with vestibular symptoms of different origins. However, some of these patients have complex, severe dizziness, meaning that a pharmacological pretreatment or parallel (to vestibular rehabilitation) treatment can help them perform the rehabilitation exercises. Hence, the present study investigated the influence of a pharmacological treatment on the efficacy of vibrotactile neurofeedback training in patients with chronic, noncompensated vestibulopathies...
August 2, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28767021/the-limits-of-stability-in-patients-with-unilateral-vestibulopathy
#18
Rafael Alvarez-Otero, Nicolas Perez-Fernandez
OBJECTIVE: To characterize the stability limits and region in patients with unilateral vestibulopathy according to the side of the lesion and determine if that imposes any bias. To analyze if the stability limits and region depend on the functional deficit as evaluated in the sensory organization test. METHODS: Forty patients with chronic dizziness and without any vertigo spell for least 6 months prior to testing. In all of them, a unilateral vestibulopathy was diagnosed clinically and at vestibular testing...
October 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28704891/mastoid-vibration-reduces-ipsilesional-shift-of-subjective-visual-horizontal-in-patients-with-acute-stage-of-unilateral-vestibulopathy
#19
Kun Woo Kim, Min Young Lee, Jae Yun Jung
BACKGROUND AND OBJECTIVES: To investigate effect of the vibration on subjective visual horizontal (SVH) in patients with acute stage of unilateral vestibulopathy. SUBJECTS AND METHODS: Twenty-five unilateral vestibulopathy patients which analyzed into 42 cases at different time points and suffered from spinning vertigo for more than 24 hours without hearing loss and neurologic abnormality were enrolled. Thirteen subjects with spontaneous nystagmus (>3 degree/sec; averaged symptom onset <1 week) at the time of SVH measurement were classified into the acute unilateral vestibulopathy group (aVU)...
July 2017: Journal of Audiology & Otology
https://www.readbyqxmd.com/read/28696571/acute-evaluation-of-the-acute-vestibular-syndrome-differentiating-posterior-circulation-stroke-from-acute-peripheral-vestibulopathies
#20
REVIEW
Benjamin Kwok-Tung Tsang, Alex Siew-Kar Chen, Mark Paine
This review article aims to provide an evidence-based approach to evaluating the patient who presents with acute prolonged, spontaneous vertigo in the context of the acute vestibular syndrome (AVS). Differentiation of posterior circulation stroke presenting as an acute vestibular syndrome has been regarded as an important diagnostic challenge for physicians involved in acute care. Current evidence suggests that a targeted approach to history taking and physical examination with emphasis on the oculomotor examination, more specifically the HINTS (Head Impulse/ Nystagmus/Test-of-skew) examination battery, yields a higher sensitivity for diagnosis of posterior circulation stroke than even standard magnetic resonance imaging with diffusion weighted imaging...
July 11, 2017: Internal Medicine Journal
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