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Vestibulopathy

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https://www.readbyqxmd.com/read/28704891/mastoid-vibration-reduces-ipsilesional-shift-of-subjective-visual-horizontal-in-patients-with-acute-stage-of-unilateral-vestibulopathy
#1
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
#2
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
https://www.readbyqxmd.com/read/28614234/motion-based-equilibrium-reprocessing-therapy-a-novel-treatment-method-for-chronic-peripheral-vestibulopathies-a-pilot-study
#3
Mirke S Hondebrink, Agali Mert, Roos van der Lint, J Alexander de Ru, Peter van der Wurff
Rehabilitation for vestibular disease is a safe method to partially alleviate symptoms of vertigo. It was hypothesized that principles of military aviation vestibular desensitization procedures that have a success rate of more than 80% can be extrapolated to chronic vestibular disease as well.The virtual reality motion base computer-assisted rehabilitation environment was used as treatment modality in 17 patients. They were exposed to sinusoidal vertical passive whole body motion in increasing intensity for a maximum of 12 sessions...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28594306/a-pilot-study-investigating-the-association-between-chronic-bilateral-vestibulopathy-and-components-of-a-clinical-functional-assessment-tool
#4
Jaap Swanenburg, Aron Zurbrugg, Dominik Straumann, Stefan C A Hegemann, Antonella Palla, Eling D de Bruin
BACKGROUND: This study aimed to analyze the association between prospectively assessed falls and functional abilities in patients with bilateral vestibulopathy (BVP). METHODS: Nineteen BVP patients had functional abilities assessed at baseline with the expanded timed get-up-and-go (ETGUG) test. Falls were prospectively recorded with a monthly "fall calendar" over a one-year period. Association between baseline functional abilities and falls was evaluated by Mann-Whitney U testing...
June 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28567027/transient-vestibulopathy-in-wallenberg-s-syndrome-pathologic-analysis
#5
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28566179/acute-unilateral-peripheral-vestibulopathy-in-neurosyphilis
#6
Allison S Young, Antonia S Carroll, Miriam S Welgampola, Peter J McCluskey, Sebastian J van Hal, Elizabeth O Thompson, Juliet Burn, Michael J Fulham, G Michael Halmagyi
INTRODUCTION: Neurosyphilis producing basal meningitis presenting as sequential transient cranial nerve palsies was well recognized before the antibiotic era. OBJECTIVE: To report two patients presenting with acute unilateral peripheral vestibulopathy due to syphilitic basal meningitis. RESULTS: In Case 1 basal meningitis occurred early in the secondary phase of the infection, in Case 2 in the late latent phase. The diagnosis was not made immediately in either case; in Case 1 after previous presentation with increasing hearing loss and then with facial palsy and then a subsequent presentation with optic neuritis; in Case 2 after investigation for possible lymphoma...
July 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28561344/bilateral-vestibulopathy-with-positive-tullio-phenomenon
#7
Sigrid Finn, Maren Dietzek, Panagiota Karvouniari, Carsten M Klingner, Rotraud Neumann, Orlando Guntinas-Lichius, Otto W Witte, Hubertus Axer
We describe the case of a 34-year-old patient presenting with the unique combination of bilateral vestibulopathy in combination with noise- and pressure-induced nystagmus. Bilateral vestibular dysfunction was demonstrated by pathological results in video-based head impulse testing as well as in caloric testing. In contrast, cervical vestibular-evoked myogenic potentials were normal, demonstrating normal sacculus function. Due to the positive Tullio phenomenon, semicircular dehiscence syndrome was excluded. Recently, this symptom combination was related to the histopathological finding of vestibular atelectasis...
May 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28555600/audiological-findings-in-charcot-marie-tooth-disease-type-4c
#8
Rafael Sivera, Laura Cavalle, Juan J Vílchez, Carmen Espinós, Herminio Pérez Garrigues, Teresa Sevilla
OBJECTIVE: Charcot-Marie-Tooth disease type 4C (CMT4C) is a hereditary demyelinating early onset neuropathy with prominent unsteadiness and occasional cranial nerve involvement. Vestibulopathy caused by the dysfunction of cranial nerve VIII has been demonstrated in a high percentage of these patients, but the presence and degree of auditory neuropathy are unknown. The aim of the study was to characterize the hearing abnormalities of a series of patients with CMT4C and to determine the presence and severity of auditory neuropathy (AN) in these patients...
April 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28484820/-vertigo-and-dizziness-in-the-emergency-room
#9
REVIEW
A Zwergal, K Möhwald, M Dieterich
Vertigo and dizziness are among the most common chief complaints in the emergency department. Etiologies can be categorized into three subgroups: neurootological (vestibular), medical (especially cardiovascular, metabolic), and psychiatric disorders. The diagnostic approach in the emergency department is based on a systematic analysis of case history (type, time course of symptoms, modulating factors, associated symptoms), clinical examination of the vestibular, ocular motor, and cerebellar systems (head impulse test, nystagmus, skew deviation, positioning maneuver, test of gait and stance), as well as a basal monitoring (vital signs, 12-lead ECG, blood tests)...
June 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28443060/the-vestibular-implant-hearing-preservation-during-intralabyrinthine-electrode-insertion-a-case-report
#10
Raymond van de Berg, Florence Lucieer, Nils Guinand, Joost van Tongeren, Erwin George, Jean-Philippe Guyot, Herman Kingma, Marc van Hoof, Yasin Temel, Jacobus van Overbeeke, Angelica Perez-Fornos, Robert Stokroos
OBJECTIVE: The vestibular implant seems feasible as a clinically useful device in the near future. However, hearing preservation during intralabyrinthine implantation remains a challenge. It should be preserved to be able to treat patients with bilateral vestibulopathy and (partially) intact hearing. This case study investigated the feasibility of hearing preservation during the acute phase after electrode insertion in the semicircular canals. METHODS: A 40-year-old woman with normal hearing underwent a translabyrinthine approach for a vestibular schwannoma Koos Grade IV...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28404567/accidental-hydroxychloroquine-overdose-resulting-in-neurotoxic-vestibulopathy
#11
Peter B Chansky, Victoria P Werth
Hydroxychloroquine is an oral antimalarial medication commonly used off-label for a variety of rheumatological conditions, including systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome and dermatomyositis. We present a case of a 64-year-old woman who presented with acute onset headache, bilateral tinnitus, and left-sided facial numbness and tingling in the setting of accidentally overdosing on hydroxychloroquine. By the next morning, the patient began to experience worsening in the tingling sensation and it eventually spread to her left arm, thigh and distal extremities...
April 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28395427/-etiological-analysis-on-patients-in-department-of-vertigo-and-dizziness-oriented-outpatient
#12
F Li, X G Wang, J H Zhuang, Y Chen, X W Zhou, B Gao, H H Gu
Objective: We aimed to explore the spectrum of causes for patients in department of vertigo and dizziness oriented outpatient, in order to provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods: Retrospective analysis were carried out with clinical data of patients in our department of vertigo and dizziness oriented outpatient. The target group under study was diagnosed based on the uniform diagnostic criteria, and re-visiting patients were excluded. Results: This clinical study was conducted on 5 348 cases, who visited our vertigo and dizziness oriented outpatient from December 2012 to July 2015...
April 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28391373/noisy-galvanic-vestibular-stimulation-an-emerging-treatment-option-for-bilateral-vestibulopathy
#13
Max Wuehr, Julian Decker, Roman Schniepp
Patients with bilateral vestibulopathy (BVP) suffer from persistent imbalance during standing and walking as well as an impaired gaze stabilization during head movements. Disabilities associated with BVP severely compromise patients' daily activities and are often linked to an increased risk of falls. Currently, the only established treatment option in BVP is physical therapy. However, treatment effects of physical therapy in BVP are most often limited and many patients do not adequately recover performance...
April 8, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28352247/refixation-saccades-with-normal-gain-values-a-diagnostic-problem-in-the-video-head-impulse-test-a-case-report
#14
Leise Elisabeth Hviid Korsager, Christian Emil Faber, Jesper Hvass Schmidt, Jens Højberg Wanscher
Refixation saccades with normal gain value occur more frequently with increasing age. The phenomenon has also been observed in different vestibular disorders. In this case, we present a young male with normal gain value and refixation saccades tested with the video head impulse test (vHIT) the day after his cochlear implantation. One month after surgery, refixation saccades were no longer present. This suggests that refixation saccades can occur as a result of temporary pathology such as surgery. Refixation saccades with normal gain values might reflect a partial deficit in the vestibulo-ocular reflex...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28346294/diagnosis-and-treatment-of-vestibular-neuritis-neuronitis-or-peripheral-vestibulopathy-pvp-open-questions-and-possible-answers
#15
Stefan C A Hegemann, Angela Wenzel
: The acute vestibular syndrome is a clinically defined entity consisting of vertigo or dizziness that develops acutely over minutes to hours and is accompanied by nausea/vomiting, gait instability, head motion intolerance, and nystagmus, while persisting over a day or more. When it is caused by a peripheral vestibular lesion and is not associated with clinically manifest auditory deficits, it is mostly labeled vestibular neuritis/neuronitis/neuropathy or sometimes peripheral vestibulopathy. Here, we propose hypotheses and discuss current research advances on viral or vascular factors in the pathogenesis, the recurrence, the site of lesion, old and new treatment options, contraindicated measures, the differential diagnosis, and the prognosis of vestibular neuritis/neuronitis/neuropathy or vestibulopathy...
June 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28265260/role-of-the-patient-s-history-of-vestibular-symptoms-in-the-clinical-evaluation-of-the-bedside-head-impulse-test
#16
Christoph Helmchen, Julia Knauss, Peter Trillenberg, Anita Frendl, Andreas Sprenger
OBJECTIVE: Our aim was to identify the role of the investigators' knowledge of the patient's history of vestibular symptoms (PVH) in the clinical evaluation of the bedside head-impulse test (bHIT). We hypothesized that this knowledge will reduce uncertainty and improve bHIT accuracy when compared to quantitative analysis of the vestibulo-ocular reflex by video head-impulse test (vHIT). METHODS: We looked for changes in the clinical assessment of the bHIT in 594 consecutive patients before and after taking PVH...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28077250/role-of-video-head-impulse-test-in-lateralization-of-vestibulopathy-comparative-study-with-caloric-test
#17
Pona Park, Joo Hyun Park, Ji Soo Kim, Ja-Won Koo
OBJECTIVE: To evaluate the lateralization value of video head-impulse test (vHIT) for the diagnosis of vestibulopathy and to analyze cases showing dissociated results with caloric test. METHODS: In total, 19 healthy volunteers and 92 dizzy patients who underwent both a caloric test and a vHIT were enrolled. Patients were divided into two groups depending on their fluctuating pattern of vertigo. The vestibulo-ocular reflex (VOR) gain and gain asymmetry (GA) of a vHIT as well as unilateral weakness (UW) and the sum of the slow-phase velocities (SPVs) of warm and cold irrigation of the same side were compared...
January 8, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/27941523/3-d-spatial-memory-and-navigation-functions-and-disorders
#18
Thomas Brandt, Andreas Zwergal, Stefan Glasauer
PURPOSE OF REVIEW: The aim of this review is to report on the specialized neuronal systems mediating spatial orientation and navigation discovered in animal experiments. These findings have important implications for the clinical management of patients with vestibular disorders or dementia and for translational research in these fields. RECENT FINDINGS: The following anatomically and functionally separate, but nevertheless cooperative cell types have been characterized: angular head velocity cells and head direction cells, which depend on vestibular input and interact with place cells and grid cells, which represent position and distance...
February 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27878442/clinical-and-neurophysiological-risk-factors-for-falls-in-patients-with-bilateral-vestibulopathy
#19
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
#20
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
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