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Journal articles on the topic 'Vestibular examinations'
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van de Berg, Raymond, Sally Rosengren, and Herman Kingma. "Laboratory examinations for the vestibular system." Current Opinion in Neurology 31, no. 1 (February 2018): 111–16. http://dx.doi.org/10.1097/wco.0000000000000526.
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Choi, Woo Young, and Daniel R. Gold. "Vestibular Disorders: Pearls and Pitfalls." Seminars in Neurology 39, no. 06 (December 2019): 761–74. http://dx.doi.org/10.1055/s-0039-1698752.
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AbstractDizziness and vertigo are symptoms that commonly lead patients to seek neurologic or emergency care. Because symptoms are often vague and imprecise, a systematic approach is essential. By categorizing vestibular disorders based on the timing, triggers, and duration of symptoms, as well as emphasizing focused ocular motor and vestibular examinations, the majority of vestibular diagnoses can be made at the bedside. This paper will discuss the pearls and pitfalls in the history and examination of the most common acute, episodic, and chronic vestibular disorders.
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Heinze, B. M., B. M. Vinck, and D. W. Swanepoel. "Does the human immunodeficiency virus influence the vestibulocollic reflex pathways? A comparative study." Journal of Laryngology & Otology 128, no. 9 (August 28, 2014): 772–79. http://dx.doi.org/10.1017/s0022215114001996.
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AbstractBackground:This study compared vestibulocollic reflex and vestibulo-ocular reflex functioning in subjects with and without human immunodeficiency virus. It also described test results throughout progression of the disease and compared the results of human immunodeficiency virus positive subjects who were receiving antiretroviral therapies with those not receiving this treatment.Methods:Subjects comprised 53 adults with human immunodeficiency virus (mean age 38.5 ± 4.4 years) and 38 without human immunodeficiency virus (mean age 36.9 ± 8.2 years). Clinical examinations included cervical vestibular-evoked myogenic potential and bithermal caloric testing.Results:Abnormal cervical vestibular-evoked myogenic potential and caloric results were significantly higher in the human immunodeficiency virus positive group (p = 0.001), with an odds ratio of 10.2. Vestibulocollic reflex and vestibulo-ocular reflex involvement increased with progression of the disease. There were more abnormal test results in subjects receiving antiretroviral therapies (66.7 per cent) than in those not receiving antiretroviral therapies (63.6 per cent), but this difference was insignificant.Conclusion:Human immunodeficiency virus seems to influence vestibulocollic reflex pathways. Combining cervical vestibular-evoked myogenic potential and caloric testing may be useful to detect early neurological involvement in human immunodeficiency virus positive subjects.
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Combs, J., A. Puskar, N. Blaney, M. Collins, and A. Kontos. "Preliminary Examinations of Concussion in Older Adults." Archives of Clinical Neuropsychology 34, no. 5 (July 2019): 768. http://dx.doi.org/10.1093/arclin/acz026.38.
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Abstract Purpose This study sought to investigate whether concussion in older adults improves through evaluating their performance on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Vestibular/Ocular-Motor Screen (VOMS) across visits and to describe and better characterize concussion in this at-risk population. Methods We conducted a retrospective review of medical records for 69 older adult patients (40 females, 29 males) that presented to a concussion specialty clinic. Participants averaged 64.71 (SD=4.1) years in age and presented within 6-998 days of injury (SD=170.9). Demographics and clinical data were recorded at intake through last appointment. Descriptive analysis, including frequencies, means, and standard deviations were performed as well as paired T-test to compare mean scores for first and last visit. Statistical significance was determined by two-sided p-values <.05. Results Twenty out of 69 participants (29%) reported a previous concussion. Concussion symptom severity scores at participants’ first clinic visit averaged 56.19 (SD=26.56) compare with 39.51 (SD=25.53) at their final clinic visit. When comparing ImPACT data, all scores improved comparatively from Visit 1 to Last Visit (P values =0.000-0.014); all VOMS total scores improved as well (P =0.00-0.047). The most frequent primary profile among participants was Vestibular (31.9%). Conclusion Older adults diagnosed with concussion showed improvement on ImPACT scores and their symptom severity scores decreased. The most frequent primary concussion profile at initial visit was Vestibular. Further research with this at-risk population is needed.
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Carey, J. P., T. Cooper, G. I. Jallo, B. S. Carson, and M. Guarnieri. "Ototoxicity of Carboplatin Delivered Locally in a Monkey Brainstem." International Journal of Toxicology 24, no. 6 (November 2005): 443–49. http://dx.doi.org/10.1080/10915810500368951.
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Ototoxicity is a common side effect of platinum-based chemotherapy. Intratumoral drug delivery theoretically could reduce the ototoxic effects of systemic drug infusions. However, local delivery to central nervous system (CNS) tumors might promote ototoxicity through drug release into cerebrospinal fluid (CSF). This report describes an examination of the cytoarchitecture of vestibular cells of cynomolgus monkeys that had chronic brainstem infusions with the maximum tolerated dose (MTD) of carboplatin. The brainstems of adult monkeys were infused for 30 days at 0.42 μl/h with 0.025 to 0.25 mg/kg (MTD) of carboplatin. The vestibular sensory epithelia of eight drug-treated animals were isolated for microscopic examination of vestibular hair cells and support cells. Local infusions produced chronic elevated CSF levels of platinum, neurological symptoms, and radiographic evidence of pontine injury. Histology revealed significant cell damage at the infusion sites. Microscopic examinations of vestibular support cells and hair cells demonstrate a small reduction in cell counts in the drug-treated monkeys compared to a noninfused control animal. Parametric and nonparametric tests show no effect of dose in predicting the vestibular cell counts. In this single study of eight monkeys, a dose-dependent reduction of vestibular hair cells or support cells was not observed in animals infused with brainstem infusions of 0.025 to 0.25 mg/kg of carboplatin.
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Jacobson, Gary P., Devin L. McCaslin, Sarah L. Grantham, and Erin G. Piker. "Significant Vestibular System Impairment Is Common in a Cohort of Elderly Patients Referred for Assessment of Falls Risk." Journal of the American Academy of Audiology 19, no. 10 (November 2008): 799–807. http://dx.doi.org/10.3766/jaaa.19.10.7.
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Background: Falls in elderly patients are associated with morbidity, mortality, and cost to the health-care system. The development of falls risk assessment programs have represented a method of responding to what is known about injurious falls. The multidimensional assessments involve the comparison against normative data of a patient's performance on metrics known to influence the likelihood of future falls. The factors assessed usually include falls and medication history, measures of mentation, depression, orthostatic hypotension, simple or choice reaction time, gait stability, postural stability, and the integrity of the patient's vision, somesthetic, and vestibular senses. Purpose: This investigation was conducted to measure the proportion of patients referred for falls risk assessment who have evidence of vestibular system impairment. Research Design: Qualitative, retrospective review of data collected from 2003 to 2007. Study Sample: The cohort was 185 consecutive patients referred for multidimensional assessments of falls risk. Data Collection and Analysis: Patients underwent quantitative assessments of peripheral and central vestibular system function consisting of electro- or videonystagmography (i.e., ENG/VNG), and sinusoidal harmonic acceleration testing. Results of these tests were compared to normative data. Results: We found that 73% of the sample who underwent vestibular system assessment had quantitative evidence of either peripheral or central vestibular system impairment. Conclusions: Our results suggest that quantitative assessments of the vestibulo-ocular reflex should be conducted on patients who are evaluated for falls risk. These examinations should include at least caloric testing and, where available, rotational testing.
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Park, HongJu, JungEun Shin, YongSoo Jeong, HiBoong Kwak, and YeoJin Lee. "Lessons From Follow-Up Examinations in Patients With Vestibular Neuritis." Otology & Neurotology 30, no. 6 (September 2009): 806–11. http://dx.doi.org/10.1097/mao.0b013e3181b0ff1b.
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Johkura, Ken, Yosuke Kudo, Yu Amano, and Koji Takahashi. "Vestibular examinations in apogeotropic positional nystagmus caused by cerebellar tumor." Neurological Sciences 36, no. 6 (January 23, 2015): 1051–52. http://dx.doi.org/10.1007/s10072-015-2086-4.
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Pan, Qi, Yixin Zhang, Ting Long, Wei He, Shanshan Zhang, Yulan Fan, and Jiying Zhou. "Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic." European Neurology 79, no. 5-6 (2018): 287–94. http://dx.doi.org/10.1159/000489639.
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Background: Dizziness and vertigo are frequent complaints of outpatients in the neurological department. Our objective was to explore the epidemiological category and clinical features of patients with dizziness or vertigo in the neurological outpatient department of a tertiary hospital. Methods: We consecutively recruited all patients with dizziness and/or vertigo visiting the neurological outpatient clinic of the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2017. All patients were interviewed by 4 neurologists and they completed self-administered questionnaires. General physical and standardized neuro-otology bedside examinations were performed in all participants. Instrumental examinations and other related examinations were prescribed as needed. Results: A total of 392 patients, 272 female and 120 male, were enrolled and the ratio of males to females was 1: 2.27. The mean age was 52.39 ± 13.87 years (range 11–90). Elderly patients (≥60 years) accounted for about one-third of the patients. Peripheral vestibular disorders accounted for 54.6% of patients, central vestibular disorders (including vestibular migraine [VM]) accounted for 22.4% of patients, psychogenic vertigo in 64 (16.3%), other reasons in 9 (2.3%) and unknown in 17 (4.3%). Benign paroxysmal positional vertigo (BPPV; 30.8%), psychiatric dizziness (20.5%), and VM (14.4%) were the 3 major vestibular diseases in patients under 60 years of age; however, BPPV (27.9%), central vertigo (21.7%), and Meniere’s disease (11.7%) were more common in patients over 60 years of age. Conclusions: This study provided a classification and clinical features of vestibular disorders in a neurological outpatient department of a tertiary hospital in China. The spectrum of vertigo or dizziness is different between different age groups and clinicians should pay attention to this difference in clinical reasoning.
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Emami, Seyede Faranak, Akram Pourbakht, Kianoush Sheykholeslami, Mohammad Kamali, Fatholah Behnoud, and Ahmad Daneshi. "Vestibular Hearing and Speech Processing." ISRN Otolaryngology 2012 (February 14, 2012): 1–7. http://dx.doi.org/10.5402/2012/850629.
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Vestibular hearing in human is evoked as a result of the auditory sensitivity of the saccule to low-frequency high-intensity tone. The objective was to investigate the relationship between vestibular hearing using cervical vestibular-evoked myogenic potentials (cVEMPs) and speech processing via word recognition scores in white noise (WRSs in wn). Intervention comprised of audiologic examinations, cVEMPs, and WRS in wn. All healthy subjects had detectable cVEMPs (safe vestibular hearing). WRSs in wn were obtained for them (66.9 ± 9.3% in the right ears and 67.5 ± 11.8% in the left ears). Dizzy patients in the affected ears, had the cVEMPs abnormalities (insecure vestibular hearing) and decreased the WRS in wn (51.4 ± 3.8% in the right ears and 52.2 ± 3.5% in the left ears). The comparison of the cVEMPs between the subjects revealed significant differences (P < 0.05). Therefore, the vestibular hearing can improve the speech processing in the competing noisy conditions.
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Pan, P., J. Huang, C. Morioka, G. Hathout, and S. M. El-Saden. "Cost analysis of vestibular schwannoma screening with contrast-enhanced magnetic resonance imaging in patients with asymmetrical hearing loss." Journal of Laryngology & Otology 130, no. 1 (September 14, 2015): 21–24. http://dx.doi.org/10.1017/s0022215115002431.
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AbstractBackground:Vestibular schwannomas are a rare cause of asymmetrical hearing loss, and routine screening with magnetic resonance imaging can be costly. This paper reports results on vestibular schwannoma screening at our institution and compares the cost of screening to a utility of hearing benefit.Method:All screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss between 2006 and 2011 were retrospectively reviewed. The cost per new vestibular schwannoma diagnosis was calculated. The cost per patient for those who benefitted from intervention was estimated based on rates of hearing preservation reported in the literature.Results:Forty-five (4.3 per cent) of 1050 screening examinations with magnetic resonance imaging performed for asymmetrical hearing loss were positive for vestibular schwannoma, and the cost per new diagnosis was $11 436. The estimated screening cost per patient for those who benefitted from surgery or radiation was $147 030, while US federal compensation for unilateral hearing loss was $44 888.Conclusion:Although we achieved a lower screening cost per new diagnosis than reported in the current literature, there remains disparity between the screening cost per benefitted patient and the ‘benefit’ of hearing.
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Dallan, I., S. Berrettini, E. Neri, and A. P. Casani. "Bilateral, isolated, lateral semicircular canal malformation without hearing loss." Journal of Laryngology & Otology 122, no. 8 (May 20, 2008): 858–60. http://dx.doi.org/10.1017/s0022215108002740.
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AbstractHypothesis:Inner-ear malformations are frequently found in patients with sensorineural hearing loss. However, isolated anomalies of the vestibular part of the inner ear are seldom described, and for this reason their impact on balance is poorly understood.Care report:We present the case of a 38-year-old Caucasian man with recurrent vestibular complaints, with a sensation of linear tilting, but no hearing impairment. Clinical and neuro-otological examinations showed peripheral involvement of the vestibular system, while audiological investigation was within normal limits. High-resolution magnetic resonance imaging of the inner ear, with three-dimensional reconstruction, demonstrated isolated vestibular anomalies involving both the lateral semicircular canal and the utricle.Conclusions:Bearing in mind this case, we speculate that isolated vestibular malformation may not be as rare as previously thought, and should be investigated with the aid of sophisticated imaging techniques. A review of the relative literature, focussing attention on the molecular aspects, is also reported.
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Asai, Masatsugu, Yukio Watanabe, Naoki Ohashi, and Kanemasa Mizukoshi. "Evaluation of Vestibular Function by Dynamic Posturography and Other Equilibrium Examinations." Acta Oto-Laryngologica 113, sup504 (January 1993): 120–24. http://dx.doi.org/10.3109/00016489309128136.
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Bauch, Christopher D., Wayne O. Olsen, Susan G. Lynn, Carl C. Reading, and Allan J. D. Dale. "Penetrating Injury to the Brainstem After a Nailgun Accident." American Journal of Audiology 8, no. 1 (June 1999): 57–64. http://dx.doi.org/10.1044/1059-0889(1999/003).
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Nonfatal penetrating injuries to the brainstem offer a unique opportunity to assess subcortical auditory pathway function. A case study of a patient suffering a severe nailgun accident is presented. Hearing sensitivity and acoustic reflexes were normal bilaterally, but word recognition was reduced for one ear. Auditory brainstem response results indicated waves I–IV were present bilaterally, but wave V was absent bilaterally. Results of vestibular findings indicated central pathology also. Results of audiologic, vestibular, radiologic, neurologic, and physical medicine examinations are discussed.
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Staab, Jeffrey P. "Persistent Postural-Perceptual Dizziness." Seminars in Neurology 40, no. 01 (January 14, 2020): 130–37. http://dx.doi.org/10.1055/s-0039-3402736.
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AbstractPersistent postural-perceptual dizziness (PPPD) was defined for the International Classification of Vestibular Disorders in 2017. It is a chronic vestibular disorder that manifests with waxing and waning symptoms of dizziness, unsteadiness, or nonspinning vertigo that last for 3 months or more and are exacerbated by upright posture, active or passive motion of self, and exposure to environments with complex or moving visual stimuli. Triggers of PPPD include a wide variety of conditions that may cause vestibular symptoms or disrupt balance functioning, including neuro-otologic and other medical conditions and psychological distress. The diagnosis is made by identifying key symptoms in patients' histories and conducting physical examinations and diagnostic testing of sufficient detail to establish PPPD as opposed to other illnesses. Ongoing research is providing insights into the pathophysiological mechanisms underlying PPPD and support for multimodality treatment plans incorporating specially adapted vestibular rehabilitation, serotonergic medications, and cognitive-behavior therapy.
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Volf, Petr, Patrik Kutílek, Jiří Hozman, Rudolf Černý, Tomáš Koukolík, and Jan Hejda. "SYSTEM FOR MEASURING KINEMATICS OF VESTIBULAR SYSTEM MOVEMENTS IN NEUROLOGICAL PRACTICE." Acta Polytechnica 56, no. 4 (August 31, 2016): 336–43. http://dx.doi.org/10.14311/ap.2016.56.0336.
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The article deals with the design of a system for studying kinematics of movement of the vestibular system. Up to now there has not existed a system which would enable to measure the kinematic quantities of movement of the individual parts of the vestibular system within its coordinate system. The proposed system removes these deficiencies by suitable positioning of five gyro-accelerometric units on the helmet. The testing of the system took place under two conditions, during Unilateral Rotation on Barany Chair and Head Impulse Test. During the testing, the system justified its application because the results show that the kinematic quantities of the movement of the left and right labyrinths of the vestibular system differ. The introduced device is mainly intended for application in clinical neurology with the aim to enable the physician to measure all linear and angular accelerations of the vestibular system during medical examinations.
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Abou-Elew, M. H., N. A. Hosni, E. A. Obaid, and A. H. Ewida. "The N3 potential and the efferent cochlear pathway in profound sensorineural hearing loss." Journal of Laryngology & Otology 131, no. 4 (February 28, 2017): 334–40. http://dx.doi.org/10.1017/s0022215117000317.
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AbstractObjective:This study aimed to evaluate the presence of the N3 potential (acoustically evoked short latency negative response) in profound sensorineural hearing loss, its association with the cervical vestibular evoked myogenic potential and the relationship between both potentials and loss of auditory function.Methods:Otological examinations of 66 ears from 50 patients aged from 4 to 36 years were performed, and the vestibular evoked myogenic potential and auditory brainstem response were measured.Results:The N3 potential was recorded in 36 out of 66 ears (55 per cent) and a vestibular evoked myogenic potential was recorded in 34 (52 per cent). The N3 potential was recorded in 23 out of 34 ears (68 per cent) with a vestibular evoked myogenic potential response and absent in 19 out of 32 ears (59 per cent) without a vestibular evoked myogenic potential response. The presence of an N3 potential was significantly associated with a vestibular evoked myogenic potential response (p = 0.028), but there was no significant difference in the latency or amplitude of the N3 potential in either the presence or absence of a vestibular evoked myogenic potential.Conclusion:The presence of an N3 potential in profound sensorineural hearing loss with good or poor vestibular function can be explained by the contribution of the efferent cochlear pathway through olivocochlear fibres that join the inferior vestibular nerve. This theory is supported by its early latency and reversed polarity, which is masked in normal hearing by auditory brainstem response waves.
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Makuszewska, Maria. "Congenital Cholesteatoma of Petrous Apex – case report and review of literature." Polski Przegląd Otorynolaryngologiczny 6, no. 1 (March 30, 2017): 62–67. http://dx.doi.org/10.5604/01.3001.0009.7991.
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Objective: Congenital cholesteatomas of the petrous apex are rare lesions that develop insidiously, which delays diagnosis and requires a high index of suspicion. A case report of supralabyrinthine congenital petrous bone cholesteatoma and review of recent literature are presented. Methods: A 27-year-old woman presented with progressive facial palsy. Otomicroscopy did not reveal any abnormalities, and hearing was normal. Although there were no complaints of vertigo or instability, vestibular examinations indicated a non-compensated peripheral vestibular lesion. Radiological examinations revealed a lesion in the petrous apex and epitympanum that had features of a cholesteatoma. Results: To preserve normal hearing, the middle fossa approach was chosen for surgery. A damaged part of the facial nerve was reconstructed with cable graft. Conclusion: Advances in radiological imaging facilitate surgical planning, and improvements in the techniques of lateral skull base surgery enable safe and radical removal of petrous bone cholesteatomas with minimal morbidity.
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Fujiwara, Keishi, Shinya Morita, Kimiko Hoshino, Atsushi Fukuda, Yuji Nakamaru, and Akihiro Homma. "Evaluation of Vestibular Functions in Patients with Vogt-Koyanagi-Harada Disease." Audiology and Neurotology 22, no. 3 (2017): 190–95. http://dx.doi.org/10.1159/000481426.
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Vogt-Koyanagi-Harada (VKH) disease is an idiopathic, multisystem autoimmune disorder characterized by bilateral, diffuse granulomatous uveitis associated with neurological, audiovestibular, and dermatological manifestations. The purpose of this study is to investigate vestibular functions in patients with VKH disease. A total of 43 patients with VKH disease in Hokkaido University Hospital were enrolled in this study. Subjective symptoms such as dizziness or vertigo and the results of various vestibular examinations including nystagmus testing, caloric testing, and vestibular-evoked myogenic potential (VEMP) testing were investigated. Eight of 42 patients (19.0%) complained of subjective vestibular symptoms. On the other hand, 12 of 28 patients (42.9%) showed nystagmus, and 7 of 15 patients (46.7%) showed unilateral or bilateral weakness in the caloric test. VEMP testing was performed for 16 patients. Seven (43.8%) and 8 (50.0%) patients were evaluated as abnormal in cervical VEMP and ocular VEMP testing, respectively. The rate of detection of nystagmus was significantly higher than that of subjective symptoms. As vestibular dysfunction in patients with VKH disease cannot be detected through history taking alone, nystagmus testing, caloric testing, and VEMP testing should be performed to evaluate vestibular functions associated with VKH disease. It is considered that abnormal VEMP findings are associated with otolith organ dysfunction.
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Duarte, Juliana Antoniolli, Elisa Morais Leão, Daniel Sobral Fragano, Germana Jardim Marquez, Anna Paula Batista de Ávila Pires, Maria Laura Solferini Silva, and Fernando Freitas Ganança. "Vestibular Syndromes in Childhood and Adolescence." International Archives of Otorhinolaryngology 24, no. 04 (February 27, 2020): e477-e481. http://dx.doi.org/10.1055/s-0039-3402443.
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Abstract Introduction The prevalence of vestibular disorders in childhood ranges from 0.4% to 15%; they may be the result of several factors, but most of the time it's an episodic vestibular syndrome related to migraine equivalents. Objective To evaluate the diagnostic and therapeutic aspects of children with vestibular signs and symptoms. Methods The present cross-sectional study evaluated data from the records of patients treated in an outpatient pediatric neurotology clinic over a 10-year period. These data included sociodemographic and clinical variables, results of complementary examinations, the treatment provided, and the clinical evolution. Results The sample was composed of 117 patients, with 54.7% of female subjects with a mean age of 10 years. The most prevalent diagnosis was benign paroxysmal vertigo of childhood (BPVC) (41.9%), followed by vestibular migraine (16.2%). The most prevalent complaint was vertigo (53.9% of the cases). Most patients (66.7%) had inadequate eating habits. Improvement of symptoms was observed in 40.4% of the patients treated with dietary guidance alone. In 80% of the cases, dietary counseling in combination with vestibular rehabilitation therapy achieved therapeutic success without the need of a drug treatment. Conclusion The predominant diagnosis was of BPVC, and its close relationship with the personal and family history of migraine, its benign evolution, and the importance of dietary guidance and vestibular rehabilitation for therapeutic success were observed.
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Sasaki, Osamu, and Kiichiro Taguchi. "Vestibular Compensation in Patients with Bilateral Vestibular Loss Assessed by Static and Kinetic Equilibrium Examinations. Body Sway Research No.39." Equilibrium Research 52, no. 4 (1993): 513–23. http://dx.doi.org/10.3757/jser.52.513.
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Lee, JH, MS Kim, and BR Park. "Vestibular end organ injury induced by middle ear treatment with ferric chloride in rats." Human & Experimental Toxicology 36, no. 2 (July 11, 2016): 146–59. http://dx.doi.org/10.1177/0960327116639365.
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Sensorineural hearing loss, ataxia, pyramidal signs, and vestibular deficits characterize superficial siderosis of the central nervous system. This study investigated changes in vestibular function, free radical formation, and phosphorylated cJun expression in the vestibular end organs after middle ear treatment with a ferric chloride (FeCl3) solution. A single injection of 70% FeCl3 solution into the unilateral middle ear cavity caused static vestibular symptoms, such as spontaneous nystagmus and head tilt. Asymmetric expression of c-Fos protein was observed in the bilateral vestibular nuclei and prepositus hypoglossal nuclei within 6 h after injection. Histopathologic examinations revealed partial hair cell loss, degeneration of the supporting stroma, and terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells in the neuroepithelial layer of the crista ampullaris in FeCl3-treated animals. 5-(And-6)-chloromethyl-2′,7′-dichlorodihydrofluorescein diacetate, acetyl ester and diaminofluorescein–2 diacetate fluorescence and immunoreactivity for nitrotyrosine increased markedly in the sensory neuroepithelial layer and nerve bundles of the crista ampullaris after 2 h. Strong immunoreactivity for phospho-cJun and cJun was observed in the type I hair cells of the crista ampullaris 120 h after injection. Thus, a single short-term treatment with a high concentration of FeCl3 in the unilateral middle ear cavity can induce activation of intracellular signals for cJun protein and oxidative stress through the formation of reactive oxygen species and nitric oxide in vestibular sensory receptors, resulting in vestibular dysfunction. These results suggest that activation of intracellular signals for cJun protein and oxidative stress may be a key component of the pathogenesis of vestibular deficits in patients with superficial siderosis.
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Arbogast, Kristy B., Allison E. Curry, Kristina B. Metzger, Ronni S. Kessler, Jeneita M. Bell, Juliet Haarbauer-Krupa, Mark R. Zonfrillo, Matthew J. Breiding, and Christina L. Master. "Improving Primary Care Provider Practices in Youth Concussion Management." Clinical Pediatrics 56, no. 9 (May 19, 2017): 854–65. http://dx.doi.org/10.1177/0009922817709555.
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Primary care providers are increasingly providing youth concussion care but report insufficient time and training, limiting adoption of best practices. We implemented a primary care–based intervention including an electronic health record–based clinical decision support tool (“SmartSet”) and in-person training. We evaluated consequent improvement in 2 key concussion management practices: (1) performance of a vestibular oculomotor examination and (2) discussion of return-to-learn/return-to-play (RTL/RTP) guidelines. Data were included from 7284 primary care patients aged 0 to 17 years with initial concussion visits between July 2010 and June 2014. We compared proportions of visits pre- and post-intervention in which the examination was performed or RTL/RTP guidelines provided. Examinations and RTL/RTP were documented for 1.8% and 19.0% of visits pre-intervention, respectively, compared with 71.1% and 72.9% post-intervention. A total of 95% of post-intervention examinations were documented within the SmartSet. An electronic clinical decision support tool, plus in-person training, may be key to changing primary care provider behavior around concussion care.
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Teggi, R., L. O. Piccioni, G. Martino, C. Bellini, and M. Bussi. "Stiff-person syndrome with acute recurrent peripheral vertigo: possible evidence of gamma aminobutyric acid as a neurotransmitter in the vestibular periphery." Journal of Laryngology & Otology 122, no. 6 (August 1, 2007): 636–38. http://dx.doi.org/10.1017/s0022215107000205.
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AbstractObjective:We report a case of a 58-year-old man suffering from stiff-person syndrome and recurrent peripheral vertigo.Method:A case report and a review of the recent literature on stiff-person syndrome are presented.Results:The patient presented with recurrent episodes of vertigo with a pure peripheral pattern and with concomitant episodes of burning muscle pain, muscle twitching, weight gain and fatigue, worsening with tension or stress that also occurred in periods without vertigo. Cochlear examinations only showed presbyacusis-like hearing loss. The diagnosis of stiff-person syndrome was made with electromyographic examination and from findings in the blood and cerebrospinal fluid of high titres of anti-glutamic acid decarboxylase (GAD67) autoantibodies. In a two-year follow-up period, therapy for stiff-person syndrome abolished episodes of both stiffness and vertigo.Conclusion:As far as we know, no other clinical case of acute vestibular damage with a possible correlation with anti-glutamic acid decarboxylase antibodies has been described. Peripheral vertigo possibly related to a lack of gamma aminobutyric acid underlines a possible role of gamma aminobutyric acid as a neurotransmitter in the peripheral vestibular system.
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Emami, Seyede Faranak, and Nasrin Gohari. "The Vestibular-Auditory Interaction for Auditory Brainstem Response to Low Frequencies." ISRN Otolaryngology 2014 (March 31, 2014): 1–5. http://dx.doi.org/10.1155/2014/103598.
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Since saccular projection is sound sensitive, the objective is to investigate the possibility that the saccular projections may contribute to auditory brainstem response to 500 HZ tone burst (ABR500 HZ). During the case-control research, twenty healthy controls compared to forty selected case groups as having chronic and resistant BPPV were evaluated in the audiology department of Hamadan University of Medical Sciences (Hamadan, Iran). Assessment is comprised of audiologic examinations, cervical vestibular evoked myogenic potentials (cVEMPs), and ABR500 HZ. We found that forty affected ears of BPPV patients with decreased vestibular excitability as detected by abnormal cVEMPs had abnormal results in ABR500 HZ, whereas unaffected ears presented normal findings. Multiple comparisons of mean p13, n23 latencies, and peak-to-peak amplitudes between three groups (affected, unaffected, and healthy ears) were significant. In conclusion, the saccular nerves can be projective to auditory bundles and interact with auditory brainstem response to low frequencies. Combine the cVEMPs and ABR500 HZ in battery approach tests of vestibular assessment and produce valuable data for judgment on the site of lesion. Regarding vestibular cooperation for making of wave V, it is reasonable that the term of ABR500 HZ is not adequate and the new term or vestibular-auditory brainstem response to 500 HZ tone burst is more suitable.
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Razakov, Azamat, Abdumannap Abdukayumov, Shavkat Amanov, Nargiza Karimova, and Jakhongir Olіmov. "Modern approaches to the diagnosis of vestibulopathy in patients with chronic suppurative otitis media." OTORHINOLARYNGOLOGY, no. 3(3) 2020 (July 20, 2020): 53–59. http://dx.doi.org/10.37219/2528-8253-2020-3-53.
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Chronic suppurative otitis media (CSOM), according to statistics, is one of the most common diseases in otorhinolaryngological practice, accounting for, on average, from 5.8 to 20.7% of all ENT pathology. The incidence of CSOM in the Republic of Uzbekistan is up to 6.5%. The pathological process in CSOM leads to the destruction of the bone structures of the middle ear and progressive hearing loss, and in some cases - to an increase in vestibular symptoms. Purpose of the study: vestibular disorders in chronic purulent otitis media using modern diagnostic methods. Materials and methods: In order to study the features of cochleovestibular disorders in CSOM, in the Department of Congenital and Acquired ENT Diseases at the Republican Specialized Scientific and Practical Medical Center of Pediatrics of the Ministry of Health of the Republic of Uzbekistan were examined 13 patients with CSOM with labial complications . All patients underwent a set of standard examinations: ENT examination, otoscopy with video recording, stato coordination tests, complex vestibulometry using modern computer video nystagmography, a set of audiometric tests, computed tomography of the temporal bones. Results: 38.4% of patients complained of dizziness, but when using the method of active survey complaints of dizziness were detected in 61.5% of cases. The analysis of the results of stato-coordination tests in 30.7% of patients revealed a deviation towards the affected ear, in 61.5% of cases - spontaneous nystagmus. Conclusions: the results allow us to conclude that the main complaint of patients with CSOM are of hearing loss (100%), discharge from the ear cavity (100%), complaints of vestibular manifestations were present in 30 to 55% of subjects. Detection of mixed deafness in 53.8% of patients during audiological examination indicates involvement in the process of the inner ear, hence all patients with CSOM, regardless of the duration and stage of the inflammatory process, should conduct a comprehensive vestibulometric examination to determine vestibular status, the degree of involvement of inner ear structures , prognosis, choice of treatment tactics and prevention of complications.
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Friedman, William A., Patrick Bradshaw, Adam Myers, and Frank J. Bova. "Linear accelerator radiosurgery for vestibular schwannomas." Journal of Neurosurgery 105, no. 5 (November 2006): 657–61. http://dx.doi.org/10.3171/jns.2006.105.5.657.
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Object Radiosurgery has become a popular treatment for small vestibular schwannomas (VSs). The aim of this study was to review an extensive, single-institution experience with linear accelerator (LINAC) radiosurgery for VSs. Methods Between July 1988 and August 2005, 390 patients with VSs were treated with LINAC–based radiosurgery at the authors’ institution. Patient and treatment variables were prospectively maintained in a computer database. Outcomes were tracked through periodic clinical examinations and annual scanning studies. Multivariate and actuarial statistics were used to analyze rates of local tumor control and complications, including facial and trigeminal neuropathies, after treatment. One- and 2-year actuarial control rates were both 98%, and the 5-year actuarial control rate was 90%. Only four patients (1%) required surgery for tumor growth. Seventeen patients (4.4%) reported facial weakness and 14 patients (3.6%) reported facial numbness after radiosurgery. The risk of these complications rose with increasing tumor volume or increasing radiosurgical dose to the tumor periphery. Since 1994, when doses were deliberately lowered to 1250 cGy, only two patients (0.7%) have experienced facial weakness and two (0.7%) have experienced facial numbness. Conclusions Radiosurgery provides a safe and effective therapeutic alternative to surgery for small VSs.
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Han, Yueh-Ying, Oren Berkowitz, Evelyn Talbott, Douglas Kondziolka, Maryann Donovan, and L. Dade Lunsford. "Are frequent dental x-ray examinations associated with increased risk of vestibular schwannoma?" Journal of Neurosurgery 117, Special_Suppl (December 2012): 78–83. http://dx.doi.org/10.3171/2012.5.gks12615.
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Object The authors evaluated the potential role of environmental risk factors, including exposure to diagnostic or therapeutic radiation and to wireless phones that emit nonionizing radiation, in the etiology of vestibular schwannoma (VS). Methods A total of 343 patients with VSs who underwent Gamma Knife surgery performed between 1997 and 2007 were age and sex matched to 343 control patients from the outpatient degenerative spinal disorders service at the University of Pittsburgh Medical Center. The authors obtained information on previous exposure to medical radiation, use of wireless phone technologies, and other environmental factors thought to be associated with the development of a VS. Conditional multivariate logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results After adjusting for race, education, cigarette smoking, alcohol consumption, occupational exposure to noise, use of cell phones, and family history of cancer, the authors identified only a single factor that was associated with a higher risk of VS: individuals exposed to dental x-rays once a year (aOR = 2.27, 95% CI = 1.01–5.09) or once every 2–5 years (aOR = 2.65, 95% CI = 1.20–5.85), compared with those exposed less than once every 5 years. Of interest, a history of exposure to radiation related to head or head-and-neck computed tomography was associated with a reduced risk of VS (aOR = 0.52, 95% CI = 0.30–0.90). No relationship was found between the use of cell phones or cordless phones and VS. Conclusions Patients with acoustic neuromas reported significantly more exposure to dental x-rays than a matched cohort control group. Reducing the frequency of dental x-ray examinations may decrease the potential risk of VS.
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Golz, Avishay, S. Thomas Westerman, Liane M. Gilbert, Henry Z. Joachims, and Aviram Netzer. "Effect of middle ear effusion on the vestibular labyrinth." Journal of Laryngology & Otology 105, no. 12 (December 1991): 987–89. http://dx.doi.org/10.1017/s002221510011802x.
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AbstractAlthough middle ear effusion was once described as the most common cause of vestibular disturbance in children, the association between glue ear and symptoms of dysequilibrium has never been quantified objectively.In this study the effect of middle ear effusion on the vestibular system of the inner ear was studied in a select group of children suffering from long lasting effusion in the middle ear with no evidence of infection at least one year prior to the study. The results were compared with results obtained from otitis free children, as well as from examinations of children after the insertion of ventilating tubes.The results of this study confirm the assumption that middle ear effusion has an adverse effect on the vestibular system, which can be resolved following the insertion of ventilation tubes.This effect may also contribute to the adverse effect that otitis media has on a child's development.
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Ramina, Ricardo, Gustavo Simiano Jung, Erasmo Barros Da Silva Jr, Guilherme José Agnoletto, Luis Fernando Moura Da Silva Jr, and Felipe Andrés Constanzo Navarrete. "Internal Auditory Canal Reconstruction After Vestibular Schwannomas Removal Through Retrosigmoid-Transmeatal Approach." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 26, no. 3 (March 31, 2018): 237–41. http://dx.doi.org/10.22290/jbnc.v26i3.1349.
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Objectives: To present a technique of internal auditory canal (IAC) reconstruction using a pediculated dural flap, after removal of vestibular schwannomas through the retrosigmoid craniotomy. Methods: From a series of 213 patients with vestibular schwannomas operated between January 2008 and March 2016 through the retrosigmoid-transmeatal approach, 183 underwent reconstruction of the internal auditory canal with a pediculated dural flap. The IAC was drilled towards the fundus preserving the labyrinthine structures. The dura mater over the IAC was dissected from the bone, remaining pediculated at the entrance of the jugular foramen. This dural flap was used to cover the cranial nerves inside the IAC after tumor removal. Opened mastoid cells and the IAC were closed with muscle or fat grafts and fibrin glue. Results: Reconstruction of the IAC using the described technique was possible in in 183 cases. Fifteen patients (6.8%) developed postoperative cerebrospinal fluid (CSF) leakage and seven patients required reoperation (3.2%) to close the fistulae. Postoperative magnetic resonance imaging (MRI) examinations showed the presence of CSF within the IAC around the preserved cranial nerves. Conclusions: This technique of IAC reconstruction after surgical resection of vestibular schwannomas may avoid scar and adhesion of muscle or fat tissue with preserved cranial nerves, allowing CSF enter inside the IAC. It may help to identify tumor remnants and/or recurrences in postoperative MRI examinations. Comparative studies are needed to evaluate if this technique improves postoperative hearing and facial nerve outcomes.
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Koerbel, Andrei, Alireza Gharabaghi, Sam Safavi-Abbasi, Marcos Tatagiba, and Madjid Samii. "Evolution of vestibular schwannoma surgery: the long journey to current success." Neurosurgical Focus 18, no. 4 (April 2005): 1–6. http://dx.doi.org/10.3171/foc.2005.18.4.11.
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The extraordinary improvement of patient outcome after surgical treatment for vestibular schwannomas is relatively recent and has occurred mainly over the last 30 years. The introduction of microsurgical techniques has resulted in increasing degrees of precise anatomical and functional preservation of the facial and cochlear nerves. An expanded microsurgical technique accompanied by continuous electrophysiological monitoring has resulted in marked changes in the primary goals for this surgery. Whereas in the past the primary goal of vestibular schwannoma management was to preserve the patient's life, the objective in vestibular schwannoma treatment today is to preserve neurological function. Long-term follow-up examinations show negligible recurrence rates, indicating that the aim of preservation of nerve function does not limit the completeness of tumor removal with modern neurosurgical techniques. Despite these advances in preserving the anatomical integrity of, for example, the cochlear nerve, losses of function and even deafness may occur postoperatively in some cases. Current biological and technical research in experimental and clinical settings addresses these problems. In this article, the authors report in detail the developments achieved in vestibular schwannoma surgery and the great clinicians to whom these results can be credited.
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Kitahara, Tadashi, Noriaki Takeda, Suetaka Nishiike, Shin-Ichi Okumura, and Takeshi Kubo. "Prognosis of Inner Ear Periphery and Central Vestibular Plasticity in Sudden Deafness with Vertigo." Annals of Otology, Rhinology & Laryngology 114, no. 10 (October 2005): 786–91. http://dx.doi.org/10.1177/000348940511401008.
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Objectives: We sought to elucidate the clinical problems and otopathology of patients with sudden deafness with vertigo (SDV). Methods: In 24 patients with SDV who had significant canal paresis (CP) at their first visit to our hospital between 1997 and 2001, we examined pure tone audiograms, caloric tests, and several questionnaires twice, at the first visit within 5 days after the onset and around 2 years after steroid therapy. Results: These examinations revealed that improvements of auditory and vestibular function in patients with SDV tended to be correlated with one another. Sixteen of the 24 patients (66.7%) still had CP. This rate in SDV was significantly worse than that reported previously for vestibular neuritis (VN). On the other hand, patients with SDV with long-lasting CP had a faster reduction of head-shaking afternystagmus and of handicaps in their everyday life due to dizziness than did patients with VN and CP. Conclusions: These findings suggest that SDV may deteriorate the inner ear function more severely but accelerate the central vestibular compensation more effectively than VN after the lesion. It is well known that vestibular neurectomy causes much more severe motion-induced dizziness after surgery than does labyrinthectomy. Taken together, these findings suggest different regions of damage in SDV (mainly the labyrinth, as in labyrinthectomy) and VN (mainly the ganglion, as in vestibular neurectomy).
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Jasińska, Agnieszka, Emilia Wnuk, Katarzyna Pierchała, and Kazimierz Niemczyk. "Endolymphatic Hydrops, Evaluated Using 3T MRI in Patients with Clinically Confirmed Meniere Disease." Polski Przegląd Otorynolaryngologiczny 8, no. 3 (September 30, 2019): 1–5. http://dx.doi.org/10.5604/01.3001.0013.4558.
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Ménière’s disease (MD) is characterized by intermittent episodes of vertigo with fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Despite numerous studies, the etiology of this disorder remains poorly understood and thus diagnostic criteria are mainly clinical. Development and progress in magnetic resonance imaging (MRI) techniques, in 2007, has enabled visualization of endolymphatic hydrops, which was the milestone achievement. We present two cases of patients with clinically confirmed MD with a set of audiological, otoneurological examinations and MRI performed. Structures of the inner ear were visualized using contrast-enhanced MR imaging after a 4-hour delayed intravenous gadolinium administration. The cochlea and vestibule were evaluated separately and classified using Barath grading scale. Endolymphatic hydrops in the clinically affected ears was confirmed using MRI. Due to disabling and intractable MD, a decision about vestibular neurectomy was made.
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GUPTA, HARI M., JOSÉ R. CAMPANHA, and FERNANDO D. PRADO. "POWER LAW DISTRIBUTION IN EDUCATION: UNIVERSITY ENTRANCE EXAMINATION." International Journal of Modern Physics C 11, no. 06 (September 2000): 1273–79. http://dx.doi.org/10.1142/s0129183100001085.
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We studied the statistical distribution of candidate's performance which is measured through their marks in university entrance examination (Vestibular) of UNESP (Universidade Estadual Paulista) for years 1998, 1999, and 2000. All students are divided in three groups: Physical, Biological and Humanities. We paid special attention to the examination of Portuguese language which is common for all and examinations for the particular area. We observed long ubiquitous power law tails in Physical and Biological sciences. This indicate the presence of strong positive feedback in sciences. We are able to explain completely these statistical distributions through Gradually Truncated Power law distributions which we developed recently to explain statistical behavior of financial market. The statistical distribution in case of Portuguese language and humanities is close to normal distribution. We discuss the possible reason for this peculiar behavior.
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Balough, B. J. "Lessons From Follow-Up Examinations in Patients With Vestibular Neuritis: How to Interpret Findings From Vestibular Function Tests at a Compensated Stage." Yearbook of Otolaryngology-Head and Neck Surgery 2010 (January 2010): 107–9. http://dx.doi.org/10.1016/s1041-892x(10)79660-8.
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Lim, Kang Hyeon, Yong Jun Jeong, Mun Soo Han, Yoon Chan Rah, Jaehyung Cha, and June Choi. "Comparisons among vestibular examinations and symptoms of vertigo in sudden sensorineural hearing loss patients." American Journal of Otolaryngology 41, no. 4 (July 2020): 102503. http://dx.doi.org/10.1016/j.amjoto.2020.102503.
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Charabi, Samih, Margit Mantoni, Mirko Tos, and Jens Thomsen. "Cystic vestibular schwannomas: neuroimaging and growth rate." Journal of Laryngology & Otology 108, no. 5 (May 1994): 375–79. http://dx.doi.org/10.1017/s0022215100126854.
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AbstractIn a series of 571 vestibular schwannomas (VS) operated on in the period 1976–1992, via the translabyrinthine approach, 23 tumours (4 per cent) from 23 patients were radiologically, peroperatively and histologically identified as cystic VS. Neuroimaging examinations (CT and MRI) revealed 15 tumours (2.6 per cent) with extracystic formations and in eight cases (1.4 per cent) intratumoural cysts. In 15 cases (65 per cent), tumours were located extracanalicularly with no involvement of the internal auditory canal (IAC). The extracanalicular tumour extension including the cystic elements ranged between 10 and 60 mm with a mean of 45 mm. In eight cases out of 23 (35 per cent) other diagnostic possibilities such as trigeminal schwannoma, epidermoid cyst and meningioma were proposed at the primary evaluation. Deformation, displacement and/or impression of the fourth ventricle was demonstrated in 17 cases (74 per cent). Three patients (13 per cent) had obstructive hydrocephalus which demanded shunt insertion. Residual tumour was detected in two patients (9 per cent). Growth rate in four cases was more than 10 times higher when compared to the annual growth rate of noncystic VS. The results of this study provide data on cystic VS attenuation demonstrated by CT or MRI which may be valuable in neuroradiological diagnosis of these cystic lesions and emphasizes that the wait-and-see policy should not be applied to the cystic variant of VS.
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Gomez-Angel, Diego, Oliver Fierek, Juan Madrazo, Carlos O'Connor-Reina, and Hugo Galera-Ruiz. "Diagnosis and documentation of central nervous system dysfunctions with craniocorpography after surgical removal of acoustic neurinomas." Otolaryngology–Head and Neck Surgery 122, no. 4 (April 2000): 592–95. http://dx.doi.org/10.1067/mhn.2000.98008.
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Among other tests, craniocorpography (CCG) was performed in 21 patients after acoustic neurinoma surgery. After surgery, 17 patients (81%) had a developing vestibular compensation or an already normal CCG pattern; 3 patients (14%) had signs of persisting central nervous system dysfunction, either localized to the brain stem or in combination with a cerebellar dysfunction, and 1 patient showed a delayed but sufficient compensation after removal of a neurinoma that compressed central nervous system structures. Brain stem and cerebellar dysfunctions caused by tumor compression demonstrated a better vestibular compensation than dysfunctions caused by surgical manipulation, despite no evidence of cerebellar alteration. As an adjunct to complete neuro-otologic and neurologic examinations CCG could become a useful tool in the topodiagnosis of central nervous system dysfunctions after acoustic neurinoma surgery and therefore in the documentation and follow-up process of these patients.
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Levinson, Harold N. "The Cerebellar-Vestibular Predisposition to Anxiety Disorders." Perceptual and Motor Skills 68, no. 1 (February 1989): 323–38. http://dx.doi.org/10.2466/pms.1989.68.1.323.
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To test for a cerebellar-vestibular (CV) predisposition to anxiety disorder, 402 consecutively referred subjects with varying anxiety symptoms were separated into eight DSM-III—R diagnostic categories and evaluated for CV dysfunction, using neurological and electronystagmographic (ENG) examinations. Of the total sample, 94% evidenced CV-dysfunction on the basis of two or more abnormal neurological or ENG parameters per subject. All DSM-III—R diagnostic anxiety-disorder categories contained a high percentage of abnormal neurological and ENG parameters, regardless of the size of the subsample. Moreover, each DSM-III—R subsample of anxiety disorders contained additional coexisting symptoms of anxiety sufficient to overlap with and form the basis for diagnosis of most other DSM-III—R anxiety-disorder categories. Such findings suggested that anxiety disorders, regardless of surface descriptions and DSM-III—R category, have a common denominator with varying symptom-shaping mechanisms and that this denominator is significantly CV-based. Although the above findings do not justify cause and effect convictions, they have provided crucial insights leading to (1) a proposed functional classification based on underlying determining mechanisms rather than on descriptions of symptoms, (2) a possible relationship between anxiety and learning disorders, and (3) a new method of treating these disorders by means of CV-stabilizing medications in conjunction with traditional approaches. Needless to say, independent and controlled studies, including comparisons with “normal” persons, are required for both validation and elucidation of those specific determining vs compensatory mechanisms and related diagnostic parameters crucial for symptom formation.
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Samii, Madjid, Andrei Koerbel, Sam Safavi-Abbasi, Federico Di Rocco, Amir Samii, and Alireza Gharabaghi. "Using an end-to-side interposed sural nerve graft for facial nerve reinforcement after vestibular schwannoma resection." Journal of Neurosurgery 105, no. 6 (December 2006): 920–23. http://dx.doi.org/10.3171/jns.2006.105.6.920.
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✓ Increasing rates of facial and cochlear nerve preservation after vestibular schwannoma surgery have been achieved in the last 30 years. However, the management of a partially or completely damaged facial nerve remains an important issue. In such a case, several immediate or delayed repair techniques have been used. On the basis of recent studies of successful end-to-side neurorrhaphy, the authors applied this technique in a patient with an anatomically preserved but partially injured facial nerve during vestibular schwannoma surgery. The authors interposed a sural nerve graft to reinforce the facial nerve whose partial anatomical continuity had been preserved. On follow-up examinations 18 months after surgery, satisfactory cosmetic results for facial nerve function were observed. The end-to-side interposed nerve graft appears to be a reasonable alternative in cases of partial facial nerve injury, and might be a future therapeutic option for other cranial nerve injuries.
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Gazulla, José, Silvia Izquierdo-Alvarez, Emilio Ruiz-Fernández, Alba Lázaro-Romero, and José Berciano. "Episodic Vestibulocerebellar Ataxia Associated with a CACNA1G Missense Variant." Case Reports in Neurology 13, no. 2 (June 11, 2021): 347–54. http://dx.doi.org/10.1159/000515974.
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Episodic vestibulocerebellar ataxias are rare diseases, frequently linked to mutations in different ion channels. Our objective in this work was to describe a kindred with episodic vestibular dysfunction and ataxia, associated with a novel <i>CACNA1G</i> variant. Two individuals from successive generations developed episodes of transient dizziness, gait unsteadiness, a sensation of fall triggered by head movements, headache, and cheek numbness. These were suppressed by carbamazepine (CBZ) administration in the proband, although acetazolamide and topiramate worsened instability, and amitriptyline and flunarizine did not prevent headache spells. On examination, the horizontal head impulse test (HIT) yielded saccadic responses bilaterally and was accompanied by cerebellar signs. Two additional family members were asymptomatic, with normal neurological examinations. Reduced vestibulo-ocular reflex gain values, overt and covert saccades were shown by video-assisted HIT in affected subjects. Hearing acuity was normal. Whole-exome sequencing demonstrated the heterozygous <i>CACNA1G</i> missense variant c.6958G>T (p.Gly2320Cys) in symptomatic individuals. It was absent in 1 unaffected member (not tested in the other asymptomatic individual) and should be considered likely pathogenic. <i>CACNA1G</i> encodes for the pore-forming, α1G subunit of the T-type voltage-gated calcium channel (VGCC), in which currents are transient owing to fast inactivation, and tiny, due to small conductance. Mutations in <i>CACNA1G</i> cause generalized absence epilepsy and adult-onset, dominantly inherited, spinocerebellar ataxia type 42. In this kindred, the aforementioned <i>CACNA1G</i> variant segregated with disease, which was consistent with episodic vestibulocerebellar ataxia. CBZ proved successful in bout prevention and provided symptomatic benefit in the proband, probably as a result of interaction of this drug with VGCC. Further studies are needed to fully determine the vestibular and neurological manifestations of this form of episodic vestibulocerebellar ataxia. This novel disease variant could be designated episodic vestibulocerebellar ataxia type 10.
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Abram, Katrin, Silvia Bohne, Peter Bublak, Panagiota Karvouniari, Carsten M. Klingner, Otto W. Witte, Orlando Guntinas-Lichius, and Hubertus Axer. "The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus." Dementia and Geriatric Cognitive Disorders Extra 6, no. 3 (September 27, 2016): 447–57. http://dx.doi.org/10.1159/000450602.
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Background/Aims: Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Methods: Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. Results: The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Conclusion: Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.
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Браїлко, Н. М., І. М. Ткаченко, Я. Ю. Водоріз, І. Я. Марченко, and А. В. Лемешко. "КЛІНІЧНИЙ ВИПАДОК ЗАСТОСУВАННЯ СИСТЕМИ «ICON-INFILTRANT» В ТЕРАПЕВТИЧНІЙ СТОМАТОЛОГІЇ." Medical and Ecological Problems 25, no. 3-4 (August 31, 2021): 33–37. http://dx.doi.org/10.31718/mep.2021.25.3-4.07.
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Modern scientific and technological progress offers a new standard of treatment of odontopathology - infiltration of enamel with resins to seal cracks, chips and to level the surface in the affected area. The aim of the research is to introduce a conservative method for caries treatment using the polymer system "Icon" in the practice of therapeutic dentistry. Patient P., 20 years old, applied to the Department of Propaedeutics of Therapeutic Dentistry of PDMU with complaints of a tingling sensation from chemical stimuli, which disappeared immediately after their removal and the appearance of white matte spots on the vestibular surface of the maxillar teeth in the frontal area. From the anamnesis - the spots appeared after removing the brace system, which the patient had been wearing for 3 years. After the clinical examination, we diagnosed acute superficial dental caries 13,12,11,21,22,23. The treatment was performed in one visit with the Icon Vestibular system. Teeth are cleaned of plaque with a brush and fluoride-free toothpaste "Depural Neo". Under application anaesthesia with Sol. Lidocaini 10%, we isolated teeth with the rubber dam system. The lesions were treated with etching gel (Icon-Etch) 15% hydrochloric acid solution, left for 2 min, then washed off with water for 30 seconds, dried with dry air. To ensure high-quality adhesion of polymer resins, complete moisture removal was performed using ethanol-containing conditioner "Icon-Dry" for 30 seconds, followed by thorough air drying. To infiltrate the lesion, the vestibular nozzle was wound on the syringe "Icon-Infiltrant", infiltrate was carefully applied with a small excess on the etched enamel and left for 3 minutes. Excess was removed with floss and photopolymerized using "Icon-Infiltrant" for 40 seconds. For the second time, having screwed a new vestibular nozzle onto the "Icon-Infiltrant" syringe, the resin was applied for 1 minute. Excess material was removed and polymerized with ultraviolet light for 40 seconds. The rubber dam system was removed. The oxygen-inhibited layer was removed and the vestibular surfaces of the teeth were polished with the help of polishing discs and heads. As a result of the treatment, most of the stains disappeared, the colour, the shine of the tooth enamel 13,12,11,21,22,23 and the surface relief were restored. In 1 and 3 months after treatment, the visual and tactile examination of the vestibular surfaces of teeth revealed that the achieved aesthetic result slightly improved – the sizes of spots, which had been noticeable on the day of treatment decreased. The obtained result satisfied the patient both on the day of infiltration and in the long term. Follow-up examinations every 3 months during the year are recommended. Thus, this method allows us to stop the development of caries and non-carious lesions. It does not require anaesthesia; during treatment, intact areas of tissue are preserved and not damaged. Consequently, a high therapeutic and aesthetic result is achieved, several teeth can be cured in one session, and treatment lasts for an average of 15 minutes.
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Vališ, Martin, Jakub Dršata, David Kalfeřt, Pavel Semerák, and Jan Kremláček. "Computerised static posturography in neurology." Open Medicine 7, no. 3 (June 1, 2012): 317–22. http://dx.doi.org/10.2478/s11536-011-0152-8.
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AbstractPosturography is a general term for techniques used to measure postural stability on static or dynamic measuring platforms. The principle of static computerised posturography (SCPG) is the detection of the centre of foot pressure (CFP) in upright stance on a posturography platform. Our communication deals with the importance of SCPG in differential topodiagnosis of vestibular syndromes in neurology. The set of examinations and evaluations carried out was divided among a control group of healthy subjects (77), a group of subjects with peripheral vestibular disorder (159), and a group of subjects with a non-peripheral balance disorder (82). Results obtained through the measurements were evaluated using descriptive statistics procedures and basic numerical and graphic statistical characteristics of the given groups. Our observations demonstrate that posturography is a valuable auxiliary test for balance disorders, especially given the lack of more suitable tests. According to our results, SCPG can be used for a rough differential topodiagnosis of balance disorders in neurology.
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Nicoucar, Keyvan, Shahan Momjian, John-Paul Vader, and Nicolas de Tribolet. "Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life." Journal of Neurosurgery 105, no. 2 (August 2006): 205–12. http://dx.doi.org/10.3171/jns.2006.105.2.205.
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Object The aim of this study was to assess the consequences of total removal of a large vestibular schwannoma on the patient’s symptoms and quality of life (QOL). Methods A questionnaire regarding preoperative and postoperative symptoms with measures of both daily and global QOL and a modified 36-Item Short Form Health Survey (SF-36) QOL instrument were sent to 103 patients who had undergone surgery via a retrosigmoid approach for total removal of a Grade III or IV vestibular schwannoma. In addition, 48 patients underwent follow-up clinical examinations to assess their conditions. Seventy-two of the 103 patients completed and returned the questionnaire. Forty-six (64%) of the schwannomas were Grade IV and 26 (36%) were Grade III. The patients’ pre- and postoperative symptoms were similar to those reported in other studies. The patients’ perceptions of facial movement were likely to be worse than the clinicians’ estimation based on the House–Brackmann classification. All scores in the QOL categories were significantly reduced when compared with normative data. Patients with large vestibular schwannomas had lower scores in all SF-36 categories except pain compared with data from other studies. Psychological problems were the preponderant symptoms, and their presence was the most powerful predictive variable for global and daily QOL. Conclusions Surgery for a large vestibular schwannoma has a significant impact on the patient’s QOL. To improve QOL postoperatively, the patient should be prepared and well informed of the consequences of such a surgery on QOL. Clinicians must be aware that early involvement of a clinical psychologist may be very helpful.
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Ikeno, Keiichi, Jiro Hozawa, Hisaki Saito, Shigeki Kamata, Kaoru Ishikawa, Fumiaki Fujiwara, Shuji Ohta, Hiroaki Ichijo, and Masayuki Tazawa. "Comparison of positional nystagmus test and rotation test as follow up examinations in peripheral vestibular disorders." Equilibrium Research 44, no. 3 (1985): 330–33. http://dx.doi.org/10.3757/jser.44.330.
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Lee, Seatbyul D. "Vestibular Schwannoma in an Elderly Patient Presenting With Tinnitus and Vertigo." Clinical Scholars Review 8, no. 2 (2015): 195–200. http://dx.doi.org/10.1891/1939-2095.8.2.195.
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The vestibular schwannoma (VS), previously known as acoustic neuroma, is a benign tumor that originated from the edge of the Schwann’s sheath of the eighth cranial nerve. It is considered the most frequently diagnosed intracranial benign tumor, of low lethality rate, and unknown etiology. Because of improvement of diagnostic tests and widespread use of magnetic resonance imaging (MRI) and computed tomography (CT) scan, the prevalence of diagnosed acoustic neuroma has increased. Current studies suggest rate may be higher considering undiagnosed asymptomatic patients and incidental findings on radiological examinations in older adults. The etiology of VS is still unclear, and investigations for risk factors are limited. Symptoms at presentation can vary from asymptomatic to complete hearing loss. Medical management can include a “wait and watch” approach, surgical resection, or radiation therapy. The decision depends on the patient’s age at identification, tumor size, severity of symptoms, patient’s preference, and other medical conditions.
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Sreenivasan, Prem K., and Kakarla V. V. Prasad. "Distribution of dental plaque and gingivitis within the dental arches." Journal of International Medical Research 45, no. 5 (August 10, 2017): 1585–96. http://dx.doi.org/10.1177/0300060517705476.
Full textAbstract:
Objective The natural accumulation of supragingival plaque on surfaces of human teeth is associated with gingival inflammation and the initiation of common oral diseases. This study evaluated the distribution of dental plaque and gingivitis scores within the dental arches after prophylaxis. Methods Adult subjects from the Dharwad, India area representing the general population who provided written informed consent were scheduled for screening. Healthy subjects over the age of 18 years, not currently requiring any medical or dental care, and presenting with a complement of at least 20 natural teeth were recruited for this parallel design study. Enrolled subjects (n = 41) underwent oral examinations for dental plaque (PI) and gingivitis (GI) using the Turesky modification of the Quigley-Hein and the Löe-Silness Index, respectively, at the baseline visit, followed by a whole mouth dental prophylaxis. Subjects were given fluoride toothpaste for twice daily oral hygiene for the next 30 days. Subjects were recalled on days 15 and 30 for PI and GI examinations identical to baseline. Results Analyses indicated that mean scores for PI and GI on either arch and the whole mouth were higher than 2 and 1, respectively, during all examinations. Anterior surfaces consistently exhibited lower PI scores than posterior regions of either arch, or the entire dentition. Regional GI differences within the dentition were similar to PI scores, with lower scores on anterior than posterior teeth. Prophylaxis reduced both the frequency and mean scores of both PI and GI, irrespective of arch, with lower scores observed on anterior than posterior regions during all recall visits. Molar and lingual regions consistently exhibited higher PI and GI scores compared with anterior surfaces. At all examinations, mean scores for both plaque and gingivitis were higher on approximal vestibular than mid-vestibular surfaces. Conclusions Differences observed in PI and GI within the dentition have several practical implications: (a) there are advantages of whole mouth assessments for oral health (b) a need for oral hygiene formulations to reduce the larger deposits of dental plaque in the posterior region and resultant gingival inflammation, and (c) a requirement for ongoing oral hygiene education.
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Uraskulova, B. B., and A. O. Gyusan. "Case report of extensive foreign body of esophagus with spread to laryngopharynx and larynx." Russian Otorhinolaryngology 20, no. 4 (2021): 79–82. http://dx.doi.org/10.18692/1810-4800-2021-4-79-82.
Full textAbstract:
Foreign bodies of the respiratory tract and esophagus remain one of the pressing problems in medicine, which is associated with the possibility of developing complications that can end in death. We present our clinical observation that demonstrates the long-term presence of a large foreign body fixed in the area of the pharyngeal narrowing of the esophagus and extending into the larynx and the vestibule of the larynx. Patient T., 57 years old, went to the emergency department of the Karachay-Cherkessia Republican Clinical Hospital with complaints of severe sore throat, inability to swallow, excessive salivation, increased body temperature to 37,5 °C, difficulty breathing, mixed shortness of breath, which persist for 3 days. The examination revealed: the epiglottis is mobile, the mucous membrane of the larynx is hyperemic, edematous, with an abundance of saliva, at the level of the vestibular part of the larynx, in the area of the arytenoid cartilage and aryepiglottic folds, an irregular shape was visualized, with smooth edges, a thin, hard whitish plate. Computed tomography of the cervical spine: in the esophagus, at the level of C4-C5 vertebrae, a foreign body with a metallic density of +2900 hU units, elongated, irregular shape, measuring 2.2 by 3.3 cm, with perifocal air bubbles is determined. A preliminary diagnosis was made: Foreign body of the esophagus, laryngopharynx with a spread to the vestibule of the larynx. 3 days after the retention of the foreign body under intubation anesthesia, it is captured using forceps with serrated cups and removed during direct laryngoscopy. There were no complications during the manipulation. The combination of X-ray and endoscopic examinations with the help of innovative medical and diagnostic equipment made it possible to establish a diagnosis in a short time, choose the most effective treatment tactics and remove a foreign body through natural pathways.
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Marcelli, Vincenzo, Antonio Russo, Elisabetta Cristiano, and Alessandro Tessitore. "Benign paroxysmal vertigo of childhood: A 10-year observational follow-up." Cephalalgia 35, no. 6 (September 1, 2014): 538–44. http://dx.doi.org/10.1177/0333102414547781.
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Aim The aim of this article is to explore the progression of neurological, neuro-otological and cochlear features in benign paroxysmal vertigo (BPV) in children over time and its relation with migraine, neuro-otological and cochlear disorders in adulthood. Methods From January 2002 to December 2002, 15 children with BPV were prospectively recruited and then evaluated during a 10-year observational follow-up. All patients underwent detailed neurological, neuro-otological and cochlear examinations during interictal phases. Six children were also studied during ictal periods. Results At first assessment, four children reported migraine with aura (MwA) and six children reported migraine without aura (MwoA). Neuro-otological examinations were abnormal in two of 15 children. Cochlear examinations were normal in all patients. During the 10-year follow-up, recurrent vestibular symptoms and/or MwA and/or MwoA have been observed in the children. Neuro-otological examinations were abnormal in three of 15 individuals during the interictal period, and abnormal in four out of six patients who were studied during the ictal period. Two patients developed cochlear signs and/or symptoms. Conclusions During the 10-year follow-up, a phenotype variability in BPV patients has been observed. Specifically, de novo cochlear signs and/or symptoms developed in children with BPV, suggesting that cochlear symptoms should be properly investigated in these patients over time.