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Biomedical subjects

M Karlberg

Publications and source records attributed to M Karlberg.

23 records · Page 2Linked to original sources
PubMed1991

Delayed onset of ototoxic effects of gentamicin in patients with Meniére's disease.

In treatment of Meniére's disease, installations of gentamicin are continued until there are signs of disturbance of vestibular or cochlear function. However, since it has been demonstrated that gentamicin is eliminated slowly from the inner ear, a continuing ototoxic effect may be suspected. The present study aimed to investigate the delay of onset of symptoms of ototoxic effects. Five patients with Meniére's disease and disabling vertigo were treated with intratympanic installation of gentamicin. The patients received two installations at two consecutive days, after which the treatment was abated, although no patient showed any symptoms of affection of the vestibular or cochlear end organs. All patients, however, developed vertigo and nystagmus beating toward the not treated ear within 3 to 5 days after the last installation. At 3 months and 1 year later, the treated ear showed no reaction on bithermal caloric stimulation and all patients had a complete relief of attacks of vertigo but hearing levels were about the same compared to before treatment. The present findings demonstrate a delayed onset of ototoxic effects and it is suggested that gentamicin treatment should not be carried on until symptoms develop. Furthermore, extremely low dose treatment may produce loss of vestibular function with the desired relief of vertigo and with less hazards of affecting the hearing level.

Adult↗
PubMed1991

Effects of restrained cervical mobility on voluntary eye movements and postural control.

The effects of restrained cervical mobility on pursuit eye movements (PEMS), voluntary saccades and postural control, as measured by posturography, were studied in 11 healthy subjects whose cervical spine movement had been restrained for 5 days by means of a rigid neck-collar. At day 5 mean peak velocity of voluntary saccades at amplitudes of 40 degrees and 60 degrees was significantly reduced, as was mean peak gain of PEMs at a stimulus velocity of 50 degrees/s; the variance of body position in vibration-induced body sway was significantly increased, but there was no difference in variance of galvanically-induced body sway or in velocity of vibration-induced body sway. The results suggest that restriction of cervical movements per se affects voluntary eye movements, a conclusion also consistent with findings in patients with tension headache. Restriction of cervical movement only marginally affects postural control.

Adult↗
PubMedDate not supplied

Dizziness of suspected cervical origin distinguished by posturographic assessment of human postural dynamics.

Useful clinical tests are lacking for the controversial entity "cervical vertigo". In earlier studies patients assumed to suffer from cervical vertigo or dizziness manifested disturbed postural control as compared to healthy subjects, but were hard to distinguish from patients with other balance disorders. Using posturography in which stance was perturbed by a vibratory stimulus applied towards the calf muscles, we studied 16 consecutive patients with recent onset of neck pain and concomitant complaints of vertigo or dizziness, but normal findings at otoneurological examination and electronystagmography; 18 patients with recent vestibular neuritis; and 17 healthy subjects. We performed system identification of a model of the control of upright human stance, using the vibratory stimulus as input and the recorded body sway as output. According to values for the three normalized parameters of the transfer function of the model (i.e., swiftness, stiffness, and damping), cervical vertigo patients were distinguished both from healthy subjects (P < 0.001), and from vestibular neuritis patients (P < 0.001). It was also possible to distinguish the vestibular neuritis group from the group of healthy subjects (P < 0.01). The results show disturbed postural control in patients with cervical vertigo to differ from that in patients with recent vestibular neuritis, and indicate posturographic assessment of human posture dynamics to be a possible future tool for use in diagnosing cervical vertigo.

Adult↗
PubMedDate not supplied

Effects of different treatments on postural performance in patients with cervical root compression. A randomized prospective study assessing the importance of the neck in postural control.

Patients with cervical root compression were used as a "model" to investigate the possible importance of neck disorders and cervical sensory information in postural control. We assessed postural performance with posturography before and after treatment in 71 consecutive patients with MRI-verified cervical root compression without medullary compression. The patients were randomized to surgery (n = 22), physiotherapy (n = 24) or treatment with cervical collars (n = 25). There were no differences in postural performance or pain intensity between the groups before treatment. After treatment, the surgery group manifested significant improved postural performance and reduced neck pain scores, as compared to the two conservative treatment groups, and their postural performance had improved to the same level manifested by healthy controls. The conservative treatment groups manifested no consistent significant changes in postural performance or pain scores. Decreased muscular tension due to reduction of cervical pain after surgery and normalization of cervical proprioception are suggested as possible explanations of the improved postural control.

Female↗