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Biomedical subjects

N S Longridge

Publications and source records attributed to N S Longridge.

16 recordsLinked to original sources
PubMed1992

Training effects during repeated therapy sessions of balance training using visual feedback.

Visual biofeedback of postural sway is currently being investigated as a therapeutic technique to reduce postural instability in selected patient populations. Before the efficacy of this type of therapy can be determined in a clinical setting, the performance curves of a normal population doing the static and dynamic balance training exercises have to be delineated. Two groups of normal subjects were evaluated during a daily and weekly protocol of dynamic balance exercises using visual feedback of their center of gravity (COG) and theoretical limits of stability. Static stability in a central position was measured with eyes open, eyes closed, and with visual feedback of the COG in a pre-therapy to post-therapy assessment. No significant change was observed in any of these variables from the pre-therapy to the post-therapy evaluation; as well there was no difference between the scores of both groups. Dynamic variables were evaluated in both a pre-therapy to post-therapy assessment, and over the course of therapy. Each of these protocols required the subjects to track targets representing 75% of their limits of stability on a computer screen with their COG. The time taken and the accuracy to move the COG cursor from target to target, as well as the body sway upon reaching the target were evaluated. Transition time and sway area both decreased significantly (p less than 0.01) from the pre-therapy to the post-therapy assessment for both groups, with path error decreasing significantly for the daily therapy group only. No significant difference was demonstrated between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The dynamic illegible E (DIE) test: a simple technique for assessing the ability of the vestibulo-ocular reflex to overcome vestibular pathology.

Vestibulo-ocular reflex (VOR) compensation, shown by the Dynamic Illegible E test (DIE test), for vestibular damage (as shown by caloric reduction) did not coincide consistently with time from initial onset of vestibular disease. We theorize that the reason for this is the variable efficiency of different compensatory mechanisms used by individuals in overcoming vestibular pathology. Methods of compensation are discussed in detail. The DIE test measures the efficiency of the VOR by comparing visual acuity with head still and head moving. While many patients compensated satisfactorily for vestibular injury to the point where they were able to function adequately, other patients appeared not to compensate. There was no obvious prior indication of which patients would compensate well. There was a suggestion that younger patients did better, but neither duration of symptoms nor severity of pathology appeared to be factors in the ability to compensate. Although younger patients may fare better as a group, there are no predictive criteria for the amount or rate of recovery which an individual patient with vestibular pathology will make.

Adult↗
PubMed1987

Bilateral vocal cord paralysis in Shy-Drager syndrome.

A patient with a permanent tracheostomy was seen and noted to have bilateral abductor vocal cord paralysis. He was being investigated neurologically and was found to have several types of autonomic failure, specifically including postural hypotension. It was felt that he had Shy-Drager syndrome. A review of the literature showed that bilateral vocal cord paralysis is a recognized abnormality in this condition for which permanent speaking tracheostomy is the treatment of choice. Reflux esophagitis due to lax cardiac sphincter may be a factor in the laryngeal symptomatology.

Autonomic Nervous System Diseases↗
PubMed1986

Machado-Joseph disease: the vestibular presentation.

Three patients presented with Machado-Joseph disease. We documented the vestibular abnormalities characteristic of Machado-Joseph disease during clinical examination. Electronystagmographic (ENG) abnormalities included bilateral gaze nystagmus, saccadic pursuit and failure of fixation suppression suggestive of cerebellar-brainstem pathology. Machado-Joseph disease is a degenerative neurological condition, inherited in an autosomal dominant fashion. It occurs in patients of Portuguese Azorean extraction. We suggest that otolaryngologists with a referral base including a Portuguese community be familiar with this disease as it may present in its early stages with symptoms of non-specific imbalance.

Azores↗
PubMed1986

Computerized ENG acquisition system.

A computerized transportable ENG acquisition system has been designed, at far less cost than a conventional ENG system, using easily obtainable and standard microcomputer components from our local computer store. Its advantages of reduced cost and greater flexibility as well as its applications to other fields such as word processing and office management would make it a useful addition to any ENG laboratory and otolaryngologist's office as well.

Computers↗
PubMed1985

Arnold-Chiari malformation and the otolaryngologist: place of magnetic resonance imaging and electronystagmography.

The Arnold-Chiari malformation (ACM) is a rare congenital condition in which there is a downward displacement of the cerebellum through the foramen magnum. Patients with this condition frequently develop symptoms of ataxia, imbalance, or vertigo. As a result the patient is often referred to an otolaryngologist. Such a case is reported. A patient presented with imbalance, had downbeating nystagmus on down gaze, and had other eye movement abnormalities recorded on electronystagmography (ENG) which were strongly suggestive of central pathology. Although her computerized tomography (CT) scan was normal, the eye findings and neurological evaluation were strongly suggestive of an ACM. A repeat CT scan with intrathecal metrizamide was abnormal. A definite diagnosis of ACM was confirmed using the new investigative technique of magnetic resonance imaging (MRI).

Adult↗
PubMed1979

A tinnitus clinic.

Eighty patients with a main complaint of tinnitus were assessed. In only 32 was help possible. In 16 of these symptomatic relief utilized the masking technique which is briefly described. These results though not outstanding are encouraging and represent a definite step forward in helping patients with this unpleasant condition. Apart from symptomatic treatment of tinnitus, the clinic allowed early diagnosis of noise-induced hearing loss in some patients. Several patients had asymmetrical hearing loss, but despite extensive investigation no cerebellopontine angle tumors were identified. These patients are being followed. For these reasons, the tinnitus clinic is regarded as a success and will continue to function as a specialty clinic in otolaryngology at Vancouver General Hospital.

Adult↗
PubMed1978

Bilateral paroxysmal positioning nystagmus.

The term "bilateral paroxysmal positioning nystagmus" (BPPN) refers to the occurrence of paroxysmal positioning nystagmus when the patient's head is placed in both right and left head-hanging positions. BPPN was found in at least 15% of 114 patients with benign positional vertigo. Head injury, central nervous system disease or both were causative in over half of patients with the finding. In some instances, paroxysmal positional nystagmus may be found when the abnormal ear (side) is uppermost rather than directed toward the floor; this fact may have important implications if singular neurectomy is to be performed.

Brain Diseases↗
PubMed1975

Fracture of the sella turcica.

A patient with a fracture of the sella turcica, visible on lateral X-ray films of the skull, is described. This fracture, although not diagnosed during life, was present in approximately 20 per cent of a series of consecutive autopsies on patients who died of head injury. The significance of this injury to the hypothalamopituitary axis is discussed and methods of investigation suggested.

Adult↗
PubMedDate not supplied

Brain stem dysfunction in transient global amnesia.

A patient with transient global amnesia also had transient bilateral gaze nystagmus which was detected both by conventional bedside examination and upon electronystagmographic recording. The nystagmus was absent one week later indicating recovery of the temporary brain stem deficit. The recording of objective evidence of brain stem dysfunction in the form of gaze nystagmus in a patient who had transient global amnesia, suggests that both were due to a transient ischemic attack involving the cerebral blood supply in the vertebrobasilar distribution.

Aged↗
PubMedDate not supplied

The dynamic illegible E-test. A technique for assessing the vestibulo-ocular reflex.

The Dynamic Illegible E (DIE) test measures visual acuity with head held still while reading a specially designed visual acuity chart of E's. The head is then moved passively and the change in visual acuity is recorded. The DIE test has previously been shown to be very useful for assessing patients with aminoglycoside ototoxicity. In the present study, statistical analysis using multiple regression showed that the degree of abnormality in the DIE test during horizontal and vertical head movement was correlated with the degree of caloric reduction. Ridit analysis allows comparison between a number of naturally ordered categories. The ridit analysis showed significant differences between groups of patients with varying degrees of caloric reduction. There was also a significant difference in DIE test scores between a group of normals with no history of otoneurological complaint and an age- and sex-matched population of dizzy patients with normal caloric results. As none of our 110 normal patients had more than a one row drop while reading the DIE test with head moving, we feel that it is safe to regard a drop of more than two rows with head moving as abnormal. Perhaps even a mild caloric reduction represents relatively severe vestibular damage and the DIE test has the potential to delineate some patients who have no caloric reduction.

Adolescent↗