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The relation between motor function development and vestibular function tests in four children with inner ear anomaly.

It is well known that the development of motor function is frequently retarded in children with congenital deafness, particularly in cases of inner ear anomaly. The relation between the results of vestibular function tests and the development of motor function in 4 children with inner ear anomaly is studied. CT scan obtained from these cases revealed the absence of lateral semicircular canals in both ears. There were no responses to caloric stimulation using 40 ml ice-water. However, damped rotation test elicited per-rotatory nystagmus in all cases. In contrast to this result, the same nystagmus was provoked only in 2 cases in Barany rotation test. Early development of motor functions, especially that of first walk, was more retarded in the 2 cases showing no per-rotatory nystagmus in Barany rotation test than in the other 2 positive cases.

Child↗

Contemporary vestibular function testing: accomplishments and future perspectives.

The development of a standard test battery for the evaluation of vestibular function required a variety of preliminary investigations about the technical and physiologic foundations of the tests. The most important technologic development was the creation of computerized methods, including hardware and software capabilities. The designs of tests were based on physiologic and diagnostic considerations, as demonstrated in experiments on normal subjects and patients. Although time tested and sound, the available test battery satisfies only a limited number of requirements for comprehensive evaluation of vestibular function. This article describes the list of accomplishments, the state of the present limitations, and the needs for the future.

Computers↗

Vestibular function test anomalies in patients with chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) is distinguished by the new onset of debilitating fatigue that lasts at least 6 months, concomitant with other symptoms to be described later. Many CFS patients complain of disequilibrium, yet the exact type of the balance dysfunction and its function and its location (peripheral vs. central) have not been described. Herein we report results of vestibular function testing performed on 11 CFS patients. These results revealed no predominant pattern of abnormalities. Patients typically performed below average in dynamic posturography testing, with a significant number of falls in the tests requiring subjects to depend heavily on the vestibular system. One patient had abnormal caloric testing, while 3 had abnormally low earth vertical axis rotation (EVA) gains at the higher frequencies tested. As a group, the average gain of EVA was significantly lower than normals in the 0.1 - 1.0 Hz range (p < 0.05). In earth horizontal axis rotation, the CFS group had a higher than normal bias value for the optokinetic (OKN) and eyes open in the dark conditions (p < 0.05), but had normal scores during visual vestibular reflex testing. Five of the 11 subjects had an abnormal OKN bias build up over the course of the run, equal to or actually exceeding the 60 degrees/s target velocity by as much as 14 degrees/s. Altogether, these results are more suggestive of central nervous system deficits than of peripheral vestibular disfunction.

Adult↗

Influence of age on results of vestibular function tests. Review of literature and presentation of caloric test results.

Following a bibliographic review of currently known, age-dependent morphological and functional changes of the vestibular and auditory system, results are presented of our investigations concerning the influence of age on the outcome of the caloric test on 102 healthy subjects from six age groups ranging between the ages of 11 and 70 years. They prove, without any doubt, that the absolute values of nystagmic parameters in the caloric test are dependent upon age; but not in such a way that the intensity of reaction decreases with advancing age. On the contrary, they indicate that in awake, healthy subjects of middle and late middle-age, the most intensive reactions occur (maximum slow phase velocity, maximum amplitude, maximum frequency, total number of beats). In addition, based on the statistical analysis, it seems probable that the extent of the side difference of excitability depends upon age. Individuals in their middle years show side differences to a considerably lesser degree than children and elderly subjects. These represent findings which, to our knowledge, are reported here for the first time. Provided our results gain further substantiation, standard values for a true quantitative evaluation of the caloric test could only be determined as in the audiometric functional tests on the basis of larger test series of healthy subjects belonging to different age groups.

Adolescent↗

Value of vestibular function tests in the differential diagnosis of vertigo.

In patients with vertigo, with unilateral auditory problems, or for whom there is a suspicion of a posterior fossa lesion, vestibular testing is mandatory. After anamnesis, and clinical investigation, it should be decided what parts of the vestibulo-oculomotor and auditory test batteries are to be used. Apart from auditory brain stem responses, the most fruitful tests seem to be the broad-frequency rotatory tests, which are of considerably greater diagnostic value than the visual suppression test and the smooth pursuit test.

Diagnosis, Differential↗