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At least 595 records · Page 33Linked to original sources
PubMed1995

The perception of head rotation in Parkinson's disease.

The accuracy in detecting angular displacements of the head and the neck was investigated in 14 patients with idiopathic Parkinson's disease (PD) and 16 age matched normal controls by the technique of vestibular and cervical "remembered" saccades. It was found that although the remembered saccades in PD patients were multiple-step and showed low initial saccadic gain, the final eye position of the eyes matched the rotational stimulus as accurately as in normals. This indicates that perception of head/neck rotation is normal in PD which is inconsistent with views that vestibulo/proprioceptive dysfunction contributes to the postural disorder in PD. The presence of multiple-step remembered vestibular and cervical saccades agrees with reported abnormalities in visual remembered saccades in PD and indicates that the difficulty in generating saccadic movements based on memorized sensory information is not confined to visual-memory.

Adult↗
PubMed1995

Recovery from bilateral vestibular failure: implications for visual and cervico-ocular function.

We report a patient who sustained severe bilateral labyrinthine lesions during Streptococcus suis meningitis but considerably recovered vestibular function over a 7 month period. This unique case allowed us to examine the cervico-ocular reflex (COR) and visual function at various levels of activity of his vestibular system. The slow phase COR, elicited by trunk oscillation (0.2 Hz) with the head earth-stationary, was negligible immediately after the acute vestibular loss but rose to a gain of 0.51 one month after. Seven months later, when vestibular function was improved, COR gain dropped to a gain of 0.15. Measurements of spatial visual function during whole body oscillation in the acute stage and after 6 months showed marked improvement which correlated entirely with VOR measurements in the dark and during optic fixation. This patient also showed the unique feature that, in the acute stage, eye movement gain and visual function were poorer during whole body motion than during identical visual target motion. These findings suggest that: i) the COR may be inhibited by the presence of vestibular signals, ii) spatial vision measurements provide accurate assessment of the patient's visual blur during head motion, and iii) the severe oscillopsia experienced by patients in the acute stage of vestibular loss may not only be due to the absence of the VOR; additional degradation in eye movements during head motion, perhaps arising from acutely distorted labyrinthine signals, may also play a part.

Dark Adaptation↗
PubMed1995

Modification of parameters in vertical optokinetic nystagmus after repeated vertical optokinetic stimulation in patients with vestibular lesions.

Eye movements were recorded in patients with unilateral and bilateral vestibular lesions after upward and downward optokinetic (OK) stimulation before and following 6 weeks' repeated exposure to OK stimulation. In control subjects there was no asymmetry between upward and downward slow-phase velocity (SPV). Before training, less subjects showed that upward and downward SPV was significantly lower than that of controls. There was no asymmetry between upward and downward SPV. After training, in unilateral cases, the values of both upward and downward SPV recovered to the control range. In bilateral cases, the downward SPV values returned to the control range, whereas the values of upward SPV exceeded the control range. The frequencies of both upward and downward OKN in controls were about 3.0 Hz. In unilateral and bilateral cases, before and after training, the OKN frequencies approximated 3.0 Hz, showing no significant differences. The recovery of the SPV in unilateral and bilateral cases after training suggests that OK stimulation acts to stabilize the body and consequently to provoke pronounced OKN, due to eye-head-body co-ordination. The asymmetry of SPV after training in bilateral cases might be a result of the lack of otolith function.

Adult↗
PubMed1995

Impaired postural control in patients with cervico-brachial pain.

Dizziness and subjective balance disturbances are common complaints in cervical pain syndromes. We assessed balance function with posturography using vibration-induced and galvanically-induced body sway in consecutive patients (n = 116) with cervico-brachial pain syndrome of more than 3 months' duration. A total of 83% of the patients showed signs of cervical root compression on MRT scans. The incidence of complaints of vertigo was 50%. The patients manifested significantly poorer postural control than sex- and age-matched controls (n = 20). Disorders of the neck should be considered when assessing patients complaining of dizziness, vertigo and balance disturbances.

Afferent Pathways↗
PubMed1997

Deviation of the subjective vertical in long-standing unilateral vestibular loss.

We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n = 25), we measured patients with a longstanding (mean 4.5 year +/- 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14 degree +/- 1.11 SD). Patients with left-sided (complete; n = 13) or right-sided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55 degrees +/- 1.57 (SD) leftward and 2.22 degrees (+/-1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (-1.17 degrees +/- 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined, by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve.

Ear, Inner↗
PubMed1987

Quantitative interpretation of audiological test battery. I. A comparison with ABR in 97 cases of unilateral sensorineural hearing loss.

A retrospective study was made of 97 patients with unilateral sensorineural hearing loss who underwent an audiological test battery and ABR during a 2 1/2-year period. The test battery included tone- and speech audiometry, Békésy audiometry, loudness balance test, tone decay test and impedance measurements (reflex thresholds and reflex decay). A quantitative interpretation of each audiological test was tried out and a mean value of included tests (audiological test score ATS), was compared with results of ABR. The audiological test score showed the same predictive value as ABR for detection of acoustic neurinomas. Among the auditory tests, Békésy audiometry had the lowest sensitivity. Eight patients with neurinomas were found in the series. Retrocochlear test results prevailed in another 23 ears, most often in combined hearing loss and vestibular dysfunction and in insidious or longstanding hearing loss. Quantitative interpretation of the audiological test battery is valuable for uniformity in classification of sensorineural hearing loss, and will facilitate extended studies on aetiology and course in auditory dysfunction.

Adolescent↗
PubMed2003

The effects of click and tone-burst stimulus parameters on the vestibular evoked myogenic potential (VEMP).

Vestibular evoked myogenic potentials (VEMP) are short latency electromyograms (EMG) evoked by high-level acoustic stimuli and recorded from surface electrodes over the tonically contracted sternocleidomastoid (SCM) muscle and are presumed to originate in the saccule. The present experiments examined the effects of click and tone-burst level and stimulus frequency on the latency, amplitude, and threshold of the VEMP in subjects with normal hearing sensitivity and no history of vestibular disease. VEMPs were recorded in all subjects using 100 dB nHL click stimuli. Most subjects had VEMPs present at 500, 750, and 1000 Hz, and few subjects had VEMPs present at 2000 Hz. The response amplitude of the VEMP increased with click and tone-burst level, whereas VEMP latency was not influenced by the stimulus level. The largest tone-burst-evoked VEMPs and lowest thresholds were obtained at 500 and 750 Hz. VEMP latency was independent of stimulus frequency when tone-burst duration was held constant.

Acoustic Stimulation↗
PubMedDate not supplied

Simultaneous acute superior nerve neurolabyrinthitis and benign paroxysmal positional vertigo.

An acutely vertiginous 47-year-old woman presented to the emergency department with simultaneous acute left neurolabyrinthitis and left posterior canal benign paroxysmal positional vertigo (BPPV). Gaze nystagmus from the neurolabyrinthitis hampered diagnosis of the BPPV. However, once the BPPV was identified and treated, the patient's subjective vertigo improved rapidly. Concomitant BPPV should not be overlooked when a diagnosis of acute neurolabyrinthitis is made in the emergency department.

Ear, Middle↗
PubMedDate not supplied

[Recording of vestibular myogenic evoked potentials in patients with disturbed inner function].

In this study, we measured VEMP in patients with disturbed function of inner ear. We studied 4 patients with unilateral sensorineural deafness and normal excitability of vestibular organs; 6 persons with unilateral weakness of vestibular function and 10 healthy subjects. We found that in patients with unilateral weakness of vestibular function VEMPs had short latencies and diminished amplitudes whereas in patients with unilateral deafness VEMPs were unchanged. These data strongly suggested that VEMPs were generated by stimulation of vestibular and not cochlear part of inner ear-sacculus. Our data confirm that VEMPs are a highly objective technique, simple, secure and comfortable for patients to assess the vestibulo-spinal connections.

Adult↗
PubMed1992

[Vestibulotoxic effects of the cytostatic drug carboplatin in patients with head and neck tumors].

Ototoxic side effects of cisplatin have often been reported, but no conclusive data have been reported about carboplatin ototoxicity. We investigated the vestibular toxicity of carboplatin therapy in two groups of 18 patients with head and neck cancer. The treated group was examined before, during and after chemotherapy. The control group comprised patients undergoing surgery and/or radiation. The incidence of peripheral vestibular dysfunction was major (27%) in patients undergoing carboplatin administration compared with the control group (10%). Central vestibular disorders which were often observed in both groups included the neurotoxic and neuropathic effects of drugs and alcohol, which are commonly consumed by patients with head and neck tumours. Similar findings have been ascribed previously to paraneoplastic syndromes.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

[Some characteristics of vertigo in vestibular neuronitis].

The authors present a detailed clinical analysis of objective neurological symptoms and vertigo in patients with vestibular neuronitis. Diagnostic criteria are specified allowing differentiation between vertigo and dizziness, pathognomonic signs of vestibular neuronitis are outlined. Peripheral location of the pathological process in vestibular neuronitis is suggested. How rotating vertigo is forming in patients with vestibular neuronitis is hypothesized.

Adult↗
PubMed1992

[Vestibular compensation. Clinical value of its dynamic study].

Vestibular compensation consists of all the processes of neurological reorganization that allow recovering balance after a unilateral vestibular lesion. According to its etiology, the peripheral lesion may be more or less severe, may evolve more or less rapidly, and be more or less reversible. Therefore, it will have a characteristic "pattern" in time, which enables us to classify the kinetic aspects of peripheral pathology. Vestibular compensation, which responds to these variations in the sensitivity of the posterior labyrinth, is a slowly progressive adaptation mechanism. This compensation will progressively reduce the musculotonic asymmetry affecting the postural muscles and the eye muscles, and it can therefore be studied on the basis of the velocity of the spontaneous nystagmus as measured in the dark. We can then define a "vestibular compensation rate" at a given moment. To achieve this, a diagram (E. UMER) is proposed to represent the lesion and the rate of vestibular compensation and to study their mutual relationships. The dynamic study of vestibular compensation and the measurement of its "time constant" than have threefold merits for diagnosis, prognosis and treatment.

Adaptation, Physiological↗
PubMed1992

[Vestibular studies: current status, prospects].

Equilibrium is based on gaze stabilization. Clinical examinations currently test, individually the three components involved in equilibrium: vestibular, visual and proprioception. New investigations are being developed to test equilibrium dynamic conditions. After briefly reviewing vestibular physiology, under the authors discuss the various tests of vestibular function and equilibrium.

Eye Movements↗
PubMed2005

Personal experiences with vestibular evoked myogenic potentials as a modern method of diagnosing vestibular organ lesion and monitoring treatment.

Vestibular evoked myogenic potentials (VEMPs) appear to represent a new and promising technique for the assessment of vestibulospinal reflex function. The primary aims of the study described in this article were (1) to record VEMPs in normal volunteers using available equipment and to establish a range of norms of VEMP parameter values (latency, amplitude); (2) to confirm the saccular origin of VEMPs; (3) to assess the diagnostic significance of VEMPs; and (4) to evaluate the usefulness of VEMPs in monitoring therapeutic results. The study population consisted of 252 patients representing various diagnoses of hearing loss and vestibular organ lesion. Twenty-three patients were treated with an antihomotoxic remedy, and some received placebo. The results of this study demonstrated that VEMPs are helpful in evaluating the physiological and pathological equilibrium system and in monitoring reflex reactions after treatment.

Adolescent↗
PubMed1991

[Differential diagnostic possibilities of the Luzern measuring plate].

Five patients with different causes of disequilibrium are presented: acute left-side periphal-vestibular function loss, post-traumatic central-vestibular disorder, cerebellar ataxia, ataxia in gonarthrosis and induced by cervical spine. The posturographic findings are recorded and the possibilities of differential diagnosis of posturography are discussed.

Adult↗