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At least 613 records · Page 34Linked to original sources
PubMed1985

Bruxism: its significance in coma.

Bruxism, the phenomenon of non-functional grinding of the teeth has been ascribed to various causes. Twenty patients with coma from different causes who displayed bruxism were studied with an attempt to correlate the phenomenon to the level of consciousness, eye movements, respiration, cold caloric test, motor deficits and sleep wake cycles. Bruxism was seen to appear at different levels of consciousness, but to disappear only after a significant improvement in the level of consciousness. A relationship with the appearance of sleep wake cycles was also seen.

Adolescent↗
PubMed2002

Permanent sensorineural hearing loss following spinal anesthesia.

A 25-year-old female developed permanent, fluctuating sensorineural hearing loss (SNHL), disabling vertigo, and tinnitus following an uneventful spinal anesthesia for cesarean section. At her first visit to the ear-nose-throat (ENT) department approximately 2 months postoperatively, pure-tone thresholds revealed profound SNHL on the right side whereas thresholds were within normal limits on the left side. The recruitment score (SISI) was 95% at 2000 Hz on the right side. Directional preponderance towards the right and the right canal paresis were evidenced by bithermal caloric testing. At follow ups the pure tone thresholds have shown some improvement, but fluctuating SNHL, disabling vertigo attacks, and tinnitus have remained. These findings imply a cochlear pathology causing endolymphatic hydrops possibly induced by lumbar puncture for spinal anesthesia.

Adult↗
PubMed1980

Changing response to caloric stimulation with gestational age in infants.

Internuclear ophthalmoplegia was found by caloric testing of the vestibuloocular reflex in normal, very premature infants, indicating that the medial longitudinal fasciculus is functionally immature. At this age, the medial longitudinal fasciculus is more responsive to stimulation by the oculocephalic (doll's-eye) reflex, which resulted in conjugate deviation of the eyes.

Caloric Tests↗
PubMed1995

Click-evoked vestibulocollic reflexes in torticollis.

A total of 26 patients with torticollis were studied using a recently developed technique for recording vestibulocollic reflexes from the sternocleidomastoid muscles in addition to conventional caloric tests of vestibular function. Previous reports of abnormalities of vestibulo-ocular reflexes in these patients were confirmed with just fewer than half having significant canal pareses or directional preponderances (nine of 20 tested). In addition, there was a high incidence of abnormal click-evoked vestibulocollic reflexes (17 of 26 tested), which were not simply the result of prior treatment with botulinum toxin, nor due to unequal levels of muscle activation. In patients never previously treated with botulinum toxin (14 patients), the effect almost always consisted of suppressed responses in the sternocleidomastoid muscle ipsilateral to the direction of head turning. Because responses were not abnormal in all patients tested, and more commonly so in those with a history of torticollis of > or = 5 years (eight of nine patients) than in de novo patients, we suggest that the changes are more likely to be compensatory than causal.

Acoustic Stimulation↗
PubMed1977

[The effects of intratympanally applied streptomycin-sulfate on the ipsi- and contralateral hearing potentials in the guinea pig (author's transl)].

11 Guinea pigs had a 50% streptomycin-sulfate solution injected into the middle ear. Complete loss of function of the peripheral vestibular organ occurred after two days, as was detectable by means of the caloric test. The high-degree decrease of the microphonic-potentials and the compound action potential was significant. Threshold and adaptation of the potentials of the opposite side were not affected. The results are discussed with regard to the treatment of Menière's disease by means of intratympanally applied streptomycin.

Action Potentials↗
PubMed1995

Vestibular dysfunction in noise induced hearing loss.

It is known that loud tones can damage the cochlea, but vestibular involvement has been given less attention. However, patients with noise induced hearing loss (NIHL) sometimes have balance disorders as well as some have symptoms resembling those of Meniere's disease. In this study, we examined the relationship between loud sounds and vestibular problems. Thirty-six NIHL patients were divided into two groups according to the presence (vertigo group) or absence (non-vertigo group) of vestibular complaints. Electrocochleograms were recorded from all subjects after pure tone audiometry. A higher incidence of increased -summating potential (SP)/action potential (AP) ratio was observed in the vertigo group than in the non-vertigo group. Caloric tests were performed in the vertigo group, and a reduced response was observed in 47.1% of ears. It is generally considered that the -SP/AP ratio is a useful indicator of endolymphatic hydrops. Therefore, episodic vertigo in NIHL patients may result from a pathophysiological mechanism similar to that of Meniere's disease.

Caloric Tests↗
PubMed1995

Neuro-otological and neuropathological findings in two cases with Machado-Joseph disease.

We report chronological changes of neuro-otological findings and associated neuropathological findings in 2 patients. Concerning gaze limitation, upward gaze was primarily disturbed, followed by downward gaze and abduction. Adduction tended to be preserved although convergence was disturbed at the early stage. And, upward gaze limitation was followed by loss of oculocephalic responses (OCRs). Bell's phenomenon was preserved until the late stage of the disease. Caloric nystagmus was absent at the early stage. One patient showed dissociation between nystagmus and vestibulo-collic reflex in the caloric test at the early stage of the disease. Neuropathological examination revealed gliosis in the interstitial nucleus of Cajal and the MLF as well as neuronal loss and gliosis in the oculomotor nuclei. The vestibular nuclei also showed gliosis and atrophy of nerve cells.

Brain Stem↗
PubMed1990

Hearing after retrolabyrinthine vestibular neurectomy.

Thirty-four patients underwent vestibular neurectomies between September 1984 and January 1989. The first 15 patients operated on through January 1987 (and followed for a minimum of 2 years) were evaluated separately for long-term hearing preservation and freedom from vertigo spells. Audiograms taken at 1 postoperative month revealed no change in the pure tone averages of 25 patients and showed improved hearing of 20 to 30 dB in 5 patients. Two patients sustained losses of 18.5 dB and 21 dB, respectively. The speech discrimination scores remained the same in 17 patients, improved in 9, and were reduced in 6. Audiograms performed 12 to 40 months postoperatively showed preservation of the pure tone averages and speech discrimination scores when compared with the earlier 1-month postoperative audiograms in 73% of the patients. The speech discrimination scores, however, tended to fluctuate with the symptomatic course of each disease. Two patients developed major vertigo spells 1 1/2 years following surgery. Postoperative ice-caloric testing revealed no responses in 25 patients and markedly reduced responses in 6. There were no major complications or facial paralysis. The retrolabyrinthine vestibular neurectomy is an effective way to control vertigo with preservation of hearing and an acceptably low incidence of complications and side effects.

Adult↗
PubMed1978

Criteria for the evaluation of nystagmus.

Suitable criteria are reported for the analysis and evaluation of the caloric nystagmus as well as for the differentiation of the pathological from the physiological spontaneous nystagmus. Relative values for the difference and the directional preponderance, related to the intensity of the total reaction, seem to be the most appropriate criteria for the evaluation of the caloric test. The values obtained in patients should be compared with interquantile areas of healthy subjects. The parameters 'maximum slow phase velocity' and 'maximum frequency' seem most suitable for the assessment of the reaction intensity in the ENG. At present, the examination with Frenzel's glasses represents the best possibility for differentiation between physiological and pathological spontaneous nystagmus.

Adolescent↗
PubMed1978

Eighth nerve in acoustic neuromas. Special reference to superior vestibular nerve function and histopathology.

Eighth nerve specimens were removed during acoustic neuroma surgery, and findings were related to cochlear and especially to superior vestibular nerve function as studied by conventional caloric testing in 21 cases. The origin of the tumor was in eight cases the inferior and in two cases the superior vestibular nerve, and in eight cases the vestibular nerve without more specific localization. In three advanced cases the exact site of origin could not be determined. Leaving age-related changes out of account, the utricle and horizontal canal ampulla appeared normal in all ears except one in which the ampulla was replaced by tumor tissue. In 11 ears the superior vestibular nerve was histologically intact and three of these ears also showed normal caloric responses. In seven ears there was a canal paresis, and in three no reaction was obtained. The ten ears with partial or total nerve invasion by tumor either showed a weak reaction or no response at all. It is likely that an early conduction block arises in both cochlear and vestibular nerves, and reduced reactions to appropriate stimuli do not warrant conclusions that the numbers of anatomically intact nerve fibers possibly are reduced.

Adult↗
PubMedDate not supplied

Temperature characteristics of squirrel monkey horizontal semicircular canals during caloric irrigation.

Current assumptions concerning body temperature of experimental animals, particularly as it relates to the selection of caloric test stimuli, are likely to be inaccurate guesses. Although the temporal bone of squirrel monkeys attenuates irrigation temperature by a factor of nearly 10, there is a high correlation between thermal changes in inner ear fluid and irrigation values. In this study, nystagmus (defined by electronystagmographic thresholds) occurred when horizontal canal temperatures deviated from resting temperature by +/- 0.14 C.

Animals↗
PubMed2004

Peripheral vestibular disorder induced by (+/-)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid (AMPA).

An intracochlear infusion of (+/-)-alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid (AMPA) was done in guinea pigs with a syringe pump and peripheral vestibular disorder was induced. Spontaneous nystagmus toward the intact side reached a peak 9 h after the infusion and disappeared within 18 h. As a control, artificial perilymph was infused and animals had no nystagmus. The nystagmus frequency was decreased by simultaneous infusion of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) in a dose-dependent manner. In the animals treated with AMPA or AMPA + CNQX, caloric tests performed 1 week after treatment revealed a partial dysfunction of vestibular periphery. These results indicate that the nystagmus observed is induced by AMPA via AMPA receptors and that AMPA-induced vestibular disorder is partial. This animal model may be a candidate for pharmacological study of inner ear diseases induced by glutamate excitotoxicity.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed2000

Clinical features of sudden hearing loss associated with a high signal in the labyrinth on unenhanced T1-weighted magnetic resonance imaging.

We report on five patients with high signals in the labyrinth on unenhanced magnetic resonance imaging who developed sudden hearing loss and vertigo. Weissman et al. (1992) suggested the possibility that such high signals were caused by hemorrhage. We assessed these patients using audiograms, caloric tests, and auditory brainstem responses to investigate the possibility of inner ear hemorrhage. Most of the patients were found to have severe and irreversible impairment of both cochlear and vestibular function. These findings were consistent with the hypothesis that their symptoms were caused by inner ear hemorrhage.

Adolescent↗
PubMed1976

Multiple sclerosis. The value of clinical vestibular examination.

A clinical vestibular examination was carried out on 82 patients with multiple sclerosis (MS) selected on McAlpine's criteria. Spontaneous nystagmus, positional nystagmus or pathological caloric test were found in 49 (60%) patients. Pathological horizontal optokinetic nystagmus occurred in 47 (57%) patients. In 36 cases horizontal optokinetic nystagmus was pathological to both sides, in 28 cases combined with a pathological vertical optokinetic nystagmus, indicative of diffuse intracerebral lesions. Lesions in the central vestibular system and in the optokinetic pathways were frequently discovered in early or atypical cases of MS.

Adult↗
PubMed1985

Vestibular response in denatured rape oil intoxication.

During the spring of 1981 a massive intoxication broke out in Spain, which is presently attributed to the ingestion of denatured rape oil, and which has been called 'Toxic Syndrome' (TS). We studied 51 patients affected by the TS one year after the onset of their disease, analyzing their vestibular responses in the caloric test with the help of an analog-digital computer. A significant decrease in the number of nystagmic beats of the affected patients can be observed, while the rest of the parameters studied show similar values to those found simultaneously in 30 normal subjects. It is suggested that these differences are yet another manifestation of the polyneuropathy found in intoxication by denatured rape oil.

Adolescent↗
PubMed1998

Unilateral vestibulotoxicity due to systemic gentamicin therapy.

Systemic gentamicin can cause acute bilateral, simultaneous, symmetrical loss of vestibular function manifested by symptoms and signs of chronic vestibular insufficiency (ataxia and oscillopsia). We report 6 patients presenting with ataxia and oscillopsia, but without a history of vertigo, who had severe unilateral loss of vestibular function on caloric testing. The absence of vertigo in these patients could be explained by two possible mechanisms: either, the unilateral loss of vestibular function was subacute, occurring over several days so that compensation could occur, or bilateral vestibular loss occurred which was then followed by asymmetrical recovery of vestibular function. The second hypothesis is supported by the observation that vestibular hair cells can regenerate after aminoglycoside damage.

Aged↗
PubMed1997

Audio-vestibular findings in meningioma of the cerebello-pontine angle: a retrospective review.

The aim of this study was the determination of the incidence of symptoms of audio-vestibular dysfunction and of abnormalities on audio-vestibular testing in patients found to have a unilateral meningioma of the cerebello-pontine angle (CPA). The case notes of 25 patients diagnosed with unilateral, sporadic and histologically proven CPA meningioma were retrospectively reviewed. The age range of this series was 31-71 years, with a mean age of 50 years. Two patients were male (eight per cent) and 23 were female (92 per cent). The mean length of history was 44.7 months. The distribution of tumour size was skewed toward larger tumours, with 15 cases (60 per cent) having tumours with a maximum diameter greater than 3.5 cm on imaging. Pure tone audiometry was normal in five cases (20 per cent), and no patients exhibited the high frequency sensorineural hearing loss that is characteristic of vestibular schwannoma. Speech audiometry was normal in 50 per cent of cases. Caloric testing was abnormal in 77 per cent of the 18 cases tested, whilst auditory brainstem responses (ABR) were abnormal in 100 per cent of the 18 cases who had sufficient hearing for this test to be possible. The presence of normal audiometry in patients with a proven CPA lesion indicates that, if in a protocol for investigation, asymmetry of hearing is mandatory then some pathology will be missed. Any suspicion of a CPA lesion warrants investigation even in the absence of hearing loss. The investigation of choice for the identification of CPA lesions has become magnetic resonance imaging (MRI). If this technique is not available then this study indicates that ABR is a suitable and sensitive investigation. It should be borne in mind however that the data in this study has been derived from a series of predominantly large tumours, and the sensitivity of ABR to smaller CPA meningiomata may fall, as is the case for vestibular schwannoma.

Adult↗
PubMed1997

Vestibular disorders in patients with migraine.

Vestibular symptoms frequently occur in patients with migraine headache. The common migraine is defined in neurology as a unilateral, pulsating headache, which may be associated with nausea and vomiting, and lasts one or several days. In the classic form patients have visual prodromal symptoms. Focal neurological signs in the migraine complique include, for example, oculomotor palsy and vestibular abnormalities. This so-called vestibular migraine is different from basilar migraine, which involves the irritation of the cervical sympathetic system, and can cause symptoms that resemble transient brainstem ischemia. In order to evaluate vestibular dysfunction electronystagmography (ENG) was used. Patients frequently had abnormal caloric test responses, especially with a directional preponderance, and most had a spontaneous nystagmus. In the migraine attack the patients are presumed to have hypersensitivity of the labyrinth with nausea and vomiting, while in the headache-free period the ENG was almost normal. At present, we have had a high success rate in treating patients with pyracetam. Diazepam was used to treat basilar migraine and flunarizine to prevent vestibular migraine.

Adolescent↗