[The effect of vibration of railroad transport on vestibular chronaxy].
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Over 250 reports concerning or related to Meniere's disease, published in English from 1978 through 1982, are summarized. Reports have been classified into the categories of incidence of occurrence, analysis and reporting results, pathophysiology, etiologic theories, diagnostic methods, medical management, and surgical procedures. Major emphases in reporting from 1978 though 1982 have been in the areas of pathophysiologic studies, expansion of diagnostic procedures, and the use of sac decompression and neurectomy procedures. This literature review reveals the continuing disagreement regarding the pathophysiology of Meniere's disease and the resultant continued controversies in its management.
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Dizziness is greeted by most doctors with a degree of despair and is often dismissed as a trivial complaint, despite the many causative pathologies. For the patient, it is disabling, disorientating, and, in unresolved cases, may lead to chronic invalidism. A simple approach to the problem is given.
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The study gives a survey of the different terminologies, opinions regarding etiology, and differential diagnoses. In accordance with animal experiments, and our own experience with 71 patients, an activating therapy, including exercises, is recommended instead of bed-rest. Under special circumstances diagnosis may be difficult. For instance, a centrally reduced thermal reactivity of the healthy labyrinth may mimic a bilateral canal paresis. The vestibular type of Menière's disease, disseminated encephalomyelitis, herpes zoster oticus, or the complication of a chronic otitis media cannot always be differentiated from a unilateral vestibular paralysis.
The methods of "reflex olfactometry" are rarely able to detect simulated anosmia because of the lack of reproducible correlations between stimulus and intensity of reaction. Interactions between the olfactory and vestibulospinal systems have not yet been investigated. Thirty persons with normosmia and 21 patients with anosmia were studied using a posturographic platform. Only in subjects with normosmia were body sway increases statistically significant in an anterior-posterior direction after the application of an olfactory nerve stimulant. Stimulations of the trigeminal nerve cause both in subjects with normosmia, and anosmia an increase in body sway occurred in a sagittal and lateral direction. The recording of vestibulospinal reactions during platform posturography after application of an olfactory stimulations enables quantification of body sway. These responses can also be useful in differentiating real from stimulated anosmia.
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Meningitis is still one of the serious infectious diseases in clinical practise. In a high percentage of cases with this disease process, the auditory and vestibular parts of the inner ear are damaged. In this study the auditory and vestibular systems of 53 children and teenagers between 1.7 and 18.7 years of age were examined following meningitis. The mean time-interval between meningitis and examination was 5.8 years. Eighty-one of 106 ears examined showed sensorineural hearing losses which varied between mild hearing loss and total deafness. Peripheral vestibular lesions were found in 60 of 106 labyrinths examined. These varied between inhibition and total loss of function. In addition, we also found central vestibular lesions in 29 cases. Mild and moderate combined auditory and vestibular lesions could be verified in 23 ears, whereas profound functional disturbances or functional losses were found in 29 ears examined. Eight of 40 ears with hearing losses and 12 of 40 ears with peripheral vestibular lesions showed progression during follow-up. The findings of this study emphasize the need for auditory and vestibular diagnostic studies followed meningitis in children and teenagers. Patients and their families should be cared for on a long-term basis to avoid social and psychological problems.
Vertigo is one of the most frequent reasons for consultation in daily medical practice. Recent studies show that vertigo involves considerable social costs before being managed efficiently, as it is often incorrectly diagnosed. Sometimes a psychiatric symptom, the original causes are vestibular in Ménière's disease, vestibular neuritis, and benign positional vertigo. Ménière's disease to some extent resembles that of progressive autoimmune deafness. Soon, perhaps, the target of the long-suspected immune reactions will be identified and specific treatments will be developed for the rapidly progressing forms. Benign paroxysmal positional vertigo is certainly a favorite of practitioners because the treatment is so simple. Not all vertigos are so easily cured, and surgery must sometimes be performed. In most cases, retrolabyrinthine vestibular neurectomy, with its acceptable risks, is the operation of choice. New diagnostic techniques, such as dynamic posturography, are interesting, but their use is not as yet clear.
We measured vertical vection during a short term space flight and 2 long term space flights to evaluate the state of adaptation to microgravity. The first phase of microgravity adaptation showed with major changes of vertical vection perception such as "inverted vection". This method will be used to reveal mechanisms of adaptation to altered vestibular inputs.