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[Viscosity of blood and sensorineural hearing loss (author's transl)].

A statistical survey about the results of treatment of Pentoxifyllin (Trental) in acute and long-standing sensorineural hearing losses is given. The pharmacological effect of viscosity lowering in such patients is demonstrated. The role of erythrocytes and their behaviour in relation to the viscosity of blood its showed by means of literature.

Acute Disease↗

Office management of the dizzy patient.

This article has attempted to set out in a logical, step by step fashion the approach to a dizzy or vertiginous patient. All that has been said will not apply to every patient. The investigator must above all be patient and thorough in obtaining the history--this is by far the most important step in the process. The physical examination is tailored to the complaint. Investigations include examinations of hearing, balance, serum chemistry, and radiology. Most otolaryngologists limit themselves to the diagnosis and limited medical management of dizziness and vertigo. It is required, however, that any physician treating dizzy patients have an understanding of the larger medical and surgical picture. A systematic and thorough approach to the dizzy patient will often yield the diagnosis, exclude otologic causes for imbalance, and ultimately set the patient on a proper course of treatment.

Ambulatory Care↗

[The exploding head syndrome].

The case is reported of a 47-year old female suffering from the exploding head syndrome. This syndrome consists of a sudden awakening due to a loud noise shortly after falling asleep, sometimes accompanied by a flash of light. The patient is anxious and experiences palpitations and excessive sweating. Most patients are more than fifty years of age. Further investigations do not reveal any abnormality. The pathogenesis is unknown, and no therapy other than reassurance is necessary.

Brain Diseases↗

The dynamic posturographic pressure test for the presumptive diagnosis of perilymph fistulas.

A diagnosis of perilymph fistulas (PLFs) can be made only by identification of repeated accumulation of crystal-clear fluid from an otic capsule defect or labyrinthine window at tympanotomy. It would be highly desirable to base a decision to operate for the diagnosis and management of PLFs on a database that includes quantitative test data, which confirms, with a high probability, a clinical suspicion of PLF. This article reviews progress in the development of a test of the vestibular response to external auditory canal pressure changes as recorded by dynamic posturography. Based on results to date, it appears that a fistula test with dynamic posturography is more sensitive than those based on VOR responses. This may be due to the ability of dynamic posturography to isolate vestibular from both visual and somatosensory influences on motor responses during external canal pressure changes.

Ear Diseases↗

Panic disorder and the vestibular system.

This article reviews the interrelationship between panic disorder and vestibular function. There is a possibility of both somatopsychic and psychosomatic interactions between panic and the vestibular system. Another possibility is that vestibular dysfunction could be associated with certain mental disorders, including panic disorder, as a nonspecific marker. Somatopsychic interactions are suggested by findings of high prevalence of vestibular dysfunction in selected patients with panic disorder, by the occurrence of "space and motion phobia" in patients with panic disorder, and by the report of anxiety and pseudoagoraphobia in some patients with a primary complaint of vertigo. Psychosomatic influences include symptoms of dizziness and increased sensitivity of the vestibular system due to anxiety or hyperventilation. Vestibular dysfunction as a nonspecific marker is discussed in the context of a review of studies of the vestibular system in schizophrenia. Before more definite conclusions can be drawn whether panic disorder is related to vestibular dysfunction in some cases, further research is needed to establish the specificity of vestibular dysfunction for panic disorder.

Agoraphobia↗

[Audiogram-analogue representation of the vestibular reaction to caloric stimulation (author's transl)].

A new diagram with audiogram-like presentation of the vestibular reaction to caloric stimulation is proposed, which facilitates the identification of typical vestibular disorders. Spontaneous nystagmus with the relevant parameters is entered in the chart. The diagram can be used for any parameter of the reaction, such as frequency, slow phase velocity or total amplitude in a defined period of time, e.g. 30 sec of maximal reaction.

Adult↗

[Medico-legal assessment of vestibular disturbances (author's transl)].

In the medico-legal assessment of vestibular disturbances the degree of handicap in daily and occupational situations is to be considered. Therefore a five degree classification of everyday performances (physiological stimuli of daily life) involving the vestibular system and a grading of vestibular disorders based on subjective and objective symptoms have been compiled. A diagram relating intensity of vestibular disturbance with performance gives the percentage of reduction in working capacity (MdE).

Diagnosis, Differential↗

Sensory integration in the rehabilitation of blind adults.

Learning difficulties displayed by the blind adult prompted an investigation of a link with sensory integrative dysfunction. A review of the literature provided evidence that tactile and vestibular deficiencies were prevalent within this population. Through observational assessment, sensory integrative dysfunction was identified in a number of clients and individual sensory integrative treatment programs were initiated. In the three case studies presented, improvements were noted in mobility, activities of daily living, handwriting, and behaviour after six months of treatment. A discussion is provided on those deficit areas responding to sensory integrative treatment.

Activities of Daily Living↗