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At least 1,027 records · Page 57Linked to original sources
PubMed2004

Vision preference in dynamic posturography analysed according to vestibular impairment and handicap.

OBJECTIVE: The objective of this work was to characterise the implications of vision preference derived from the sensory organisation test of computerised dynamic posturography, in terms of impairment, disability and handicap. MATERIAL AND METHOD: This was a prospective assessment of 88 patients suffering from dizziness who denied experiencing any visually induced vertiginous symptoms. The level of impairment of each patient was estimated by performing a complete analysis of vestibular function by means of the caloric and rotatory stimulation tests. Disability and handicap were determined with the Dizziness Handicap Inventory questionnaire (DHI). RESULTS: The results of the caloric test in patients were independent of vision preference although canal paresis was more frequently abnormal in patients without visual preference. No differences were found in the results of rotatory stimulation by means of impulse and sinusoidal tests, both at high velocities of stimuli, in between patients with and without vision preference. Similarly, the responses in the DHI, a common questionnaire for vestibular disability and handicap and, specifically to questions addressing the problem of visual and vestibular disability, were not able to differentiate either group of patients. Nevertheless, we have found that patients with vision preference tend to have poorer balance. CONCLUSION: We consider that in the patients studied here, vision preference must be considered as a normal finding as this represents a normal strategy in a subject that relies more heavily on visual cues for his or her postural control.

Adult↗
PubMed2000

Toward a standard for electronystagmography.

Although the adoption of a standard is desirable, no person or laboratory will be entirely happy with whatever standard because ENG testing has become so individualized. Hopefully, a standard that will enhance patient care can be implemented without much cost.

Caloric Tests↗
PubMed1989

Menière's disease as a late manifestation of congenital syphilis.

Five patients, suffering from tinnitus, perceptive hearing loss and vertigo were examined. A positive FTA - ABS test and a history of interstitial keratitis in early adult - life suggest a causal relationship between the Menière's triad and congenital syphilis in these cases. The value of a positive serological test (FTA - ABS or MHA - T.P.) in the presence of inner-ear symptoms is discussed.

Caloric Tests↗
PubMed1994

Acceleration registrography of head movement during alternating inclination of the support platform.

The righting reflex, essential for maintaining equilibrium, keeps the head and trunk in a state of balance with regard to gravity. Because patients suffering from vestibular disorders almost always complain of dizziness during everyday movements such as rising and walking, the righting reflex should be evaluated within the context of these dynamic states. A new method of acceleration registrography was designed to enable the testing of this reflex as the subject stands upon a moving platform. Participating in the study were 49 normal control subjects and 80 patients with peripheral vestibular disorders. The test we devised proved to be more successful in detecting labyrinthine righting reflex dysfunction in patients than the tests of righting reflex and deviation evaluations used thus far, such as Romberg's, Mann's and the stepping test, and to more accurately represent the disequilibrium and/or dizziness experienced by patients in everyday movements.

Acceleration↗
PubMed1989

[Amplitude summation and the pendulum test as elements of the otoneurologic examination].

Vestibular tests were performed in more than 600 otoneuological patients. The data analysed included the otoneurological history, audiograms, observation of spontaneous nystagmus, caloric and swing tests, and recording by electronystagmography. The tracings were subjected to summation of the amplitudes of the slow-phase nystagmus and classification of the recording as peripheral (small amplitude, high frequency) or central (dysrhythmia with bouts of high-frequency nystagmus). The correlations between spontaneous nystagmus and directional preponderance in caloric and rotation tests are complex, and our results show that an isolated abnormality has little significance. The expected correlation between hearing loss and unilateral caloric paresis was confirmed. Other lesions, such as peripheral or central ENG tracings and reduced vestibular reaction, did not correlate with any other pathological finding. Directional preponderance and spontaneous nystagmus were significantly more frequent in patients with unilateral caloric paresis than in those with a symmetrical response. The incidence of a peripheral type of ENG tracing, hearing loss and unilateral paresis increased with the age of the patients. Reduced vestibular response, a central type of tracing and directional preponderance did not correlate with age. The well-known variability of the subjective threshold of vertiginous sensations was confirmed by the results in patients with no vertigo, and deserves more attention.

Adult↗
PubMed1989

Recognition of food by individual, food-naive, weaning rats (Rattus norvegicus).

To control and observe first feeding experiences, pups were reared without access to food. At weaning age, individual pups received simultaneous access to a palatable, noncaloric diet and a similar diet containing starch. Each diet contained a flavor cue. Within 20 min of sampling both diets pups preferentially ingested the caloric alternative. Further tests indicated that pups learned a preference for flavor cues paired specifically with ingestion of starch. In caloric discrimination tests in which the diets were not distinguished by artificial flavors, pups did not show the rapid preference for the caloric diet seen in earlier experiments. We suggest that recognition and preference for the caloric diet is based on its rapid postingestive effects rather than readily preferred sensory features of the starch. Our findings demonstrate the abilities of individual, food-naive pups to rapidly recognize food and indicate a role for associative learning in the onset of independent feeding.

Animals↗
PubMed1983

Vestibular dysfunction and psychopathology.

A review of the empirical findings linking vestibular response abnormalities to psychopathology, and particularly to schizophrenia, indicates that these data do not unequivocally document the presence of peripheral or central disease of the vestibular system in any patient group. The reasons for this ambiguity include: use of imprecise stimulation techniques, inaccurate measures of responsiveness, unreliable measures of quantification, and the absence of experimental control over extravestibular variables. Future directions for research in this area are discussed, including the localizing information derived from properly conducted tests of the vestibulo-ocular reflex in studies of oculomotor function.

Adult↗
PubMed1983

Illuminance and recording of eye movements by electro-oculography.

The fluctuation of the d.c. potential of the eye following changes in the ambient level of illuminance is well recognised in the field of ophthalmology. However, the influence of this factor in the recording of eye movements in the oto-neurological clinic has been little investigated. In this study the variation in the d.c. potential was measured for fixed periods of time after subjects entered a clinic environment of known illuminance and after entering the dark. In the short term (3-4 min), the variation in d.c. potential was less than 20% in the 22 subjects tested. Suggestions are made to minimise these fluctuations in the recording of nystagmus and other eye movements.

Adaptation, Ocular↗
PubMedDate not supplied

Rationale of rehabilitation treatment for vertigo.

Rehabilitation treatment is based on experimental data concerning compensation and adaptation in peripheral vestibular lesions. Patients with a steady state of peripheral vestibular dysfunction are candidates for rehabilitation therapy. Provoked (positioning) vertigo resulting from such lesions is treated by individually selected exercises (vestibular habituation training). Functional evaluation is indispensable for patient selection. In accordance with experimental data, the exercises are selected individually by testing patients with a vestibular habituation training test battery. The favorable effect of vestibular habituation treatment is suggested by comparison with drug and sham treatments in similar cases.

Caloric Tests↗
PubMed1978

Vestibular function in benign intracranial hypertension.

Investigation of vestibular function in 34 patients with benign intracranial hypertension was performed and a follow-up examination 3-20 years after the primary examination, when the symptoms of intracranial hypertension had disappeared. A primarily affected vestibular function was found in 19 patients (56%), viz. hyporeactivity in 9, preponderance in 9, and hyperreactivity in 2. Except for 2 patients, all had normal vestibular reactions at follow-up. These patients exhibited no evidence of what is called 'congestive inner ear'. An account is given also of the role of vestibular testing in connection with brain death criteria and recent experience of continuous monitoring of intracranial pressure.

Adolescent↗
PubMed1997

Prevalence of head-shaking nystagmus in patients according to their diagnostic classification in a dizziness unit.

OBJECTIVE: In a previous publication, the authors documented the prevalence and characteristics of head-shaking nystagmus (HSN) in over 1300 consecutive dizzy patients during formal electronystagmography (ENG) at the combined Otologic Function Unit (OFU) of the Toronto and Mount Sinai Hospitals. This companion study was done to prospectively analyze a subgroup of 300 patients with known clinical diagnoses belonging to the senior author (J.R.). METHODS: The prevalence of HSN in this series of patients with a known diagnosis is prospectively compared to the presence of HSN in a series of normal controls. RESULTS: Results indicate that HSN is seen significantly (p < .05) in those patients with peripheral vestibular dysfunction and that the more globally the peripheral vestibular disorder involves end-organ (i.e., Meniere's) or primary afferent-neuron function (i.e., vestibular neuronitis), the more likely HSN will be present. CONCLUSION: We further comment on the usefulness of the head-shake test and its clinical relevance in the bedside examination of the dizzy patient.

Adolescent↗
PubMedDate not supplied

Audiovestibular findings in patients with delayed and idiopathic endolymphatic hydrops: a comparative study.

OBJECTIVE: The objective of this study was to analyze the neuro-otological findings in patients with delayed endolymphatic hydrops and compare them with audiovestibular abnormalities found in patients with idiopathic endolymphatic hydrops. Study design A retrospective open case study. SETTING: A referral ambulatory dizziness clinic. PATIENTS: Medical records of 30 patients with delayed endolymphatic hydrops and of 33 patients with idiopathic hydrops were analyzed. Outcome measures Clinical, electronystagmographic, caloric, and audiometric results in both groups of patients. RESULTS: No differences in the prevalence of abnormalities on clinical testing, electronystagmography (including rotatory chair), or caloric testing were found between the groups. The clinical outcome of conservative therapy was better in patients with idiopathic endolymphatic hydrops (P =.03). CONCLUSIONS: These findings are in keeping with the presumed common pathophysiology of delayed and idiopathic endolymphatic hydrops. However, it is important to identify patients with delayed hydrops in view of the chance of the potential poor response to medical therapy.

Adolescent↗
PubMed1989

Electronystagmography in the diagnosis of multiple sclerosis.

The aim of our study was to define the diagnostic importance of a complete electronystagmographic (ENG) examination (visual-vestibular, vestibular and visual suppression tests on caloric nystagmus) in patients affected by MS. Of 144 patients examined, 116 were definite and 28 possible. Descriptive data of the instrumental findings showed very frequent alterations of one or more subtests: pursuit movements and visual suppression test were especially pathological, in respectively 56% and 58% of the cases; spontaneous and/or evoked nystagmus was present in 45%. A comparison between clinical and instrumental evidence of brainstem/cerebellar involvement indicated that 18% of the definite and 32% of the possible MS cases presented a negative clinical examination with positive instrumental findings. The usefulness of including a comprehensive ENG examination to obtain paraclinical evidence of a second lesion in the CNS in early MS is discussed.

Adult↗
PubMedDate not supplied

Some electronystagmographic manifestations of central nervous system disease.

A battery of tests with electronystagmography were performed on two groups of patients, one in which posterior fossa abnormalities had been confirmed independently by neurologic findings, contrast studies, or surgery; the other group consisted of what seemed clinically clear cut peripheral VIII nerve or labyrinthine disturbances. The two groups were compared statistically for the incidence of factors thought to indicate the presence of brain stem lesions. No single factor is absolutely reliable by itself as an indicator of brain stem disease, but the use of a test battery permits a much more accurate indication of probability of the presence of brain stem lesions.

Brain Diseases↗
PubMedDate not supplied

Follow-up vestibular examination in Menière's disease.

A retrospective study was carried out on repeated audio-vestibular examinations in 53 patients with unilateral Meniere's disease, between the vertiginous spells. Most patients showed no change in the caloric response reduction of the afflicted ear in the subsequent tests compared with the first one. These patients had a comparatively long illness duration, a small percentage of fluctuations in the pure tone audiogram and mostly flat or falling type curves. A minority of patients showed an increase in or a fluctuating caloric test reduction. This group consists of patients with a short disease duration, mostly a fluctuating pure tone audiogram and rising or dome-shaped curves. The hearing loss and the caloric test reduction appear to deteriorate mainly in the first years of the disease. A certain parallelism between the course of vestibular and audiological damage seems to be present.

Adult↗
PubMed2005

Food viscosity influences caloric intake compensation and body weight in rats.

OBJECTIVE: To determine the effects of food viscosity on the ability of rats to compensate for calories in a dietary supplement. RESEARCH METHODS AND PROCEDURES: In a series of four experiments, rats consumed dietary supplements equated for caloric and nutritive content but differing in viscosity. Experiments 1 to 3 examined the ability of the rats to compensate for the calories consumed in low- compared with high-viscosity premeals by reducing intake of a subsequent test meal. Caloric compensation was assessed with a wide range of premeal viscosity levels and with two different non-nutritive thickening agents. Experiment 4 assessed the effects of consuming daily a low-viscosity compared with an equicaloric high-viscosity dietary supplement on longer term body weight gain. RESULTS: Consuming a lower viscosity premeal was followed by significantly more caloric intake (i.e., less caloric compensation) compared with consuming premeals with higher viscosity levels. This effect was not specific to one thickening agent. Furthermore, rats given a low-viscosity supplement daily gained significantly more weight over a 10-week period compared with rats given a high-viscosity supplement. DISCUSSION: The results of these experiments suggest that food viscosity may be an important determinant of short-term caloric intake and longer term body weight gain.

Animals↗
PubMed1991

The investigation of acoustic neuroma.

Gadolinium-enhanced magnetic resonance (GdMR) is the long awaited, easy and definitive investigation for imaging or excluding small acoustic neuromas. However, on the grounds of cost alone it is unrealistic to submit every patient with mild unilateral sensorineural deafness to GdMR. A screening regime is described which combines simple but effective imaging studies of the internal auditory meatus with clinical testing of vestibular function and objective audiometry. The 'two out of three positive' approach based on these tests has proved to be a reliable screening regime for selecting patients for GdMR.

Audiometry, Evoked Response↗
PubMed1985

Bilateral vestibular loss, oscillopsia, and the cervico-ocular reflex.

Oscillopsia during head movement occurs in patients with bilateral vestibular loss and may be transient or persistent. To investigate mechanisms underlying recovery we tested the vestibulo-ocular reflex (VOR), visual-vestibular interaction, and the cervico-ocular reflex (COR); we used a pseudorandom oscillatory stimulus with a frequency band width of 0 to 5 Hz in six patients with bilaterally absent caloric responses and in 10 normal controls. Seven control subjects had low-gain COR responses, but these were anticompensatory with respect to the VOR. Three asymptomatic patients with an absent or grossly deficient VOR had increased oculomotor responses at all frequencies when oscillated in light. Compensatory COR responses were detected in these patients but not in patients with persisting oscillopsia. In some patients with bilateral vestibular loss, augmented cervico-ocular and visual reflexes may compensate, at least partially, for an absent VOR.

Adaptation, Physiological↗