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At least 1,045 records · Page 58Linked to original sources
PubMed1985

The effects of TTS-scopolamine, dimenhydrinate, lidocaine, and tocainide on motion sickness, vertigo, and nystagmus.

The effects of TTS-scopolamine, dimenhydrinate, lidocaine, and tocainide on motion sickness and vertigo and on caloric and postrotatory nystagmus were evaluated in healthy volunteers. TTS-scopolamine was administered transdermally (delivering approximately 10 micrograms X h-1 scopolamine base) and 100 mg dimenhydrinate orally. Lidocaine and tocainide were administered intravenously (average plasma concentration of lidocaine 6 mol X L-1 and of tocainide 20 mol X L-1). TTS-scopolamine and dimenhydrinate significantly reduced vertigo induced by calorization of the ears, nausea provoked with Coriolis maneuvre, and nystagmus in caloric and rotatory tests. During treatment with lidocaine and tocainide no alleviation of vertigo and nausea was observed. Caloric nystagmus was reduced but rotation induced nystagmus was virtually unchanged. Presumably the motion sickness drugs act at the brain stem where TTS-scopolamine and dimenhydrinate have their target cells in the vestibular nuclei. Furthermore, the alleviation of motion sickness was linked to a decline of nystagmus. Lidocaine and tocainide, the action of which in vertigo and nausea in patients is proposed to be on the vestibular end organs and the supratentorial brain structures, consistently failed to alleviate motion sickness.

Administration, Topical↗
PubMed1992

Diagnosis of cerebellopontine angle tumors.

Between 1980 and 1990, 9,176 patients suffering from otoneurological disorders were investigated in our clinic. Sixty-six (0.72%) internal auditory canal or other cerebellopontine angle tumors (CPAT) were diagnosed. Brainstem auditory evoked potentials (BAEP), interaural time discrimination, and magnetic resonance imaging (MRI) revealed to be the most sensitive and efficient tests for the detection of CPAT. However, the investigation of otoneurological symptoms cannot be limited to BAEP and MRI on the a priori of a hypothetical CPAT. Electrophysiologic tests such as impedancemetry, and electronystagmographic testing are also needed to elucidate the many causes of otoneurological symptoms.

Adolescent↗
PubMed1995

Neurootologic findings in patients with so called Menière-like disease.

A group of 150 patients was clinically observed using a complete battery of neurootological methods. The patients were believed to suffer from Menière's disease (MD). After taking anamnestic data [NODEC III] and performing calorimetry, cranio-corpo-graphy and audiology tests we could confirm a former established diagnosis of MD in a few cases only.

Adult↗
PubMed1994

Computerised dynamic posturography: its place in the evaluation of patients with dizziness and imbalance.

As well as vestibular information, computerised dynamic posturography (CDP) measures visual and proprioceptive contributions to the balance system. Three hundred and seventy-five patients were evaluated by computerised dynamic posturography and the results were compared to electronystagmography (ENG) results. CDP demonstrated abnormalities in the balance system in many of the patients who had normal ENGs. It can hone the physician's skill in recognising subtle balance disease; it does not provide localization to one side; it does not offer disease-specific information; however, taken in conjunction with history, physical examination, and other tests, CDP will prove to be a helpful addition to the battery of tests available, and it may provide an objective measure of abnormal balance function in contentious cases.

Adult↗
PubMed2007

Accuracy of the bedside head impulse test in detecting vestibular hypofunction.

OBJECTIVE: To determine the accuracy of the bedside head impulse test (bHIT) by direct comparison with results from the quantitative head impulse test (qHIT) in the same subjects, and to investigate whether bHIT sensitivity and specificity changes with neuro-otological training. METHODS: Video clips of horizontal bHIT to both sides were produced in patients with unilateral and bilateral peripheral vestibular deficits (n = 15) and in healthy subjects (n = 9). For qHIT, eye and head movements were recorded with scleral search coils on the right eye and the forehead. Clinicians (neurologists or otolaryngologists) with at least 6 months of neuro-otological training ("experts": n = 12) or without this training ("non-experts": n = 45) assessed video clips for ocular motor signs of vestibular deficits on either side or of normal vestibular function. RESULTS: On average, bHIT sensitivity was significantly (t test: p<0.05) lower for experts than for non-experts (63% vs 72%), while bHIT specificity was significantly higher for experts than non-experts (78% vs 64%). This outcome was a consequence of the experts' tendency to accept bHIT with corresponding borderline qHIT values as still being normal. Fitted curves revealed that at the lower normal limit of qHIT, 20% of bHIT were rated as deficient by the experts and 37% by the non-experts. CONCLUSIONS: When qHIT is used as a reference, bHIT sensitivity is adequate and therefore clinically useful in the hands of both neuro-otological experts and non-experts. We advise performing quantitative head impulse testing with search coils or high speed video methods when bHIT is not conclusive.

Adult↗
PubMedDate not supplied

Sinusoidal harmonic acceleration test in clinical practice.

The author's experience during the first year of use of the Sinusoidal Harmonic Acceleration test in clinical practice is presented. The advantages of this test both in the diagnostic and monitoring areas are illustrated with patient evaluation summaries. Further, use of this test on a daily basis in the office practice of neurotology will define its role in the evolution and follow-up of neurotologic problems.

Adult↗
PubMed2003

[Study of 1,000 patients with disequilibrium].

We present a series of one thousand patients tested with electronystagmography (ENG) for evaluation of complaints of unstability. Personal data and electronystagmographic results are analysed.

Adult↗
PubMed1983

Vestibular studies in Pelizaeus-Merzbacher disease.

Pelizaeus-Merzbacher disease is a rare sex-linked recessive neurological disorder. It presents with a slowly progressive neurological deterioration. It is liable to be misdiagnosed as cerebral palsy. A family history of similar disease is a clue to the diagnosis. A patient with this condition has been followed over many years. Nystagmus was noted to be present shortly after birth. Audiovestibular investigations were performed. All tests of peripheral hearing were normal. ABR indicated abnormal brainstem conduction. Several electronystagmographic abnormalities were present. These were of a central type. They included failure of fixation suppression, poor smooth pursuit, and impaired performance of optokinetic nystagmus at high stripe speeds. During caloric-induced nystagmus an excessively prolonged slow phase of nystagmus with wide eye excursions was seen. We have not seen this feature in any other diseases and we suggest it may be specific for this syndrome.

Adult↗
PubMed1990

Unterberger stepping test: a useful indicator of peripheral vestibular dysfunction?

Deviation of gait in a stepping test has been proposed as a useful indicator of peripheral labyrinthine dysfunction. A prospective study of 26 patients suspected of having uncompensated peripheral labyrinthine dysfunction and 49 normal patients with normal labyrinthine dysfunction showed no significant difference in performance of the Unterberger stepping test between patients with electronystagmographically significant canal paresis and those with normal vestibular function.

Adult↗
PubMed1994

[Unterberger's test not useful in testing of vesitibular function].

OBJECTIVE: Quantification of the stepping test in routine neurological examination. SETTING: University Hospital Groningen, the Netherlands. DESIGN: Prospective, controlled study. METHODS: The stepping test was assessed in 41 healthy subjects, in 7 subjects with artificially induced vertigo and in 83 patients with disturbances of gait or equilibrium resulting from different affections of the central nervous system. Displacement and rotation to the right or the left side were measured. The different groups were then compared with each other. RESULTS: We found a great inter- and intra-individual variation in direction and width of rotation and in displacement. The results of the test are not influenced by right(+)-or left(-)-handedness or by dominance of the right or the left leg. CONCLUSION: The current test does not appear to be useful for detection of abnormalities in the vestibular system or for distinguishing normal individuals from patients.

Caloric Tests↗
PubMed1983

Clinical findings in patients with acoustic neurinoma.

Herein we review the symptoms, physical findings, and test results in 131 patients with acoustic neurinoma. The earliest symptoms are unilateral hearing loss, tinnitus, and dysequilibrium. As the disease progresses, facial numbness, facial weakness, and headaches become more prominent. Physical findings other than hearing loss are uncommon; the most frequently observed are a decreased corneal reflex, nystagmus, and facial hypoesthesia. Routine audiometry provides objective information about the hearing loss. Some degree of asymmetry is found in the pure-tone tests. In addition, the speech discrimination scores are frequently lower than expected. Special audiometric tests should be performed on those patients with residual hearing; at the present time, acoustic reflex tests and the brainstem-evoked response yield the most information. Computed tomography with dye enhancement with or without the use of air contrast has become the most accurate roentgenographic test. Our goal is to identify acoustic neurinomas sufficiently early so that surgical removal is safe and leaves minimal deficit.

Adolescent↗
PubMed1995

Balance testing in saturation diving.

UNLABELLED: The literature is sparse and equivocal concerning the possible influence of hyperbaric exposure on postural control and the vestibular system. HYPOTHESIS: Deep heliox diving may influence postural control and the vestibular system. METHOD: Multiple objective measurements of postural control were made in four divers by means of a static balance platform before, during and after an onshore experimental saturation heliox chamber dive of 32 d duration. Saturation pressure was 4.6 MPa, corresponding to a depth of 450 m of seawater (msw). Downward excursions to 470 msw were also performed. Clinical ENT and otoneurological examination, including bithermal caloric vestibular testing with electronystagmography (ENG) was performed before and after the dive. RESULTS: Reduced postural control was detected by the balance platform test in all four divers from approximately 200 msw and deeper. Body sway showed a distinct increase during compression, reaching a maximum value during the bottom phase. The Romberg index was not suitable for describing shifts in postural stability. All sway parameters returned to pre-dive values after surfacing. Immediately post-dive, most caloric responses were reduced, compared to the pre-dive results. CONCLUSION: We conclude that deep heliox diving influences postural control and the vestibular system. Computerized stabilometry is a convenient and sensitive method of monitoring postural control during saturation diving. The path length of the center of pressure (COP) seems to be suitable as a monitoring parameter.

Adult↗
PubMed1976

Cerebellar-pontine angle tumors. Results of quantitative vestibulo-ocular testing.

A new quantitative vestibulo-ocular test battery was evaluated in 12 patients with surgically confirmed cerebellar-pontine angle tumors. The battery consisted of precise vestibular and visual stimuli and digital computer analyses of responses. Eleven of 12 patients, including all patients with acoustic neurolemmomas, had significant vestibular deficits on the tumor side (P less than .01). Contrary to previous reports, rotatory tests (impulse and sinusoidal acceleration) reliably identified the side and magnitude of vestibular deficit. Eight of nine patients with surgically confirmed brain stem compression had significantly impaired smooth pursuit (P less than .05). Optokinetic nystagmus was impaired in five of nine patients with brain stem compression (P less than .05). By combining the results of the entire test battery with standard clinical evaluation, a good prediction of tumor size, location, and type was possible.

Adolescent↗
PubMed1994

Assessment of prognosis in sudden deafness.

We investigated the usefulness of three-dimensional audiograms in assessing prognosis during the early phase in 116 patients with sudden deafness. The initiation time of improvement in middle-frequency hearing at 15 dB or more was valuable in assessing prognosis in patients with deafness and scale-out types of hearing loss. Improvement within 13 days in patients with the deafness type, and within 17 days in those with the scale-out type, was correlated with a high incidence of marked improvement or complete recovery. Patients with an initial mean hearing level below 80 dB, or in whom the glycerol test and electrocochleography results suggested the presence of endolymphatic hydrops, had a good hearing outcome. Patients without tinnitus showed an unfavorable hearing outcome.

Adult↗
PubMed1986

Functional amaurosis: diagnostic value of electronystagmography.

Hysterical and malingered blindness may be distinguished from organic ocular and cortical blindness by a variety of clinical and electrophysiological tests. This report discusses the limitations of these tests and emphasizes the objective superiority of a new test which utilizes the electronystagmographic technique. This test is based on the principle that visual input blocks nystagmus induced by vestibular stimulations: the presence of nystagmus suppression will indicate that blindness is either hysterical or malingered.

Blindness↗
PubMed1985

Usher's syndrome type III: ENG findings in four affected and six unaffected siblings.

ENG recordings showed abnormal findings in subjects affected by Usher's syndrome and in unaffected siblings. Unaffected subjects with hearing impairment may be heterozygote carriers with inner ears more sensitive to various injurious stimuli, e.g. noise, than those of healthy subjects. Vestibular tests may facilitate the detection of heterozygote carriers but the number of patients studied by us is too small to allow definitive conclusions to be reached.

Adult↗
PubMed1996

Panic, agoraphobia, and vestibular dysfunction.

OBJECTIVE: Otoneurological abnormalities have been reported in panic disorder. The purpose of this investigation was to determine the prevalence of such findings in panic disorder with and without agoraphobia and to discern whether vestibular dysfunction was associated with specific symptoms. METHOD: Clinical audiological and vestibular tests were administered to 30 patients with uncomplicated panic disorder (without agoraphobia or with only mild agoraphobia), 29 patients with panic disorder with moderate to severe agoraphobia, 27 patients with anxiety but no history of panic attacks, 13 patients with depressive disorders but no history of anxiety or panic attacks, and 45 normal comparison subjects. Evaluators were blind to subjects' diagnostic group. Quantitative measures of subjects' discomfort with space and motion and of the frequency of certain symptoms between and during panic attacks were obtained. Anxiety state levels were measured during the vestibular tests. RESULTS: Vestibular abnormalities were common in all the groups but most prevalent in the patients with panic disorder with moderate to severe agoraphobia. Vestibular dysfunction was associated with space and motion discomfort and with frequency of vestibular symptoms between, but not during, panic attacks. There were no major differences between the two panic groups in anxiety levels during vestibular testing. There were no significant differences between groups on the audiological component of the test battery. Exploratory data analysis indicated that the constellation of vestibular tests most specific for agoraphobia was one indicating compensated peripheral vestibular dysfunction. CONCLUSIONS: Subclinical vestibular dysfunction, as identified by clinical tests, may contribute to the phenomenology of panic disorder, particularly to the development of agoraphobia in panic disorder patients.

Adult↗
PubMed2004

Neurosensory deficits after myocardial infarction.

Cardiovascular diseases are extremely widespread and often cause vestibular system dysfunctions. They are related mainly to organic lesions of the brain. To investigate neurootological functional changes, we compared two samples from among our patients, of whom those in group A (42 persons: 92.86% male, 7.14% female) had experienced myocardial infarction within 1 year before our neurootometric investigation and those in group B had undergone infarction 1 year or more before examination (104 patients: 81.73% male, 18.27% female). Considering only the six most important vertigo symptoms experienced by patients, we found 1.48 symptoms per patient in group A and 2.02 symptoms per patient in group B. As regards acoustic symptoms, 45.24% of patients in group A experienced tinnitus and 52.38% reported hearing loss. In patients in group B, 48.08% were affected with tinnitus and 58.65% with hearing loss. Abnormalities in the neurootometric measurements were revealed as follows: in group A, butterfly calorigrams, 80.95%; stepping-test craniocorpography (CCG), 64.29%; and bone conduction audiometry on the right side, 40.48%, and on the left side, 52.38%; in group B, butterfly calorigrams, 78.85%; stepping-test CCG, 61.54%; bone conduction audiometry on the right side, 28.85%, and on the left side, 41.35%.

Audiometry, Pure-Tone↗