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PubMedDate not supplied

[The magnetic amplipulse therapy of vestibular dysfunctions of vascular origin by using the Sedaton apparatus (experimental research)].

The paper describes the results of combined utilization of magnetic field (MF), sinusoidal modulated current (SMC) and galvanic current (GC) generated by a specially devised unit "Sedaton". This multimodality physiotherapy was tested in chronic experiments on 25 cats with experimental vascular and vestibular dysfunction. MF in combination with SMC displayed greater efficacy than in monotherapy. Positive physiological reactions were more pronounced.

Animals↗
PubMed2005

Diagnosis and management of lateral semicircular canal benign paroxysmal positional vertigo.

OBJECTIVE: Describe the diagnosis, treatment, and outcome of a group of 20 patients with lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). STUDY DESIGN AND SETTING: Retrospective review of 20 patients with LSC-BPPV (10 with geotropic and 10 with apogeotropic nystagmus) presenting to a tertiary balance center. Diagnosis was confirmed with infrared nystagmography in Dix-Hallpike positioning tests and supine positional tests. Patients were treated with one or more particle repositioning maneuvers. RESULTS: Addition of supine positional nystagmus tests to Dix-Hallpike positioning testing improves sensitivity in the diagnosis of LSC-BPPV. Treatment outcomes in the apogeotropic LSC-BPPV group were poorer than the geotropic LSC-BPPV group. SIGNIFICANCE: Adding supine positional testing to routine vestibular diagnostic testing will increase the identification of LSC-BPPV. Apogeotropic LSC-BPPV is more challenging to treat.

Adult↗
PubMed2005

Dix-Hallpike maneuver results are not influenced by the time of day of the test.

CONCLUSION: The result of the DH maneuver does not appear to be affected by the time of day at which it is performed. OBJECTIVE. To determine whether the time of day at which the Dix-Hallpike (DH) maneuver is performed influences the result. MATERIAL AND METHODS: This was a retrospective study. We reviewed the records of all electronystagmagrams (n = 1220) performed at our facility between January 2001 and January 2003, looking at the results of the DH maneuver, the medical history of the patients and the time of day of the test. The distribution of the time of day at which the DH maneuver was performed and induced a positive response was compared to the distribution of the time of day at which all the tests were performed. RESULTS: The distribution of the times during the day when the DH maneuver was positive was not statistically different from that when the DH maneuver was negative.

Caloric Tests↗
PubMed1993

Vestibular neuritis: an overview using a classical case.

Although acute unilateral and/or bilateral vestibular paralysis, known as vestibular neuronitis, is the second most common cause of vertigo (the most common is benign paroxysmal positional vertigo (BPPV), it is fraught with controversies. The clinical symptoms and methods of treatment of vestibular neuronitis are well defined; however, the etiology and pathophysiology of this disorder are still sketchy. Furthermore, there are no specific diagnostic tests available, and unfortunately, there are no animal models for this disorder. The purpose of this paper is to present an overview of those controversies using a classical case of vestibular neuronitis.

Adult↗
PubMed2005

[Myringoplasty and its effect on a vestibular function in patients with otitis media purulenta chronica (OMPC)].

A complex vestibulologic and audiologic examination was made in 25 patients with OMPC free of mesotympanitis before and after experimental myringoplasty with hen's egg amnion. The patients were divided into two groups depending on the presence of vestibular complaints. Partial or complete disappearance of subjective vestibular symptoms, reduced stimulation of the vestibular receptors (by 19%, on the average) were detected by experimental vestibular tests on the side of the affected ear. The asymmetry coefficient by labyrinth lowered by 31.1%, on the average.

Caloric Tests↗
PubMed1981

Diagnosis of acoustic neuroma.

The acquisition and application of new techniques in diagnostic screening have changed the approach to patients with suspected acoustic neuroma. In this paper, we review the extensive recent literature on acoustic tumors and present a critical analysis of the various diagnostic investigations. The older tests for cerebrospinal fluid protein, vestibular testing, and arteriography have been supplanted by modern audiometry with acoustic reflex testing, brain stem evoked responses, and computed tomography (CT). The various types of plain radiography are confirmed as an extremely useful screening modality. CT is insufficiently sensitive to serve as a primary screening procedure, but is a valuable confirmatory test. We propose a logical method of screening patients suspected of having an acoustic neuroma that can be applied by any practitioner in any clinical situation.

Adult↗
PubMed2003

Gentamicin perfusion vestibular response and hearing loss.

OBJECTIVE: To compare hearing results as a function of vestibular ablation in the treatment of Ménière's Disease, using gentamicin perfusion. STUDY DESIGN: A retrospective review of patients with Ménière's Disease treated by gentamicin perfusion of the inner ear via the MicroWick device. SETTING: A tertiary otologic referral center. PATIENTS AND INTERVENTIONS: The charts of patients treated with gentamicin perfusion via the MicroWick between the years 1998 and 2000 were reviewed. The results for patients with functional hearing in the affected ear were analyzed and were compared with the results in patients without functional hearing. MAIN OUTCOME MEASURES: Audiologic and vestibular test results as well as subjective symptoms. RESULTS: There were 45 patients who met the inclusion criteria. The averages for speech discrimination score and pure tone average before treatment were 92% and 38 dB, and after treatment were 82% and 47 dB. Patients were divided into two groups: Group 1 (20 patients), less than 75% ice air caloric reduced vestibular response (RVR); Group 2 (25 patients), those who reached greater than 75% ice air caloric RVR. There were 8 patients (17.6%) with persistent vertigo; 7 were from Group 1, and 1 was from Group 2, which was statistically significant (p = 0.007)wwww. The pure tone average dropped an average of 3 dB for Group 1 and 15 dB for Group 2. The difference in hearing loss between the two groups was statistically significant (p = 0.01). CONCLUSION: This study suggests that there is a correlation between the degree of vestibular ablation, the control of vertigo, and the risk of hearing loss. Patients with functional hearing seem to have a similar success rate for vertigo control, compared with patients who already had lost functional hearing before treatment. Future investigation may determine if less than 100% RVR, but greater than 75% RVR, is an alternative end point with adequate vertigo control and reduced risk of hearing loss.

Administration, Topical↗
PubMedDate not supplied

Otoneurological functioning in panic disorder patients with prominent dizziness.

Fifteen panic disorder patients with prominent dizziness underwent audiologic, caloric, and vestibuloocular reflex activity testing and were compared with normal controls. There were no abnormalities detected on audiologic and caloric tests. Compared with normal controls, panickers with dizziness showed a greater discrepancy between eye and head movements on vestibulo-ocular reflex activity in the dark. Panickers with prominent dizziness did not differ from a second control group of panickers with severe heart palpitations on a number of psychological tests. The results did not support the hypothesis that organic dizziness is etiologically important in the causation of panic or agoraphobia, but do suggest that vestibuloocular reflex activity should be further studied in panic disorder.

Adult↗
PubMed1991

[Equilibrium disorders and their diagnosis in childhood].

Vertigo in children is rarer than in adults and the examiner in cases showing these symptoms must rely on the parents' or relatives' observations and details. Besides the equilibrium disorders caused by hereditary malabsorption or lesions in the peripheral or central vestibular structures, e.g. ototoxic drugs, tumours in the brain, meningitis, encephalitis, otitis, labyrinthine fistulas or head trauma, we only known of typical diseases, associated with vertigo, that develop during childhood. These are: so-called benign paroxysmal vertigo of childhood, benign paroxysmal torticollis, basilar migraine, spasmus nutans, visual-cliff phenomenon, and kinetosis. Careful examinations are necessary to differentiate these illnesses from vestibular epilepsy, brain tumours, and hereditary episodic vertigo. Neuro-otologic examination in children, especially small children, is a kind of "stepchild" in ENT departments. The reasons are the time-consuming examination necessary in the case of children and by problems connected with a plethora of troublesome individual tests. Additional difficulties arise in cases of sensory, mental, and other impairments. - The paper gives an overview of vestibular disturbances during childhood and diagnostic procedures for determination by means of Frenzel glasses, electronystagmography, cranio-corpography, and posturography.

Caloric Tests↗
PubMedDate not supplied

Common migraine and vestibular function. Electronystagmographic study and pathogenesis.

Even though "classic migraine" and "complicated migraine" may be diagnosed readily, "common migraine" may be easily confused with other types of vascular headaches. This differential diagnosis is of great importance for the appropriate choice of drug therapy. It is frequently stated that family history of migraine and history of motion sickness in childhood suggest that a periodic vascular headache is most likely of migrainous origin; although this statement applies to ophthalmoplegic and hemiplegic migraine, it is doubtful that it applies to common migraine. In fact, in a pilot study of patients with common migraine, we have observed that family history and history of motion sickness in childhood did not contribute to the diagnosis. Vestibular dysfunctions are frequently associated with migraine including the common type. Utilizing labyrinthine tests with the aid of electronystagmography, abnormalities of labyrinth function were demonstrated in 80% of patients with common migraine who had no history of vertigo or of other otological and neurological disorders.

Adult↗
PubMed1973

The significance of optic fixation in tests of vestibular function.

Claims are often made that the electronystagmographic recording of induced nystagmic responses either with eye closure or in darkness enhances the sensitivity of the test. While this may be true of certain parameters it is not true of all and may in fact lead to a reduction in the diagnostic information obtainable with optic fixation upon a target.

Caloric Tests↗
PubMedDate not supplied

[Posturography in unilateral peripheral vestibular deficiency].

A thorough study of vestibular function cannot be limited to the evaluation of VOR alone; it must also include the study of VSR which serves to control erect stance under both static and dynamic conditions. In unilateral peripheral vestibular lesions (UVL) computerized stabilometry makes it possible to perform a more accurate evaluation of the VSR complex through the quantification of "postural sway". Furthermore, the diagnostic potential of stabilometry can be further fine-tuned by introducing a sensitization test, in particular the head retroflexion (OCR) and head shaking (OC-HST) tests. In the present study 61 patients with UVL of various etiology (viral, toxic, vascular, idiopathic) were studied. Besides electrooculography, stabilometry was performed under base conditions (eyes open and closed) and with sensitizing tests (OCR, OC-HST). L and S were used as statokinesigram parameters while frequency and oscillation amplitude on the sagittal and transverse planes were used as stabilogram parameters. Of the 61 UVL patients, 47.5% showed VOR compensation while static postural alterations were found in 31.1%; this raised to 50.8% when the sensitization test was introduced. Apparently the compensation phenomena became manifest more quickly for VOR than for VSR. The introduction of the sensitization test, however, markedly reduced this variance. The two sensitization, maneuvers used provided quantitatively equivalent results although in the absence of reciprocal agreement. Agreement was not even recorded between stabilometric HST and the head shaking test. This confirms the presence of two different routes for VOR and VSR. Nonetheless, the introduction of the sensitization test made it possible to identify those "false negative" VSR cases which were really pathological, thus making it possible to properly identify the patients' condition and arrange for adequate treatment.

Adolescent↗
PubMedDate not supplied

The effects of noise on the vestibular system.

PURPOSE: Subjects with noise-induced hearing loss sometimes also complain about balance disorders, but reports of clinical series that give contradictory results are highly controversial. This study was designed to evaluate the effects of intense noise on the vestibular labyrinth, both in subjects with symmetrical hearing loss and in subjects with asymmetrical loss, and to examine the correlation between the subjects' complaints and the results of the vestibular function tests. METHODS: A total of 258 male military personnel, heavily exposed to various intense noises, were included in the study. They were divided into 2 groups according to their hearing; 134 had a symmetrical high-tone hearing loss, and 124 had asymmetrical losses. Each group was divided into 2 subgroups according to the presence or absence of vestibular complaints. All of the subjects underwent a complete audiological and electronystagmographic evaluation. RESULTS: We found that vestibular damage caused by intense noise exposure might be expressed clinically in subjects with asymmetrical hearing loss. There was a strong correlation between the subjects' complaints and the results of the vestibular function tests. There was no correlation between the severity of the hearing loss and the vestibular symptomatology and pathology. CONCLUSIONS: Subjects exposed to intense noise may have evidence of vestibular pathology only when there is an asymmetrical hearing loss. Whenever hearing loss is symmetrical, an equal damage to the vestibular system of both ears is most probably responsible for the absence of abnormal findings on the vestibular function tests. The results of this study have important medicolegal implications for individuals exposed to intense noises.

Adult↗
PubMed1999

Delay of gastric emptying by duodenal intubation: sensitive measurement of gastric emptying by the paracetamol absorption test.

AIMS: To examine the influence of duodenal intubation on gastric emptying measured by the paracetamol absorption test using a new algorithm developed to estimate emptying parameters, and to determine the sensitivity of this test. METHODS: A caloric liquid meal with paracetamol as marker of emptying was administered orally to eight healthy volunteers during phase I and phase II of the migrating motor complex (MMC) and without intubation on 3 separate days, and to 10 patients with partial gastrectomy. RESULTS: Healthy subjects: With duodenal tube, time until 25% of the meal had emptied (t25%) was 24+/-7 (phase I, P<0.02) and 21+/-6 min (phase II, P<0.02) compared with 14+/-4 min for meal intake without intubation. Time until 50% of the meal had emptied (t50%) was 45+/-8 (phase I, P<0.001) and 35+/-8 min (phase II, P<0.02) compared with 26+/-9 min for meal intake without intubation. Intraduodenal instillation of 10-20 mL of the liquid meal was reliably detected. PATIENTS: In 9 out of 10 patients with partial gastrectomy t25% was below the lower limit of the range for healthy controls, and t25% detected accelerated emptying with a higher degree of sensitivity than the commonly applied pharmacokinetic parameters Cmax and Tmax. CONCLUSIONS: A duodenal tube delays gastric emptying of a caloric liquid meal. The paracetamol absorption test emerges as a sensitive method suitable for detecting both delayed and accelerated gastric emptying of caloric liquid meals.

Acetaminophen↗
PubMed1992

Is head-shaking nystagmus a sign of vestibular dysfunction?

It has been proposed that head-shaking nystagmus is a reliable test or indicator of vestibular dysfunction. Using a series of 340 patients and 20 controls, this paper compares the vestibular test data to head-shake test data to answer some of the questions about this poorly understood response. Head-shaking nystagmus appears to reflect the underlying spontaneous nystagmus and its direction has no relationship to the side of the vestibular asymmetry.

Caloric Tests↗
PubMed1989

[The visual fixation test in the study of visual-vestibular interactions. General aspects and results in normal subjects and patients].

Whenever we need to study visual-vestibular interactions, our method of choice among the ones based on thermal stimulation is the visual suppression test. In the vestibular laboratory of the II E.N.T. Clinic of the University of Parma the V.S.T. has been employed since 6 years systematically in all patients undergoing Electronystagmography. Our study was based on 10 normal patients and on 30 patients suffering from different pathologies. These patients were divided into groups according to the site of the lesion. The results we obtained are interesting: this test gives us important clinic data that we cannot obtain using other methods and allows us to discriminate the central or the peripheral site of the vestibular system lesion.

Adolescent↗
PubMed1999

One-year vestibular and balance outcomes of Oklahoma City bombing survivors.

This multisite investigation assessed subjective, behavioral, and objective balance function in 30 blast survivors. Subjects with vertigo, dizziness, or imbalance were screened (n = 6) or evaluated (n = 27) during 1 year. Tests included a questionnaire, electronystagmography (ENG), and computerized dynamic posturography (CDP). Ninety-seven percent of subjects were located inside a building during the blast, and 63 percent of subjects experienced dysequilibrium within 48 hours. Forty-three percent of symptoms could not be attributed to head injury. Sixty percent of subjects had abnormal ENG and/or CDP; ENG abnormalities mostly were peripheral or nonlocalizing, whereas CDP patterns were "vestibular," "surface dependent," and "physiologically inconsistent." At 1-year postblast, 55 percent of initially abnormal CDP results were normal, and 72 percent of subjects said symptoms were unchanged or occurred intermittently. A serial, test battery approach is recommended to assess symptoms. Blast-related dysequilibrium had clinically significant manifestations and should be considered a valid component of aural blast injury.

Adult↗