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At least 1,099 records · Page 61Linked to original sources
PubMed1996

Head stabilization in peripheral vestibular syndromes.

In classical posturography the standing position has been evaluated by recording the postural sway on a force-plate and measuring some parameters such as surface and velocity (Platform or P-recording). The postural sway not only results in forces exerted on the support surface by the feet, but the head also participates in the movements of this postural sway. For recording of the head movements (H-recording), a lightbulb is placed on top of the head and the described light-path is recorded by a TV camera. Such an H-recording can be achieved simultaneously with the platform-recording. A comparative study indicates that, for some patients differences could be found between H- and P-recordings, for others not. The H-recording, in fact, gives information about the stabilization of the head, compared with the stability on the platform (P-recording). The importance of the information furnished by the double recording in Static Posturography type IV (SPGIV) can be deduced from the number of patients showing one or more differences between the types of recording. Nearly 70% showed a difference in at least one test. In fact, 55% showed it in two or more tests. In half of the tests, considered separately, a difference was noted. The differences observed provide complementary information in this combined recording. If the H-recording were to be used as a separate technique, it has to be born in mind that the results are certainly not always the same as when using P-recording, as in classical posturography.

Adolescent↗
PubMed2005

Audiological and vestibular features in affected subjects with USH3: a genotype/phenotype correlation.

The aims were to compare the genotype/phenotype relationship between USH3 mutations and the consequent hearing and vestibular phenotype; and to compare hearing loss (HL) progression between Usher syndrome types IB, IIA and USH3. Genetic, audiometric and vestibular examinations were performed in 28 subjects with USH3. Five different mutations in USH3 were identified. Severe HL was present from an early age (4 to 6 years) in 35% of subjects with USH3. Progression of HL begins in the first decade, and approximately 50% of subjects with USH3 become profoundly deaf by age 40. Various vestibular abnormalities were found in about half (10/22) of the tested subjects with USH3. Depending on the severity of HL, subjects with USH3 might be misdiagnosed as either Usher type IB or IIA. The results from this study can be used as discriminatory features in differential diagnosis of this syndrome.

Abnormalities, Multiple↗
PubMed1994

Intratympanic gentamicin in bilateral Menière's disease.

Treatment of bilateral Menière's disease is a delicate task. Streptomycin has demonstrated its ability to successfully control the vertigo attacks, but in some cases it results in oscillopsia and transforms the periodic attacks to permanent instability. If the site of the active labyrinth can be determined, a more specific treatment can be tried. We have treated 14 patients with intractable bilateral Menière's disease with intratympanic gentamicin (Garamycin, 40 mg/ml) administered initially in either 1, 2, 3, or 4 injections. The patients were tested at frequent intervals and followed up for 2 years. The work capacity, severity of vertigo, and gait difficulties were scored before treatment and during each test occasion. The postural stability was evaluated on a force platform and sway velocity was analyzed. Before treatment, moderate or severe reduction of work capacity was experienced by all of the subjects, which correlated to severity of vertigo and gait problems. Two years after treatment, the vertigo attacks were eliminated in 11 subjects and controlled in three subjects. The work capacity of three subjects was still moderately or severely reduced. This reduction depended on gait disturbance and Tumarkin attacks. The average postural stability returned to pretreatment level 2 years after the treatment was begun. The outcome of the caloric responses did not correlate with the outcome of the treatment. Hearing was not significantly affected by the treatment. Intratympanic gentamicin treatment is a relatively safe and effective way to treat bilateral Meniere's disease when the symptoms can be localized to one ear.

Adolescent↗
PubMed1977

[The present status of vestibular testing (author's transl)].

Proceeding from the standard aims of every vestibular test, modern fine-quantitative investigatory methods with or without electronystagmographic recording in opposition to the systematic search for spontaneous and provoked nystagmus are presented with a view to their value for medical practice. Examination of spontaneous nystagmus and provoked nystagmus including the fistula symptom and coarse-quantitative excitability tests still represents the most important and most profitable part of the vestibular investigation. For modern research methods standardization of nomenclature and restriction of their plurality are as necessary as a method, which takes in not only single parameters but the whole data contents of vestibular reactions. The practicability of the method is documented by the author's own research work in this field.

Caloric Tests↗
PubMedDate not supplied

Cardiac rehabilitation without exercise tests for post-myocardial infarction and post-bypass surgery patients.

PURPOSE: To compare the progress of patients who were exercise tested before or during cardiac rehabilitation versus those patients who were not tested. METHODS: Eighty-eight (88) post-myocardial infarction patients and 141 post-bypass surgery patients had a symptom-limited exercise test before or during 12 weeks of cardiac rehabilitation. Another 125 post-myocardial infarction and 146 post-surgery patients were not tested. RESULTS: Caloric expenditure during class increased for the entire group (P < 0.001) from week 1 to week 12. Body weight decreased for the entire group as a result of cardiac rehabilitation (P < 0.001). Tricep skinfolds decreased for the entire group (P < 0.001) while subscapular skinfolds did not change (P = 0.28). The percent change from week 1 to week 12 for both groups was similar for all variables. No problems occurred during cardiac rehabilitation that required emergency medical management. CONCLUSIONS: Patients completing a 12-week cardiac rehabilitation program can be safely progressed in terms of their exercise capacity without an entry exercise test. This is desirable in a managed-care setting for reducing costs while maintaining effective patient care. Such factors as staff training and experience, institutional philosophy, patient referral patterns, and facility location must be considered before adopting a no-test policy.

Body Composition↗
PubMedDate not supplied

[The prognostic value of EEG and ENG recording in deep coma].

The eeg and eng test were performed in 53 patients admitted in deep coma. The eeg patterns was analysed using Hockaday's scale and the eng test was appreciated by Nathanson-Bergman's scale. It was noticed that grade IV and V by Hockaday's scale and stage IV by Nathanson-Bergman's scale suggested malignant prognosis. Grade III in Hockaday's scale and stage II in Nathanson-Bergman's scale were unrelated to prognosis.

Adolescent↗
PubMed2005

Vestibular function at the end of intratympanic gentamicin treatment of patients with Ménière's disease.

The aim of this study is to analyze the effects of intratympanic gentamicin injections on vestibular function in 33 patients with unilateral Meniere's Disease (according to AAO-HNS guidelines 1995) that had been unresponsive to medical therapy for at least one year. In such patients, the results of bedside examination of vestibular function vestibular examination is compared to those from laboratory tests. Intratympanic gentamicin injections (27 mg/ml) were performed at weekly intervals until symptoms or signs of vestibular hypofunction developed in the treated ear. Vestibular function was evaluated in two different rotatory chair tests. The parameters that were specifically considered were the time constant of the vestibulo-ocular reflex (VOR) after impulse rotation with a peak chair velocity of 100 degrees s(-1), and the phase and gain of the VOR after the sinusoidal harmonic acceleration (SHA) test with a peak chair velocity of 50 degrees s(-1). After treatment, both the time constant of the VOR after rotation towards the treated side and the gain in the SHA test were significantly reduced. These reductions were in accordance with the number of additional signs observed upon bedside examination at the end of the treatment. The changes observed in the VOR correlate well with the results of bedside examination of vestibular function, which in turn reflects the damage induced by intratympanic gentamicin injection.

Administration, Topical↗
PubMed1996

MRI in the detection of acoustic neuromas--a suggested protocol for screening.

Magnetic resonance imaging (MRI) is the definitive investigation in the detection of an acoustic neuroma and its use is becoming increasingly widespread for this purpose. In the Oxford region, this facility has been available for 3 years, resulting in the scanning of the internal auditory meati and cerebellopontine angles of 892 patients and the detection of 38 acoustic neuromas. Based on our use of this investigation over this time period, we have attempted to rationalize our entry protocol for screening by limiting the availability of the test to those patients up to 70 years of age presenting with unilateral audiovestibular symptoms in the absence of significant neurological symptoms or signs, with an average difference in hearing threshold of 15 dB between normal and symptomatic ears or unilateral tinnitus with normal hearing. By following these entry criteria, we would hope to maximize the available resources.

Adult↗
PubMed1981

Effects of ocular fixation on perrotatory nystagmus in damped pendular rotation test.

Effects of ocular fixation on pendular rotation nystagmus were investigated in 65 patients. There were 25 with peripheral vestibular or vestibulo-cochlear disorders, 17 with central vestibular disorders, five with congenital nystagmus, 16 patients over 60 years old with vertigo in whom peripheral vestibular disorders were ruled out, however, the causes were unknown. Damped pendular rotation test (DPRT) was performed both under darkness and employing mental arithmetic and under ocular fixation. These findings were related to those of caloric vestibular suppression test (VST) by Takemori and those of optokinetic pattern test (OKP), eye tracking test (ETT), and spontaneous nystagmus. Thirteen of 17 patients with central vestibular disorders and five with congenital nystagmus showed loss of visual suppression during ocular fixation in DPRT, whereas in cases of peripheral lesions, visual suppression was observed. Loss of visual suppression during ocular fixation in DPRT was often seen in cases of brainstem and cerebellar lesions. In brainstem lesions, perrotatory nystagmus was evoked during ocular fixation, whereas no nystagmus was seen in darkness with eyes open. In cerebellar lesions, perrotatory nystagmus was partly suppressed or decreased during ocular fixation. Relationships between the direction of the visual suppression during ocular fixation in DPRT and the side of the lesion were not apparent. Ocular fixation test in DPRT has a diagnostic value not only for central lesions, but for differentiating brainstem lesion from cerebellar lesion with the findings in DPRT under darkness. The findings under ocular fixation in DPRT are closely related to those of VST in cases of caloric nystagmus.

Adult↗
PubMed1995

Nystagmus and postural instability after headshake in patients with vestibular dysfunction.

Nystagmus after rapid head-shaking (post-headshake nystagmus) is often seen in patients with vestibulopathy. Post-headshake nystagmus is transient and is frequently associated with symptoms of dizziness, dysequilibrium, or vertigo. The phenomenon presumably reflects headshake-induced asymmetry in vestibulo-ocular reflex pathways, which persists after head-shaking stops. We postulated that the same vestibular imbalance that underlies post-headshake nystagmus might produce an equivalent in postural instability. To test this hypothesis, we investigated the effect of headshake on postural control and eye movements in patients who exhibited post-headshake nystagmus, vestibulopathy, or both. Postural instability was quantified with a dynamic platform device, whereas eye movements were recorded with electrooculography. Ten normal controls and 21 patients with a history of post-headshake nystagmus or unilateral vestibulopathy were evaluated. Subjects were tested for 20 seconds before and immediately after passive horizontal headshake (+/- 30-degree amplitude) at 2 Hz for 20 seconds. Postural stability was assessed while subjects stood with eyes closed, and the floor was modulated proportionally with sway. The difference in normalized peak-to-peak sway (equilibrium score) before and after headshake was assessed in all subjects and compared between groups. Post-headshake nystagmus was documented by electro-oculography recorded during posturography. Results for normal controls and vestibulopathic subjects without post-headshake nystagmus showed only a small transient decline in postural stability after headshake. Those with post-headshake nystagmus (regardless of caloric asymmetry) showed a robust decline in postural stability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Vestibulospinal function in two syndromes with spontaneous attacks of vertigo: evaluation by posturography.

Two vestibular syndromes comprising attacks of spontaneous vertigo were studied and disturbance of the vestibulospinal reflex was evaluated. Patients with Menière's disease were examined between attacks and patients with a sudden unilateral vestibular loss syndrome at least 3-4 weeks after the initial attack. Posturography, (recording and analysing the postural sway) was used to evaluate the influence of these disorders upon the vestibulospinal reflex. In 50% of the patients, the postural sway was disturbed compared with the performance of a normal control group. Menière's disease had a more pronounced effect on the posturographic results, whereas for the unilateral vestibular loss syndrome the rotation tests showed more asymmetry. It is obvious that the effect upon the vestibulospinal reflex cannot be deduced from the rotational test results. Indeed in a large number of patients discordance between rotational test results and posturography was seen. The presence or absence of attacks during the previous year in patients with Menière's disease had no influence on the presence of abnormal posturographic results. If other complaints of dizziness were mentioned by the patient, posturography was nearly always abnormal. It is evident that a complete evaluation of such patients must include information obtained by posturography.

Adult↗
PubMed1998

Video-oculography as part of the ENG battery.

Recording and quantifying eye movement is the basis of audiologic balance testing. The ability to record and quantify eye movement is a key part of the electronystagmography (ENG) test battery. With computerization, eye movements can be more accurately detected and analysed--testing the limits of the standard recording technique. In response to this, manufacturers are introducing alternative recording protocols. Specifically, infra-red video technology allows an accurate and sophisticated recording and analysis of eye motion in response to balance-related stimuli. The purpose of this technical note is to discuss the limitations of the EOG recording method and discuss the advantages that video-oculography offers.

Caloric Tests↗
PubMed2005

The subjective visual vertical in benign paroxysmal positional vertigo. A preliminary study.

In Benign Paroxysmal Positional Vertigo (BPPV), the existence of otoconial debris in the cupula or canal explains most of the symptoms and signs characteristic of this common inner ear disorder. We have studied the ability of patients with BPPV to correctly determine the subjective visual vertical, as this is a good test to evaluate utricular function. Only 1 of 10 patients with BPPV displayed a clearly abnormal response, and there was no correlation between the side of the lesion and the perceived tilt. This might imply that the limited damage induced by the dislodged otoconia does not disrupt utricular function or that the saccule is the source of the problem.

Adult↗
PubMedDate not supplied

Neural discharge of medial geniculate body units and single semicircular canal stimulation.

In curarized guinea pigs, 68 neurons of the medical geniculate body (MGB) were tested with vestibular and acoustic stimulations. Single semicircular canals were stimulated thermally. Convergence of acoustic and vestibular afferences on the same MGB unit was observed. Following stimulation of the semicircular canals, activation and inhibition of urinary discharge were recorded, inhibition being predominant, while, when clicks were delivered, bursts of activity occurred. The implications of MGB in vestibular and acoustic integration are postulated.

Acoustic Stimulation↗
PubMed1983

Eye tracking abnormalities in patients with cerebrovascular disease.

Ten patients with disequilibrium, ataxia, and cerebrovascular abnormalities were studied using computer aided eye tracking and vestibular function tests. The patients had severe abnormalities in smooth pursuit (decreased gain) and saccade tests (increased delay, decreased accuracy). Optokinetic responses were less affected. The gain of the vestibulo-oculomotor reflex was sometimes affected. Patients with eye tracking abnormalities frequently had symptoms of difficulty reading and watching television. When the lesion was asymmetrical, abnormal eye tracking tests usually pointed to the side of the lesion. Computer aided eye tracking tests are a useful adjunct to the evaluation of the patient with suspected vascular disease. They help to locate areas of central nervous system dysfunction, and produce an objective measurement of the severity of impairment. Conversely, when impairment of the smooth pursuit or saccade system is detected in patients being evaluated for disequilibrium, an assessment of the patients' cerebrovascular system should be considered.

Adult↗
PubMed1993

Vestibular function in cochlear implant patients.

Thirty-five patients receiving a cochlear implant were evaluated using vestibular function tests. Twenty-five patients received an intracochlear implant (Nucleus). Three out of 6 patients with normo- or hyporeflexia before implantation showed postoperative vestibular damage. In one case this was iatrogenic. Together with available data from the literature the risk of losing preoperative vestibular function is estimated to be around 60%. Improvement of implantation techniques can probably reduce this risk considerably.

Adult↗
PubMed1993

Clinical usefulness of the personal computer for equilibrium examinations.

A personal computer (PC) system and its usefulness for equilibrium examinations is reported. The system was introduced into clinical routine practice for the following purposes: i) Reduction of test result measurement troubles in clinical practice, ii) Clearer observation of eye movements and body sway, iii) Quantitative analysis of nystagmus responses or body sway, iv) Easy introduction into clinical practice of new parameters or new tests, v) Programmable arrangement of stimulating devices, and vi) Effective storage of test data. Our PC system has been successful for these purposes and provided many useful options in equilibrium examinations. Although computer systems for equilibrium examination have not been popular due to high costs, the PC system, which can be obtained at a reasonable price, has become as powerful a device as the conventional small computer, and is expected to become a popular method for both research and routine clinical practice in the near future.

Caloric Tests↗
PubMed1994

[Computer system of electronystagmographic examination. Part II. Analysis of nystagmus].

It is a description of automatic registration and analysing of the eyes movement. In this method had beed applied a test of the eye movement in the limited momentary speed, test of the time taken by the deflection and the test of unanimity in analysing both deflection and direction of the quick phase. The analysis procedure has two stages. In the first stage the signal undergoes an introductory analysis which is aimed at smoothing it out and approximating it a saw-toothed shape. At this stage the computer identifies the phases, direction of nystagmus and deflection which are not real eye deflections. In the second stage the computer makes measurements of nystagmus parameters.

Caloric Tests↗