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Evaluation of balance function in peripheral vestibular disorders.

The functional influence upon overall balance function induced by a peripheral vestibular disturbance is evaluated by positioning, rotatory and posturographic testing. The information does not contribute to the diagnostic labelling of a patient (as e.g. Ménière's disease, etc), but it is of primary importance in the determination of a logical and adequate treatment and so for rehabilitation treatment. Some important items are reviewed.

Electronystagmography↗

[State and types of adaptation of the vestibular function after space flights].

This paper presents the results of studying the vestibular function before and after space flight in response to separate and combined vestibular, optokinetic, proprioceptive and postural tests as well as cerebellar coordination tests. After prolonged space flights most crewmembers showed spontaneous, position and positional nystagmus that pointed to vestibular dysfunction. This integrated procedure made it possible to differentiate mechanisms of vestibular dysfunctions seen after flight: some subjects showed nystagmus responses only during tilt table tests while others displayed them in response to additional proprioceptive and optovestibular stimulation as well as cerebellar coordination tests. Different patterns and types of vestibular adaptation to gravity were identified.

Adaptation, Physiological↗

Vestibular and sensory interaction deficits assessed by dynamic platform posturography in patients with multiple sclerosis.

Vestibular impairments have not been routinely identified in patients with multiple sclerosis (MS), because of the confounding effects of deficits in other neural systems. In this study, 35 patients with MS were evaluated by means of a systematic alteration of the sensory environment (dynamic posturography) in order to identify those patients who became unstable when vestibular inputs were needed to maintain stance. Subjects were assigned to either a high-function (HF) or a low-function (LF) group on the basis of a functional status assessment score obtained prior to the posturography test. For the HF group, 30% (7/23) had abnormal posturography scores. Of those subjects, 3 had a vestibular dysfunction pattern or a somatosensory-vestibular impairment. In contrast, 58% of the LF group (7/12) had abnormal posturography scores. Nearly all of these LF patients (6/7) had a vestibular dysfunction pattern or a combined visual-vestibular or somatosensory-vestibular impairment. Posturography might serve as one method to evaluate the functional consequences of a vestibular deficit in patients with MS.

Adult↗

Vestibular findings in 25 patients with Waardenburg's syndrome.

Vestibular pathology does not seem to occur more frequently in patients with Waardenburg's syndrome than in those suffering from other types of congenital deafness. This was concluded from the results of vestibular examination by means of electronystagmography of 25 subjects with Waardenburg's syndrome from five families in the Netherlands. Ten of these subjects had a hearing loss, four of them bilateral and six unilateral. A review of the literature concerning more than 1,000 cases with Waardenburg's syndrome shows that in only 26 deaf patients was a very simple vestibular examination performed (in only three patients by means of electronystagmography).

Abnormalities, Multiple↗

Role of posturography in the management of vestibular patients.

Computerized dynamic posturography uses a force platform that can both translate and rotate. When combined with visual stimuli, it can be used to determine the relative importance of the various sensory inputs critical for balance, namely vision, somatosensation, and vestibular sensation. Studies to date have shown several patterns of abnormalities on posturography, the best recognized being the vestibular pattern. Many patients with a high suspicion of having a peripheral vestibular abnormality (based on other information) have such a pattern. Moreover, few normal subjects have such abnormalities. Although computerized dynamic posturography does not help in localizing a lesion or determining its etiology, such testing does provide a functional measure that can be helpful in understanding a patient's ability to properly use vestibular system information. Posturography is helpful in the management of patients with suspected vestibular disorders. In addition to suggesting the presence of a vestibular system abnormality, particularly an uncompensated peripheral vestibular deficit, a bilateral peripheral vestibular deficit, or a central vestibular abnormality, computerized dynamic posturography may help guide the clinician regarding choice of treatment and counseling of patients. Further studies are required to determine the ultimate role of computerized dynamic posturography in the management of patients with vestibular disorders.

Humans↗

Absolute and relative caloric responses.

The statistical features of absolute-based and percentage-based post-caloric EOG response measures were investigated on ten normal and twenty pathological cases. Criteria for the best EOG response measure are introduced. It is concluded that, using the method adopted in this study, the mean interbeat interval can be regarded as the measure of choice for quantifying the post-caloric EOG response.

Caloric Tests↗