1.The study of galvanic vestibular stimulation in patients of total unilateral vestibular loss.
Hyun Jik KIM ; Chang Woo KIM ; Won Sang LEE
Journal of the Korean Balance Society 2003;2(2):211-220
OBJECTIVES: The aim of this study was to observe the nystagmus of totally unilateral vestibular function loss on galvanic vestibular stimulation and the diagnostic value of galvanic vestibular stimulation. Additionally we wanted to evaluate which portions may be stimulated by galvanic vestibular stimulation. MATERIALS AND METHODS: We evaluated the three parameters of galvanic stimulation in fourteen patients with totally unilateral vestibular function loss, 1)spontaneous nystagmus, 2)galvanic stimulating nystagmus, 3)Post galvanic stimulating nystagmus through 3-dimensional video-oculography technique. RESULTS: When negative electrode was attached to the intact side, The nystagmus on galvanic vestibular stimulation was directed to the negative electrode side in all patients and post galvanic stimulating nystagmus was directed to the opposite side but on functional loss side, we couldn't detect any nystagmus on galvanic vestibular stimulation and in 10 patients, post galvanic stimulating nystagmus was observed and directed to the intact side. CONCLUSIONS: Galvanic vestibular stimulation is very useful for evaluating the vestibular function and for diagnosing the vestibular disease.
Electrodes
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Humans
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Vestibular Diseases
2.Audiovestibular and radiological findings in patients with migrainous vertigo
Anjali Lepcha ; Amit Kumar Tyagi ; GauravAshish ; Ann Mary Augustine ; AchammaBalraj
Neurology Asia 2015;20(4):367-373
Objective:To describe the audiological, vestibular and radiological profile of patients with migrainous
vertigo. Methods: This is a prospective descriptive study of patients who presented with migrainous
vertigo in a tertiary care institute over one year.All patients between the ages of twenty to sixty who
presented between 2013 and 2014 with migrainous vertigo diagnosed according to Neuhauser’s criteria
were included in this study. The diagnostic intervention was audiovestibular tests and magnetic resonance
imaging (MRI) of brain with gadolinium. The main outcome measures were types and degree of
auditory and vestibular deficits; MRI findings in migrainous vertigo, and whether age at presentation
and duration of symptoms affected these findings.Results:Of the 112 patients recruited, the overall
female-to male ratio was 1.7: 1. On pure tone audiogram, 18 (16%) patients had sensorineural hearing
loss and this was similar in age groups<41 and >40 years. Caloric abnormalities were seen in 64
(61.5%) patients and there was no significant difference in the younger versus older age groups. MRI
abnormality was present in 24% and the commonest finding was deep white matter hyperintensities
in the brain. In the <41 age group, there were 8/46 with headache < 7 years (17.3%) and 5/9 (55.5%)
with headache for >7 years with MRI abnormalities, and this difference was statistically significant
(Chi sq 4.14, p=0.041).
Conclusions:Both audiological and vestibular abnormalities were seen in migrainous vertigo patients
and older age did not appear to be an additional risk factor for the presence of theseabnormalities.
Deep white matter hyperintensities were the commonest abnormality found on MRI scans and longer
headache duration was associated with higher chances of MRI abnormalities in younger people.
Vestibular Diseases
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Vertigo
6.Effects of vestibular spontaneous nystagmus on visual smooth pursuit function.
Shi Shi XIE ; Tai Sheng CHEN ; Qiao Mei DENG ; Shan Shan LI ; Xiang MAO ; Chao WEN ; Qiang LIU ; Wei WANG ; Peng LIN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(3):280-284
Objective: The aim of the study is to analyze the effects of vestibular spontaneous nystagmus(SN) on the smooth pursuit function of visual ocularmotor system. Methods: A total of 46 patients with acute unilateral peripheral vestibular syndrome with SN (26 cases of vestibular neuritis, 6 cases of Ramsay Hunt Syndrome (RHS) with vertigo, 14 cases of sudden deafness with vertigo) were included in this work. In the study group, the results of SPT and SN test with videonystagmography(VNG) were also reviewed. Taking SPT parameters, the influence of SN intensity on SPT gain, asymmetry and waveform and their correlation were analyzed.SPSS19.0 software was used for statistical analysis. Results: Among the 46 patients, there were 36 cases of SN pointing to the healthy side(SN intensity range of 2.68°/s-32.53°/s), and 10 cases of SN pointing to the affected side (SN intensity range of 2.66°/s-16.54°/s). SN intensity was divided into 3 groups, including light(0.50°/s-5.00°/s), medium(5.01°/s-10.00°/s) and strong(>10.01°/s), accounting for 14 cases(30.4%), 18 cases(39.1%) and 14 cases(30.4%), respectively. The differences of the gain of SPT to the fast phase and slow phase direction in the overall groups and light, medium and strong groups of SN intensity respectively were statistically significant(ttotal=13.338, tlight=6.184, tmedium=8.436, tstrong=8.477, all of P<0.001). The difference of SPT gain in SN fast phase direction between groups with different SN intensity was statistically significant(F=9.639, P<0.001),there was no statistically significant difference in SPT gain between the groups on the SN slow phase direction(F=1.137, P=0.330).The SN intensity significantly negatively correlated with the SPT gain of the fast phase direction of SN (r=-0.433, P=0.003), that was, the SPT gain on the fast phase direction of SN decreased with the increase of SN intensity. There was no significant correlation between SN intensity and the gain of SPT on the slow phase direction of SN (r=-0.061, P=0.687). SPT waveform analysis showed that type I, type II and type III accounted for 8 cases(17.4%), 21 cases(45.6%) and 17 cases(37.0%), respectively. The corresponding mean values of SN intensity were (3.71±0.69)°/s, (7.44±1.88)°/s, (20.04±5.53)°/s, respectively, without type IV wave. The intensity of SN was positively correlated with the asymmetric value of the gain of SPT left and right(r=0.450,P=0.002). That was, with the increase of SN strength, the asymmetric value also increased, and the worse the asymmetry of the gain of SPT left and right pursuit was, the worse the SPT waveform was. Conclusion: SPT gain, asymmetry and SPT waveforms are all affected by SN, and the greater the intensity of SN, the greater the influence on the three. When SN is strong, type III waves may occur, suggesting that acute peripheral vestibular syndrome can also affect the visual ocularmotor systems.
Humans
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Nystagmus, Pathologic
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Pursuit, Smooth
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Vertigo
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Vestibular Diseases
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Vestibular Function Tests
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Vestibular Neuronitis