3.Mechanism of Downbeat Nystagmus While Normal Subjects HaveHead Upside-down Position in Darkness.
Journal of the Korean Neurological Association 2000;18(6):716-720
BACKGROUND: Bohmer and Straumann have proposed that downbeat nystagmus is due to an asymmetry of the geometry of the vertical semicircular canals of the vestibular labyrinth. This hypothesis does not predict any sustained change in vertical nystagmus when subjects are placed in a head-upside-down position. METHODS: Using the magnetic search coil technique, I measured vertical eye movements in darkness in three normal human subjects while they maintained head-erect or head-upside-down positions. RESULTS: Two subjects had upbeat nystagmus and one downbeat nystagmus with their heads erect (slow-phase velocity < 1 deg/sec). All developed sustained nystagmus with quick phases directed towards their chins while in the head-upside-down position. CONCLUSIONS: These findings suggest that factors other than canal imbalance - otolithic or ocular - may also cause downbeat nystagmus.
Cerebellum
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Chin
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Darkness*
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Eye Movements
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Head
;
Humans
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Nystagmus, Pathologic
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Otolithic Membrane
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Semicircular Canals
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Vestibule, Labyrinth
4.Normal values of vestibular autorotation test in young people.
Lei ZHANG ; Bo GAO ; Li-Yi WANG ; Wei-Ning HUANG
Acta Academiae Medicinae Sinicae 2008;30(6):663-667
OBJECTIVETo explore the normal values of vestibular autorotation test (VAT) in young people.
METHODSVAT was performed in 31 young people aged 20-30 years. The measured value were analyzed and compared with the reference normal value.
RESULTSThe measured values of VAT in healthy young people are almost within the normal range of the general population. Compared with the reference normal values, the horizontal gains at 2.0, 2.3, 2.7, 5.5, and 5.9 Hz, the vertical gains at 2.0 and 5.9 Hz, and the vertical phases at 2.0, 2.3, 2.7, 3.1, 3.5, and 3.9 Hz were significantly different (P < 0. 05). No significant difference was shown in the horizontal phases and asymmetry.
CONCLUSIONSThe normal values of VAT in young people is within the reference normal range of the general population. The vestibular function of young people may be more sensitive in lower frequency range (2-3Hz).
Adult ; Female ; Humans ; Male ; Reference Values ; Vestibular Function Tests ; standards ; Vestibule, Labyrinth ; chemistry ; physiology ; Young Adult
5.Neuronal plasticity of otolith-related vestibular system.
Suk-King LAI ; Chun-Hong LAI ; Fu-Xing ZHANG ; Chun-Wai MA ; Daisy K Y SHUM ; Ying-Shing CHAN
Acta Academiae Medicinae Sinicae 2008;30(6):741-746
This review focuses on our effort in addressing the development and lesion-induced plasticity of the gravity sensing system. After severance of sensory input from one inner ear, there is a bilateral imbalance in response dynamics and spatial coding behavior between neuronal subpopulations on the two sides. These data provide the basis for deranged spatial coding and motor deficits accompanying unilateral labyrinthectomy. Recent studies have also confirmed that both glutamate receptors and neurotrophin receptors within the bilateral vestibular nuclei are implicated in the plasticity during vestibular compensation and development. Changes in plasticity not only provide insight into the formation of a spatial map and recovery of vestibular function but also on the design of drugs for therapeutic strategies applicable to infants or vestibular disorders such as vertigo and dizziness.
Animals
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Humans
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Neuronal Plasticity
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Neurons
;
physiology
;
Otolithic Membrane
;
innervation
;
physiology
;
Vestibule, Labyrinth
;
innervation
;
physiology
7.A Case of Intravestibular Lipoma Presenting with Sudden Hearing Loss.
Eun Jae LEE ; Seong Ki AHN ; Dong Gu HUR ; Ho Yeop KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2013;56(1):34-36
Intracranial lipomas are unfrequent tumors developed from mesenchymatous cells. The corpus callosum is the most frequent location (50%) in the intracranial regions, and these tumors are rarely present in the cerebellopontine angle, the internal acoustic meatus, or intravestibular lesions. With a review of literature, authors report a rare case of the left-sided intravestibular lipoma presented as sudden hearing loss in 17-year-old female. Furthermore, differential diagnostic magnetic resonance imaging characteristics of lipomas are discussed in detail.
Acoustics
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Cerebellopontine Angle
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Corpus Callosum
;
Female
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Hearing Loss, Sudden
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Humans
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Lipoma
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Magnetic Resonance Imaging
;
Vestibule, Labyrinth
8.The changes of blood-labyrinth barrier in idiopathic sudden sensorineural hearing loss and the relationship with clinical features and prognosis.
Ming Ming WANG ; Xiao SUN ; Na HU ; Zhi Qiang HOU ; Wen Ping XIONG ; Ying Jun WANG ; Zhao Min FAN ; Hai Bo WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2022;57(8):937-942
Objective: To investigate the clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) with blood-labyrinth barrier breakdown (BLB-B). Methods: Clinical data of patients with unilateral ISSNHL hospitalized from December 2017 to December 2018 were retrospectively analyzed. According to the results of 3D-FLAIR MRI and enhanced MRI scanning, these patients were divided into two groups, i.e., normal and abnormal inner ear groups. The patients in abnormal inner ear group were further divided into two subgroups: BLB-B and BLB-B with exudation. The differences and correlations among the groups in clinical characteristics, in terms of gender, age, deafness side, basic diseases, dizziness/vertigo, vestibular function, hearing loss degree, as well as classification of hearing curve, and prognosis were analyzed by statistical software SPSS 23.0. Results: Data were collected from 150 cases, in which 68 were male and 82 were female, aged (46.2±14.6) years, including 67 cases with normal inner ears and 83 cases with abnormal inner ears (13 cases with BLB-B; 70 cases with BLB-B and exudation). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, HIT and VAT) and therapeutic effect were different between normal and abnormal inner ear groups (P<0.05). The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different among normal inner ear, BLB-B and BLB-B with exudation groups (P<0.05). Pairwise comparison between groups revealed that vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B groups (P<0.05); The dizziness/vertigo incidence, side ratio, hearing loss degree, classification of hearing curve, vestibular dysfunction (vestibular double temperature test, o/cVEMP, HIT and VAT) and therapeutic effect were different between normal inner ear and BLB-B with exudation groups (P<0.05). There was no significant different between BLB-B and BLB-B with exudation groups. Conclusion: BLB-B displayed by 3D-FLAIR MRI manifestation in ISSNHL patients indicates more serious cochlear and vestibular dysfunction, and worse therapeutic effect.
Dizziness
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Female
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Hearing Loss, Sensorineural
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Hearing Loss, Sudden
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Humans
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Male
;
Prognosis
;
Retrospective Studies
;
Vertigo
;
Vestibule, Labyrinth
9.Intervention strategies for residual dizziness after successful repositioning maneuvers in benign paroxysmal positional vertigo: a single center randomized controlled trial.
Pei Xia WU ; Jian Ping LIU ; Wu Qing WANG ; Hua Wei LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(1):41-46
Objective: To compare the effects of different intervention strategies for the management of residual dizziness following successful canalith repositioning procedure (CRP) in patients with benign paroxysmal positional vertigo (BPPV). Methods: A total of 129 BPPV patients with residual dizziness following successful CRP were recruited during January 2019 and July 2019. They were randomly assigned into three groups with 43 cases in each group: the vestibular rehabilitation group received rehabilitation training for four weeks; betahistine group was given orally 12 mg betahistine three times a day for four weeks; and the control group had no specific treatment. The primary outcomes were daily activities and social participation assessed by the Vestibular Activities and Participation measure (VAP). Secondary outcomes includedbalance function assessed by sensory organization test (SOT) and the duration of residual symptoms. Stata15.0 software was used for statistical analysis. Results: The scores of VAP in the three groups decreased over time, but a more significant decrease was found in vestibular rehabilitation group. Further paired comparison showed that the difference between the vestibular rehabilitation group and the control group was of statistical significance (B=-3.88, χ2=18.29, P<0.01), while the difference between the betahistine group and the control group was not statistically significant (B=-0.96, χ2=1.16, P=0.28). The balance function of the three groups showed a trend of recovery over time, with no significant differences between groups (χ2=1.37, df=2, P>0.05). The median duration of residual dizziness for both vestibular rehabilitation and betahistine groups was 14 days, while that of control group was 19 days, with no significant difference between three groups[Log-rank (Mantel-Cox) test; χ2=1.82, df=2, P=0.40]. Conclusion: Vestibular rehabilitation can significantly improve the daily activities and social participation function in BPPV patients with residual symptoms following successful CRP, but its effects on shortening the duration of residual symptoms and promoting the recovery of balance function remain uncertain.
Benign Paroxysmal Positional Vertigo
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Betahistine/therapeutic use*
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Dizziness
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Humans
;
Patient Positioning
;
Vestibule, Labyrinth
10.Clinical features of vestibular syncope associated with tumarkin attacks in delayed endolymphatic hydrops.
Yang Ming LENG ; Ren Hong ZHOU ; Jing Jing LIU ; Hong Chang WANG ; Jian CHEN ; Bo LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(11):1194-1198
Objective: To analyze the clinical characteristics of vestibular syncope (VS) associated with drop attacks (DA) in delayed endolymphatic hydrops (DEH). Methods: DEH cases with complete data were retrospectively analyzed, including three DEH cases with DA and VS (VS group), and six DEH cases without DA or VS (control group). The clinical profile, the results of neurotological examinations [such as pure tone audiometry, electrocochleography (EcochG), caloric test, vestibular evoked myogenic potentials (VEMP), and video head impulse test (vHIT)] and treatment outcomes were analyzed. Results: (1) In the VS group, there were three cases of ipsilateral DEH; in the control group, there were six cases of ipsilateral type. One case in each group had a history of migraine. (2) The prevalence of abnormal results in caloric test, vHIT, cervical VEMP, and ocular VEMP in the VS group was 3/3, 1/3, 2/2, and 2/2, respectively, and in the control group was 3/6, 0/3, 1/6, and 4/6, respectively. Two cases in each group underwent EcochG, and no identifiable waveform was elicited on the affected side, and-SP/AP ratio of unaffected side was less than 0.4. (3) Patients in both groups were initially treated with conservative medication. Two cases in the VS group subsequently received intratympanic injections of dexamethasone. No DA or VS occurred during a follow-up period lasting over one year. All patients achieved good control of vertigo during the follow-up period. Conclusions: VS may occur in the patients with DEH. The differential diagnosis of syncope in patients with otogenic vertiginous disease can help improve clinical diagnosis and treatment.
Endolymphatic Hydrops/diagnosis*
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Humans
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Retrospective Studies
;
Syncope
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Vestibular Evoked Myogenic Potentials
;
Vestibule, Labyrinth