Electronystagmography ; Humans ; Postural Balance ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: Canalith repositioning procedure (CRP) is an effective treatment for benign paroxysmal positional vertigo (BPPV). However, there is a significant number of patients who require multiple treatment visits for reliefs of symptoms. The purpose of this study is to identify factors that may be associated with these difficult to treat cases. MATERIALS AND METHODS: A retrospective review was made of 179 patients who were diagnosed as BPPV. 20 patients who required more than three treatment visits for CRP were included in this study. Statistical analysis included age and sex of patients, the kind of involved semicircular canal (SCC), direction of nystagmus, latency of nystagmus on electronystagmography (ENG) and duration of symptoms. RESULTS: There was no significant statistical association between the number of treatment visit and patient's age, sex. Although significant statistical association was not found, the therapeutic efficacy of lateral SCC BPPV was lower than that of posterior SCC BPPV. In the cases where the direction of nystagmus was ageotrophic, the efficacy of CRT was decreased and statistical significant association was found. Also when short latency of nustagmus on ENG and long duration of symptoms appeared, more trial of CRP was needed and statistical significant association was found. CONCLUSION: In the treatment of BPPV by CRP, we can consider latency of nystagmus on ENG, duration of symptoms, direction of nystagmus and type of involved semicircular canal as prognostic factors.
Electronystagmography ; Humans ; Rehabilitation* ; Retrospective Studies ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. METHODS: We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2+/-6.7) and 24 controls (mean age : 60.5+/-4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. RESULTS: Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. CONCLUSION: The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found.
Darkness ; Electronystagmography ; Eye Movements ; Humans ; Nystagmus, Optokinetic ; Parkinson Disease* ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

From retrospective review of medical charts of patients diagnosed as bilateral vestibulopathy during the past seven years, this study investigated incidence, etiologies, symptoms, vestibular function test findings; electronystagmography (ENG) studies, rotatory chair testing, and posturography, and post-vestibular rehabilitation (VRT) follow-up results. we have an incidence of 1.2% of all the 3423 patients who have undergone vestibular function test. Ototoxicity was the first known etiology and we had a lot of patients of idiopathic bilateral vestibulopathy. Most patients in our study had experiences of sudden onset vertigo rather than slowly progressive symptoms. The most frequently complained symptoms were dysequilibrium and oscillopsia. Post-VRT courses were better in patients whose initial gain of vestibulo-ocular reflex(VOR) was high or ascending type.
Electronystagmography ; Follow-Up Studies ; Humans ; Incidence ; Rehabilitation ; Retrospective Studies ; Vertigo ; Vestibular Function Tests

OBJECTIVE: To show the value of rotating chair test (ROT) as an adjunct to the conventional electronystagmography (ENG) examination including caloric test for the diagnosis of vestibular lesions. BACKGROUND: Since caloric stimulatim is regarded as a very low frequency (0. 003Hz) test, it is desirable to test the function of horizontal semicircula canals by stimulating with faster frequencies. Baloh et al. (1984a) described that lesions ofdifferentiated by ROT. Leigh and Zee(1991) told that ROT can give more accurate and reproducible results than do caloric tests. METHOD: 30 patients who suffered from vertigo with either peripheral or central pathology were given computerized ENG and ROT. We discuss the representative examples of our initial experience with ROT. RESULTS: 1.In eight patients with known peripheral pathology, low-frequency phase deficits, asymmetry toward the lesim side and VOR suppression by gazefixation were seen during ROT. With bilateral peripheral vetibular disease, the ROT could identify remaining vestibular function at higher frequencies. 2. Seven patients with lesions of central vestibular structure showed abnormalities of saccades and pursuit during ENG and failure of VOR suppression by gaze fixation during ROT. 3. Out of 15 patients whose lesions could not be localized distinctly after caloric test, four patients were suggested to have central pathology. CONCLUSION: ROT can be a useful method to study the vestibular abnonnahties and an adjunct to the conventional ENG test.
Caloric Tests ; Diagnosis ; Electronystagmography ; Humans ; Pathology ; Saccades ; Vertigo* ; Vestibular Function Tests

Albinism is associated with neural anomalies including foveal hypoplasia and aberrant optic pathway projection that result in a variety of oculomotor instability. We present a 38-years-old man with oculocutaneous albinism who had horizontal jerk-type nystagmus, which showed a reverse in direction by any extraneous light stimulation which was documented by electronystagmogram. The mechanism of the nystagmus in this case is uncertain. These findings in albinism have not been reported previously, to our knowledge, and suggest a defect in the visual pathway system.
Adult ; Albinism/*physiopathology ; Case Report ; *Electronystagmography ; *Eye Movements ; Human ; Male ; Nystagmus, Physiologic/radiation effects ; Photic Stimulation

Periodic alternating nystagmus(PAN) is a form of spontaneous nystagmus with a specific pattern. It may be of congenital origin in many cases, and may be related to vestibulo-cerebellar system disease. It usually causes not only many ophthalmic problems such as decreased vision but also neurologic symptoms such as ataxic gait. So, ophthalmologist must perform both ophthalmic and neurologic examinations. Nystagmus can be treated with muscle relaxant. We report our experience about 30-year-old woman who complained of involuntary ocular movement and ataxic gait, and were diagnosed as PAN associated with Chiari-1 malformation and syringomyelia through electronystagmography and brain MRF.
Adult ; Brain ; Electronystagmography ; Female ; Gait ; Humans ; Neurologic Examination ; Neurologic Manifestations ; Nystagmus, Pathologic* ; Syringomyelia*

BACKGROUND AND OBJECTIVES: In the past studies, it was reported that vertigo was accompanied by sudden deafness patients from 25% to 47% and it increased to 56% when electronystagmography was used. They also reported that when sudden deafness patients showed vertigo symptom. The initial hearing losses were severe and their prognoses were poor. But they divided the sudden deafness patients simply by whether vertigo existed, not considering the extent of hearing loss. So we compared the prognosis between the sudden deafness patients showing the same level of hearing loss. MATERIALS AND METHOD: We sampled 157 sudden deafness patients (Feb 1999 - Mar 2002). Of these, 17 patients with acute vertigo (group A) and 17 control patients without vertigo (group B) having the same level of mean air conduction as group A were selected. RESULTS: Group A showed frequent flat form of audiogram, poor response to treatment regardless of the age than group B. CONCLUSION: In sudden deafness patients, objectively proven acute vertigo symptom is a prognostic factor of hearing recovery.
Electronystagmography ; Hearing Loss ; Hearing Loss, Sudden* ; Hearing* ; Humans ; Incheon* ; Prognosis ; Vertigo*

BACKGROUND AND OBJECTIVES: Psychogenic dizziness has not been studied extensively in Korea while it is seen frequently. We investigated the prevalence of psychiatric diagnosis and the results of vestibular function testings in patients with the diagnosis of psychogenic dizziness at a Korean tertiary university hospital. MATERIALS AND METHODS: The study was conducted on 38 patients with the diagnosis of psychogenic dizziness. They all received vestibular function testings (ENG, rotating chair test and posturography). Patients with central or vestibular organic disease were excluded from this study. RESULTS: Somatoform disorder was the most common psychiatric disorder causing psychogenic vertigo(47.4%) in this study. Anxiety disorder(21.1%) and depression(21.1%) were the next common causes. The vestibular function testings were abnormal in 19 patients(50.0%). The electronystagmography in 11, rotating chair test in 6, and posturography in 14 patients were abnormal. CONCLUSIONS: Somatoform disorder was the most common psychiatric disorder and vestibular function tests were abnormal in 50% of psychogenic dizziness patients. It implies that the patients with psychogenic dizziness have functional abnormalities in vestibular system.
Anxiety ; Diagnosis ; Dizziness* ; Electronystagmography ; Humans ; Korea ; Mental Disorders* ; Prevalence ; Somatoform Disorders ; Vestibular Function Tests*

OBJECTIVETo discuss the objective characteristics and mechanism of nystagmus direction, intensity and time in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) .

METHODSA total of 233 patients with HSC-BPPV, whereas 179 horizontal semicircular canalithasis (HSC-Can) and 54 horizontal semicircular cupulolithiasis (HSC-Cup) were involved respectively. The induced nystagmus in roll tests recorded by video-nystagmograph(VNG) , whose direction, intensity and time characteristics were compared in various BPPV.

RESULTSHorizontal nystagmus was both induced by turning left or right in HSC-BPPV roll tests. The direction of the induced nystagmus was the same with turning in HSC-Can. The latency, duration time and intensity ([AKx(-)D] ± s) turning to lesion and normal side were (1.922 ± 1.501)s and (1.447 ± 0.855)s, (25.620 ± 10.409)s, and (22.110 ± 10.931)s, (56.441 ± 33.168)°/s and (24.239 ± 13.892) °/s in HSC-Can. The latency, duration time and intensity turning to lesion side were larger than normal side (t = 3.715, 15.219 and 4.070, P < 0.01) , the difference was statistically significant, and the intensity rate was about 2: 1. The direction of the induced nystagmus was opposite to turning in HSC-Cup. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2: 1, the difference was statistically significant (t = -7.634, P < 0.01) . While the latency and intensity of turning to lesion side in HSC-Can were larger than turn to normal side in HSC-Cup, and the difference detected no statistically significant difference (t = 1.554 and 0.305, P > 0.05).

CONCLUSIONSThe induced nystagmus intensity of head to two sides in roll tests for HSC-BPPV both follow Ewald's law, and the ratio between stronger and weaker are both 2: 1. These nystagmus parameters of VNG in roll tests are an objective guideline for BPPV diagnosis.

Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; Electronystagmography ; Head ; Humans ; Nystagmus, Pathologic ; complications ; diagnosis ; Semicircular Canals ; Vertigo