2.Analysis of Factors that Affect the Result of Vestibular Rehabilitation in the Treatment of Benign Paroxysmal Position Vertigo.
Hyung Gyu JEON ; Se Ho SONG ; Gyu Cheol HAN ; Jin Myoung HUH
Korean Journal of Otolaryngology - Head and Neck Surgery 2001;44(12):1259-1263
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*
3.Eye movement changes in albinism : a case report with electronystagmographic findings.
Young Chul CHOI ; Soon Kwan KIM ; Soong Hyun LEE ; Myung Sik LEE ; Il Saing CHOI ; Un Kyo CHUNG
Yonsei Medical Journal 1993;34(2):195-200
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
4.Hearing Recovery in Patients of Sudden Hearing Loss with Vertigo ; Incheon.
Eun Jung LEE ; Gyu Cheol HAN ; Kyu Sung KIM
Journal of the Korean Balance Society 2003;2(1):103-106
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*
5.Psychogenic Dizziness : The psychiatric diagnosis and vestibular function tests.
Chung Ku RHEE ; Geun Hwan PARK ; Chang Hoon LEE ; Sang Yong CHUNG ; Phil Sang JUNG
Journal of the Korean Balance Society 2003;2(1):73-77
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*
6.The Rotating Chair Test in the Patients with Vertigo.
Geun Ho LEE ; Jae Il KIM ; Chung Ku RHEE
Journal of the Korean Neurological Association 1995;13(3):631-645
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
7.Vestibular dysfunction in patients with idiopathic parkinson's disease..
Hyung LEE ; Tae Wan KIM ; Ji Eun KIM ; Jeong Geun LIM ; Sang Doe YI ; Young Choon PARK ; Seong Ryong LEE
Journal of the Korean Neurological Association 1998;16(2):172-179
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
8.Clinical Analysis of Bilateral Vestibulopathy.
Chung Ku RHEE ; Sang Jun JEON ; Tae Woo KOO ; Yong Won CHUNG ; Jin Goo LEE ; Sin Keun JUNG
Journal of the Korean Balance Society 2002;1(1):103-107
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
9.Periodic Alternating Nystagmus Associated with Chiari-1 Malformation and Syringomyelia.
Sueng Han HAN ; Jae In JUNG ; Hee Sun KIM ; Sin Jeong JIN
Journal of the Korean Ophthalmological Society 1999;40(1):283-286
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*
10.Clinical Analysis of Childhood Vertigo.
Chae Hyeok LEE ; Hyun Min PARK ; Baeck Hee LEE ; Yun Hwan KIM ; Chung Ku RHEE
Journal of the Korean Child Neurology Society 2001;9(2):362-367
PURPOSE: Vertigo and dizziness are not common complaints in childhood, but are present more often than formerly thought. A detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. The purpose of our study was to obtain our own etiological, clinical and diagnostic statistics, and to review the major related pathologies. METHODS: We investigated eighty-five children who visited Dankook University Hospital with a chief complaint of vertigo. Presenting symptoms, the result of diagnostic tests, and etiologic diagnoses were evaluated. RESULTS: Benign paroxysmal vertigo in childhood was the most common etiology of childhood vertigo accounting for about 38.8%, and migrainous vertigo and post-traumatic vertigo were present in 17.6% and 12.9% respectively. In vestibular function testings, electronystagmography and rotating chair test were abnormal in 11.2% and 21.2%, and the score of sensory organization test in posturography was lower than 50 in 44.4%. Other clinical diagnostic tests were informative for elucidation of individual etiologies. CONCLUSION: Benign paroxysmal vertigo in childhood and migrainous vertigo were the most common etiologies in childhood vertigo, with the former more common in under 12 years and the latter more common in over 12 years. Vestibular function tests were not so informative in diagnostic approach of childhood vertigo.
Child
;
Diagnosis
;
Diagnostic Tests, Routine
;
Dizziness
;
Electronystagmography
;
Humans
;
Pathology
;
Vertigo*
;
Vestibular Function Tests