Research in Vestibular Science

Model Experiment of Benign Paroxysmal Positional Vertigo: Sung Huhn Kim; Res Vestib Sci. 2013;12(2):39-46.

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Abstract: Benign paroxysmal positional vertigo (BPPV) is a most common cause of vertigo. Although endolymphatic flow which is caused by movement of detached-otoconia from otolithic organs has been suggested as a cause of positional vertigo, none has proved it in the human inner ear. Therefore, there were many trials to explain the anatomical characteristics of cupula, physiology of cupula deviation, pathologic mechanisms of BPPV, and clinical characteristics of BPPV using animal membranous labyrinth. In this review, results of basic animal experimental studies to understand anatomical structures and pathological mechanisms related to BPPV are introduced. In addition, future directions for experimental studies to elucidate the mechanism of BPPV will be suggested.

Initiation of Smooth Pursuit in Acute Cerebellar Infarction: A Preliminary Study: Tae Ho Yang, Sun Young Oh; Res Vestib Sci. 2013;12(2):47-53.

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Abstract: Background and Objectives: The cerebellar lesion causes an initiation deficit of smooth-pursuit eye movement depending on the location of the lesion. We investigated the initiation of smooth pursuit in patients with cerebellar infarction and in healthy subjects, using step-ramp stimuli. Materials and Methods: Ten patients with cerebellar infarction documented by brain magnetic resonance imaging and fifty healthy subjects are recruited. To estimate the initiation of smooth pursuit, the onset latency and initial acceleration during the first 100ms of the horizontal smooth pursuit were estimated using the step-ramp target stimuli (5°/sec, 10°/sec, and 20°/sec). Results: In healthy subjects, onset latency of pursuit was shortened and initial acceleration was increased as target velocity was increasing. In patients with unilateral cerebellar infarction, the onset latency of ipsilesional smooth pursuit was significantly delayed at the target velocities of 10°/sec and 20°/sec. For the fast target velocity of 20°/sec, there was significant decrease of the initial acceleration of contralesional pursuit. Conclusion: In comparison with the healthy subjects, the patients with unilateral cerebellar lesions showed significant delay of pursuit onset and decrease of initial eye acceleration in the fast target velocity. These results support that the cerebellar lesions affect not only steady-state smooth pursuit gain but also the processing time required to initiate smooth pursuit, i.e., onset latency and initial acceleration. More extensive study is needed to confirm the role of cerebellum for parametric adjustment of each component of smooth pursuit.

Clinical Characteristics of Benign Paroxysmal Positional Vertigo of the Anterior Semicircular Canal: Minbum Kim; Res Vestib Sci. 2013;12(2):54-57.

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Abstract: Background and Objectives: The aim of this study is to investigate the characteristics of anterior semicircular canal benign paroxysmal positional vertigo (BPPV). Materials and Methods: This is a retrospective chart review of 1,150 patients who were diagnosed with BPPV at an ENT special hospital. We investigated a number of canalith repositioning procedure (CRP), canal switch and a history of recurrence or head trauma. Results: Anterior semicircular canal BPPV was observed in 41 (3.5%) patients. The average number of CRPs in patients with anterior semicircular canal BPPV was 2.19, which was higher than 1.60 in those with posterior semicircular canal BPPV (p<0.0001). Canal conversion from anterior to posterior semicircular canal was found in 5 (12.1%) patients during treatment. The average number of CRPs in conversion cases was 4, which was higher than 1.94 in non‐conversion cases (p=0.001). Conclusion: More CRPs were necessary for the treatment of anterior semicircular canal BPPV than posterior semicircular canal BPPV. Canal switch could be considered as a factor to prevent a successful treatment.

Recurrent Vertigo in Vestibular Schwannoma Responsive to Oxcarbazepine: Jae Hwan Choi, Min Ji Kim, Kwang Dong Choi, Dae Soo Jung; Res Vestib Sci. 2013;12(2):58-61.

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Abstract: Vestibular schwannoma (VS) are benign neoplasms that arise from Schwann cells of the eighth cranial nerve. Although progressive unilateral hearing loss with dizziness or disequilibrium provides a high suspicion index of VS, vertigo is the symptom causing the most pronounced negative effect on quality of life in patients with VS. We report a 55-year-old woman with recurrent paroxysmal vertigo and hyperventilation-induced nystagmus due to VS, which improved by oxcarbazepine treatment. We suggest that episodic vertigo in VS may be ascribed to the ectopic paroxysmal neuronal discharge from the partially demyelinated vestibular nerve due to tumor compression.

Asymmetric Audiovestibular Dysfunction in Patients With Systemic Aminoglycoside Treatment: Jae Hong Park, Yoon Chan Rah, Ji Soo Kim, Ja Won Koo; Res Vestib Sci. 2013;12(2):62-66.

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Abstract: Since the characteristics of aminoglycoside ototoxicity is typically bilaterally symmetric progression of cochlea-vestibular dysfunction, a unilateral involvement has rarely been reported. However, ototoxicity can be asymmetric or focal after systemic aminoglycoside treatment. The authors report 2 cases of asymmetric or focal audiovestibular deficits in patients treated with systemic aminoglycoside. In such cases, further investigations are also necessary to rule out other possible causes of unilateral sensorineural hearing loss such as cerebellopontine angle tumors.

Herpes Simplex Encephalitis Suffered Rotatory Dizziness as a Primary Symptom: Sun A Choi, Jae Yong Byun, Sun Kyu Lee; Res Vestib Sci. 2013;12(2):67-71.

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Abstract: Herpes simplex encephalitis (HSE) is rare, serious sporadic encephalitis associated with high mortality in untreated cases. Although cognitive impairment with fever could be the clue of diagnosis, various symptoms can make it difficult to be diagnosed. Dizziness is one of the most frequent symptoms ENT doctors can encounter. Authors experienced the HSE patient suffered rotatory sense of dizziness as a primary symptom and treated the patient successfully without major complication. We reported our experience and findings of vestibular function test of patient. It could be helpful to other ENT doctors who encounter similar patients.

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