Research in Vestibular Science

Vascular Origin of Central Vertigo: Brainstem: Sun-Uk Lee; Res Vestib Sci. 2021;20(1):1-6. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.1

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Various neurotologic findings can be observed in stroke involving the brainstem. Analyses of the neurotologic findings are important in brainstem stroke since it can have negative diffusion-weighted image, as well as, presenting with acute vestibular syndrome in isolation without any associated neurologic deficits. In this review we discuss the neurotologic findings from lesion involving (1) the medial vestibular nucleus, (2) nucleus prepositus hypoglossi, (3) inferior cerebellar peduncle, (4) medial longitudinal fasciculus, (5) rostral interstitial nucleus of the medial longitudinal fasciculus, (6) interstitial nucleus of Cajal, and (7) middle and (8) superior cerebellar peduncles. It is important to recognize these specific neurotologic findings depending on the neural structures involved that may guide early detection and proper management.

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A Case of Ramsay Hunt Syndrome Showing Central Findings due to Brainstem Involvement
Min Hyuk Lee, Min-Beom Kim
Research in Vestibular Science.2023; 22(4): 120. CrossRef

Differential Diagnosis of the Acute Vestibular Syndrome: Sung-Hee Kim; Res Vestib Sci. 2021;20(1):7-16. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.7

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Abstract PDF: Acute vestibular syndrome refers to the rapid onset of vertigo, nausea, vomiting, and unsteady gait. Acute unilateral vestibular neuritis is the most common cause of acute vestibular syndrome. However, vascular lesions involving the brainstem and cerebellum also produce acute vestibular syndrome even without other neurologic deficits. The vestibular nucleus or nucleus prepositus hypoglossi in the dorsal portion of the brainstem, cerebellar structures including flocculus, tonsil, and nodulus, and cerebellar peduncle can produce isolated vertigo and imbalance when damaged. Early recognition of the pseudo-vestibular neuritis of the vascular etiology is warranted for clinicians.

Impact of Vestibular Function on Health-Related Quality of Life: A Cross-Sectional Study Based on Korea National Health and Nutrition Examination Survey: Hyun Jung Kim, Soo Bin Lee, Michelle J. Suh; Res Vestib Sci. 2021;20(1):17-23. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.17

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Abstract PDF Supplementary Material: Objectives
This study was performed to investigate whether vestibular dysfunction affects health-related quality of life in Korean adults.

Methods
This retrospective cross-sectional study was performed with data from the 2010 to 2011 Korea National Health and Nutrition Survey for adults aged 40 years or more. The modified Romberg test and health-related quality of life evaluation using the EuroQoL 5-dimensional (EQ-5D) questionnaires were performed. Data were analyzed using a complex-sample chi-square test of independence and multivariate linear regression analysis. The main outcome measures were vestibular dysfunction and the calculated health-related quality of life questionnaire score.

Results
The overall prevalence of vestibular dysfunction was 3.4% (95% confidence interval, 2.5%–4.3%). In adults aged more than 40 years, multivariate linear regression analyses showed a significant reverse correlation between vestibular function and health-related quality of life since the EQ-5D index showed a lower score than normal (B coefficient=‒0.09, R²=0.299, p=0.003) for a decrease in balance function, and the scores for mobility, self-care, general activities, and pain/discomfort were worse, except for anxiety/depression. On the other hand, subjective dizziness was significantly associated with the EQ-5D index and all its subcategories.

Conclusions
Since adults with vestibular dysfunction have poor health-related quality of life, active monitoring and rehabilitation are necessary.

Diffuse Cerebellar Dysfunction as a Permanent Neurological Sequela of Organophosphate Poisoning: A Case Report: Hyun Ah Kim, Hyung Lee; Res Vestib Sci. 2021;20(1):24-27. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.24

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Abstract PDF: The diffuse cerebellar dysfunction as a permanent neurological sequela of organophosphate poisoning has not yet been reported in the published literature. We report a diffuse cerebellar dysfunction as a permanent manifestation of organophosphate poisoning. A 55-year-old man diagnosed with acute organophosphate poisoning was brought to the emergency room of our hospital. He had slurred, monotonous scanning speech with irregularly distributed articulatory deficits, and prominent bilateral limb ataxia. He presented left-beating spontaneous nystagmus with a downbeat component and strong downbeating nystagmus after head shaking. He also showed saccadic hypometria with a normal saccadic velocity at fixed horizontal saccades and symmetrically impaired horizontal smooth pursuit on both sides. The poisoning of organophosphate poisoning may lead to a diffuse permanent cerebellar dysfunction as a neurological sequela event.

Nystagmus in Intracranial Vertebral Artery Dissection Caused by Golf Swing: Jin Woo Choi, Yeonsil Moon, Jung Eun Shin, Chang-Hee Kim; Res Vestib Sci. 2021;20(1):28-32. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.28

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Abstract PDF Supplementary Material: Vertebral artery dissection (VAD) during a golf swing is extremely rare. Golfrelated VAD has been reported to occur more commonly at extracranial segments on the right side. In the present study, we report a 57-year-old, right-handed, female amateur golfer with golf-related VAD which developed at the intracranial segment (V4) of the left vertebral artery. The patient complained of sudden vertigo with nausea and vomiting, and aggravation of the left tinnitus. Video oculography showed very weakly left- and upbeating spontaneous nystagmus. The intensity of nystagmus was increased by positioning such as bowing, lying down or right head-rolling. The patient was treated with oral aspirin, and complete recanalization of the left vertebral artery was observed in a follow-up imaging study.

A Case of Spinocerebellar Ataxia Type 28: Jae-Hwan Choi, Eun Hye Oh, Seo Young Choi, Kwang-Dong Choi; Res Vestib Sci. 2021;20(1):33-36. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.33

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Abstract PDF: Spinocerebellar ataxia type 28 (SCA 28) is characterized by young-adult onset, very slowly progressive gait and limb ataxia, dysarthria, nystagmus, ptosis, and ophthalmoplegia. It is caused by a heterozygous pathogenic mutation in the AFG3L2. So far, approximately 80 cases with genetically-confirmed SCA 28 have been reported in the literature. We report a patient with mild gait ataxia and dysarthria who carried a known pathogenic mutation in the AFG3L2. This is the first report of genetically-confirmed SCA 28 in Korea.

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