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- Volume 9 (2); June 2010
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Review
Original Articles
- Effect of Preset Angle on Subjective Visual Vertical/Horizontal: Comparison between Normal Subjects and Patients with Dizziness
- Tae Hyun Moon, Sung Hyen Bae, Myung Whan Suh, Chung Ku Rhee, Jae Yun Jung
- Res Vestib Sci. 2010;9(2):52-57.
- 1,974 View
- 29 Download
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Abstract
PDF - Background and Objectives Subjective visual vertical (SVV) and subjective visual horizontal (SVH) are well known otolith function tests. Patients with acute unilateral vestibular weakness have a tendency to set the bar toward the side of the lesion in SVV and SVH tests. The object of this article is to identify the effect of preset angle on SVV and SVH tests in normal subjects and patients with dizziness. Materials and Methods From October 2008 to March 2009, thirty healthy volunteers, twenty eight vestibular neuritis (VN) patients (14-uncompensated, 14-compensated), Twenty five patients who had migrainous vertigo (MV) were enrolled. All subjects performed the test two times in each of the clockwise and counter-clockwise preset angle. Results In normal subjects, there was significant influence by preset angle on SVV test, not on SVH test. In VN patients with nystagmus, both SVH and SVV were not influenced by preset angle. In VN patients without nystagmus and in MV patients, there were significant influence by preset angle on both SVV and SVH tests. Conclusion SVV and SVH values depend on the direction of the preset angle in MV and uncompensated VN patients. The preset angle should be considered in the interpretation of SVV and SVH values.
- Effect of Elderly Organized Vestibular Rehabilitation for Presbystasis
- Tae Hoo Kim, Beom Gyu Kim, Chul Young Heo, Jae Seok Lee, Il Seok Park, Yong Bok Kim, Tae Won Jang, Seong Ki Ahn
- Res Vestib Sci. 2010;9(2):58-63.
- 2,544 View
- 83 Download
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Abstract
PDF
- Background and Objectives Recently, The number of patients who have been complaining of the vertigo or dizziness has been increasing due to rapid growth of the elderly population and senile change. Aging is associated with decreased balance abilities, resulting in an increased risk of fall. The purpose of this study is to analyze the result of elderly organized vestibular rehabilitation therapy for presbystasis. Materials and Methods A prospective study was performed on elderly population over sixty-five years. 148 dizzy patients who were admitted to Hallym University Medical Center. We recruited 64 consecutive patients with a diagnosis of presbystasis and treatment of rehabilitation. They were asked to complete the Korean vestibular disorders activities of daily living scale (K-VADL) for the functional aspect before and two to twelve weeks after elderly organized vestibular rehabilitation therapy. The result was analyzed by statistical methods. Results The K-VADL scores were decreased in patient of presbystasis compared with first questionnaire. There were statistically significant differences in the K-VADL scores between before and after rehabilitation therapy. Conclusion Most patients can effectively and safely utilize the modified vestibular rehabilitation therapy. Our results suggest that the vestibular rehabilitation therapy could provide a recovery for dizzy symptoms in presbystasis.
- Effects of Galvanic Stimulation on Spontaneous Nystagmus in Meniere’s Disease and Vestibular Neuritis: A Preliminary Study
- Seong Hae Jeong, Ji Soo Kim
- Res Vestib Sci. 2010;9(2):64-69.
- 2,518 View
- 32 Download
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Abstract
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- Background and Objectives Galvanic vestibular stimulation (GVS) is known to induce nystagmus, ocular torsion, a tilt of subjective visual vertical, and perceptual and postural shift. The aim of this study was to compare the findings of GVS among the patients with spontaneous nystagmus (SN) caused by Meniere’s disease (MD) or vestibular neuritis (VN). Materials and Methods Three-dimensional video-oculography was performed without fixation in 4 patients with MD and 2 with VN, as diagnosed by history, independent vestibular function tests and neuroimaging. We recorded the eye-movements in response to bilateral, bipolar, and surface GVS (2.5~3 mA) for 30 seconds, and analyzed mean slow phase velocity of SN. Results Of the 4 patients with MD, two exhibited a suppression of the left beating SN during anode stimulation of left mastoid and an augmentation of the nystagmus during cathode stimulation of left mastoid. The same patterns of galvanic modulation were observed in the other 2 patients with right beating SN due to MD. In contrast, the patients with VN showed an absent or decreased response to GVS. Conclusion In MD, the responses to GVS were preserved while the responses were impaired in VN. These results suggest that the irregular vestibular fibers, which are sensitive to GVS, are relatively spared in MD. In contrast, both regular and irregular fibers appear to be damaged in VN. GVS may be helpful in discriminating MD from VN, especially when the patients presented without auditory symptoms.
- Assessment of Anxiety using Beck's Anxiety Inventory in Patients with Vestibular Neuritis
- Jin Yong Kim, Seong Ki Ahn, Oh Jin Kwon, Soo Yeon Cho, Dong Gu Hur, Sea Yuong Jeon, Dae Woo Kim
- Res Vestib Sci. 2010;9(2):70-75.
- 2,049 View
- 16 Download
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Abstract
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- Background and Objectives The intimate relationship of vertigo and anxiety has been previously recognized. Anxiety may have an important influence on recovery of symptoms in vestibular neuritis (VN). The aim of study was to evaluate subjective anxiety of the pre-VN, at the time of onset of VN, and just after vestibular rehabilitation therapy (VRT) using Beck Anxiety Inventory (BAI) questionnaire, respectively. Materials and Methods Twenty-eight patients with VN were asked to complete the BAI and dizziness handicap inventory (DHI). Each of the BAI and DHI was scored. We also evaluated the relationship between the DHI and BAI scores. Results The VN patients at the time of attack had significantly more anxiety with vertigo and related symptoms (p<0.05). In most patients, anxiety level decreased following VRT. Conclusion These findings indicate that almost every VN patients can recovery from anxiety as vertigo regressed. However, the emotional support as well as physical and/or functional rehabilitation may be required to provide a more rapid and complete return to normal daily lives for these patients.
Case Reports
- A Case of Tumarkin Otolithic Crisis: Failed to Treat with Intratympanic Gentamicin Injection
- Young Hyo Kim, Hoseok Choi, Kyu Sung Kim, Young Mo Kim
- Res Vestib Sci. 2010;9(2):76-79.
- 10,991 View
- 134 Download
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Abstract
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- Tumarkin otolithic crisis is an unusual manifestation of Meniere’s disease that shows sudden falling without loss of consciousness. As a kind of life-threatening otologic emergency due to high risk of injury, the surgical ablation therapy rather than the medical one is preferred. Intratympanic injection of gentamicin (ITIG) is being introduced as a treatment by chemical ablation of vestibular function. The authors report a case of life-threatening Tumarkin otolithic crisis in 76-year-old female, after onset of Meniere’s disease, failed to treat with multiple application of ITIG, and successfully eradicated the symptom with total labyrinthectomy after then. Also we introduce her clinical feature of Tumarkin otolithic crisis. A 76-year-old female visited clinic suffering from recurrent rotatory vertigo accompanied with fluctuating hearing loss and tinnitus on her left ear, and diagnosis of Meniere’s disease was made. Four months after medical treatment, the patient experienced sudden drop attack during walking on the street without any prodromes, and her right wrist and skull base were fractured as a result. She denied to got surgery and ITIG was applied. During 1 year after initial drop attack, she experienced 7 times of severe drop attack and 4 times of ITIG, and finally she accepted to get surgery. The patient no longer suffered from drop attack after total labyrinthectomy later. Tumarkin otolithic crisis is an otologic emergency, may cause life-threatening falling. Our experience from this case is that vestibular ablation by surgical method is needed for safety and quality of life of patients.
- A Case of Posterior Fossa Meningioma Mimicking Meniere’s Disease
- Sol Kil Oh, Sunchul Hwang, Mookyun Park, Jong Dae Lee
- Res Vestib Sci. 2010;9(2):80-83.
- 2,760 View
- 16 Download
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Abstract
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- Posterior fossa meningioma constitute approximately 10% of meningiomas. It can rarely involve the endolymphatic sac and produce symptoms of Meniere’s disease. We present the case of a 41-year-old male patient who was suffering from recurrent vertigo. The pure tone audiogram revealed low tone hearing loss on right side and temporal magnetic resonance image revealed a meningioma in posterior fossa. Posterior fossa meningioma should be considered in the differential diagnosis of patients with signs and symptoms of Meniere’s disease.
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