Research in Vestibular Science

Review

Vestibular Migraine: A Recent Update on Diagnosis and Treatment: Young Seo Kim, Hak Seung Lee; Res Vestib Sci. 2022;21(3):67-74. Published online September 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.3.67

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Abstract PDF: Vestibular migraine (VM) is a variant of migraine resulting in vestibular symptoms in addition to symptoms typical of migraine. However, without a biomarker or a complete understanding of the pathophysiology, VM remains underrecognized and underdiagnosed. Therefore, the diagnosis of VM is still challenging. Meanwhile, VM should be clearly differentiated from other similar diseases. Here, we highlight these challenges, discuss common vestibular symptoms and clinical presentations in VM, and review the current aspects of its clinical diagnosis and evaluation. The concepts related to the treatment of VM are also discussed.

Original Article

Canal Dysfunction Detected by Video Head Impulse Test in Patients with Vestibular Migraine and Its Relationship with Symptomatic Improvement: Ji Won Choi, Won Sub Lim, Sung Seok Ryu, Yeonjoo Choi, Sang Hun Lee, Seung Cheol Ha, Hong Ju Park; Res Vestib Sci. 2022;21(2):46-52. Published online June 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.2.46

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Abstract PDF: Objectives
Video head impulse test (vHIT) can evaluate function of the vestibuloocular reflex for high frequency range of head rotation. We aimed to characterize the abnormal patterns of canal dysfunction by vHIT in vestibular migraine (VM) and evaluate the relationship between the presence of canal dysfunction and symptomatic improvement.
Methods
Eighty-seven patients with VM were included. Abnormality of vHIT at the initial examination was determined by the vHIT gain and the degrees of the corrective saccades at each canal and each side. The relationship between the abnormal patterns and the symptomatic improvement (no need for preventive medication) after modification of life styles and preventive medications for 1, 3, and 6 months was evaluated.
Results
Abnormal vHIT of the lateral canal was 13.8% when determined by the gain criteria and 31.0% when based on both gain and corrective saccade, regardless of the side. Abnormal vHIT of the superior and posterior canals were 18.4% and 27.6%, regardless of the side. Abnormal vHIT at any canal and side was observed in 47%. Patients showed symptomatic improvement in 29.9%, 71.3%, and 88.5% after modification of life styles and preventive medications for 1, 3, and 6 months. Abnormal vHIT results of canals were significantly related to the poor response to preventive mediations.
Conclusions
Prolonged preventive medication was required for symptomatic improvement in VM patients when vHIT results of any canals were abnormal, suggesting that peripheral vestibular abnormality is closely related to the pathophysiology of vestibular migraine.

Reviews

Benign Paroxysmal Positional Vertigo: Diagnostic Criteria and Updated Practice Guideline in Diagnosis: Dae Bo Shim; Res Vestib Sci. 2020;19(4):111-119. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.111

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Abstract PDF: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo that is characterized by sudden onset of vertigo elicited by positional change. American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Neurology provided clinical practice guideline for BPPV in 2008. Since then, Bárány Society has published BPPV diagnostic criteria in 2015, and AAO-HNS has revised BPPV clinical practice guideline in 2017 to publish update version. This article reviewed recent diagnostic criteria for BPPV included in the International Classification of Vestibular Disorders of Bárány Society and updated practice guideline in the BPPV diagnosis presented by AAO-HNS.

Persistent Postural-Perceptual Dizziness: Overview and Diagnostic Criteria: Sung-Hee Kim; Res Vestib Sci. 2020;19(2):42-48. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.42

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Abstract PDF: Persistent postural perceptual dizziness (PPPD) is a chronic functional vestibular disorder that manifests with 3 or more months of dizziness, nonspinning vertigo, and unsteadiness. These main symptoms are exacerbated by upright posture, active or passive self-motion, and exposure to visual stimuli. PPPD is usually precipitated by illnesses that cause vertigo, dizziness, or unsteadiness. The common precipitants are acute or episodic peripheral vestibular diseases including vestibular neuritis, Meniere disease, or benign paroxysmal positional vertigo. PPPD is not a diagnosis of exclusion. An abnormal finding on examination or laboratory testing does not necessarily exclude a diagnosis of PPPD. This article reviewed the Bárány Society’s diagnostic criteria for PPPD in detail and discussed directions of future investigations.

Original Article

Is the Auditory Brainstem Response Diagnostic for Vestibular Paroxysmia?: Ju Han Lee, Sung-Kwang Hong, Hyung-Jong Kim, Hyo-Jeong Lee; Res Vestib Sci. 2018;17(2):55-59. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.55

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3 Crossref

Abstract PDF

Objectives
Vestibular paroxysmia (VP) of the eighth cranial nerve is characterized by recurrent auditory and vestibular disturbances when a proximal part of the eighth cranial nerve is continuously pressed by a vessel. A detailed history and several ancillary diagnostic tools, such as tinnitogram, caloric test, auditory brainstem response (ABR) and magnetic resonance imaging, are used for diagnosis of VP. Among them, although Møller criteria using ABR is a simple method, the previous study is insufficient. Therefore, this study aimed to evaluate ABR’s diagnostic value of VP.
Methods
ABR records of the 14 patients (patient group) who were diagnosed with VP and 45 patients (as control) who were diagnosed with only tinnitus were reviewed retrospectively. We analyzed the differences in Møller criteria between 2 groups.
Results
Mean age of the patient group was 52.9 years old and the control group was 55.4 years old. As compared with the control group, there were no significant differences of Møller 3 criteria contents (peak II wave amplitude＜33% [35.7% vs. 15.5%, p=0.133], interpeak latency I–III ≥2.3 msec [42.8% vs. 35.5%, p=0.622]), Contralateral interpeak latency III–V ≥2.2 msec (0% vs. 4.4%, p=1.000) in patient group.
Conclusion
There was no significant difference of ABR parameters according to the Møller criteria between patient and control groups.

Citations

Citations to this article as recorded by

Application of ABR in pathogenic neurovascular compression of the 8th cranial nerve in vestibular paroxysmia
Huiying Sun, Xu Tian, Yang Zhao, Hong Jiang, Zhiqiang Gao, Haiyan Wu
Acta Neurochirurgica.2022; 164(11): 2953. CrossRef
The Effects of Different Reference Methods on Decision-Making Implications of Auditory Brainstem Response
Zhenzhen Liu, Xin Wang, Mingxing Zhu, Yuchao He, Lin Li, Li Chen, Weimin Huang, Zhilong Wei, Shixiong Chen, Yan Chen, Guanglin Li, Plácido R. Pinheiro
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
The Effects of Random Stimulation Rate on Measurements of Auditory Brainstem Response
Xin Wang, Mingxing Zhu, Oluwarotimi Williams Samuel, Xiaochen Wang, Haoshi Zhang, Junjie Yao, Yun Lu, Mingjiang Wang, Subhas Chandra Mukhopadhyay, Wanqing Wu, Shixiong Chen, Guanglin Li
Frontiers in Human Neuroscience.2020;[Epub] CrossRef

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