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Clinical Analysis of Down Beat Nystagmus in Atypical Positional/ing Vertigo
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Gyu Cheol Han, Ju Hyoung Lee, Eun Jung Lee, Jae Jun Song
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J Korean Bal Soc. 2004;3(1):150-155.
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 Abstract
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- Background
and Objectives : Traditionally, down beat nystagmus is regarded as a sign of central nervous system
dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during
treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this
study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss
the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior
semicircular canal BPPV, and to propose the new treatment method.
Materials and Method : From November 1999 to March 2004, we sampled the 103 patients with positional or
positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous
system dysfunction, nonspecific or artifact result, idiopathic origin.
Results
: All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was
reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and
reversibility was reported in 1 patient. Average latency was checked less than 2 seconds.
Conclusion
: Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not
controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down
beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Key Words : Benign paroxysmal vertigo, Positional vertigo, Superior semicircular cana
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Clinical Analysis of the Dizzy Patients in a Department of Emergency Medicine
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Gyu Cheol Han, Eun Jung Lee, Jong Su Ha, Dong Kyu Kim
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J Korean Bal Soc. 2003;2(2):206-210.
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Abstract
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- Background
and Objectives: The patient presenting to the emergency department with the complaint of dizziness is one of the most common as well as most challenging problems confronting the emergency physician today. Dizziness is a vague symptom of disease ranging from serious to benign. The differential diagnosis and proper management of dizziness in a department of emergency medicine are the most important things. We undertook this study to evaluate the character and clinical analysis of the dizzy patients and to discuss the significance and necessity of primary care in a department of emergency medicine.
Materials and Method: From September 1999 to October 2003, we sampled the 1,371 dizzy patients who visited the Emergency Department(ED). Of these patients, the 650 patients performed electronystagmography(ENG) and rotatory chair test were selected, except for the patients with loss of consciousness, known psychiatric disease or direct brain injury.
Results
The 650 patients were attributed to acute peripheral vestibulopathy in 88.5% (575 patients) of patients, benign paroxysmal positional vertigo in 9.5% (62 patients) of patients, central origin in 1.4% (9 patients) of patients, other organic origin in 0.6% (4 patients) of patients. In a retrospective analysis of patients with central origin, the symptoms estimated at central origin, for example, persistent headache, were found.
Conclusion
The exact diagnosis and management for the dizzy patients in a department of emergency medicine require the primary physician's concern and understanding for dizziness.
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Hearing Recovery in Patients of Sudden Hearing Loss with Vertigo ; Incheon
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Eun Jung Lee, Gyu Cheol Han, Kyu Sung Kim
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J Korean Bal Soc. 2003;2(1):103-106.
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Abstract
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- 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.
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KBS
