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Eye Movement Abnormalities and Neuroimaging Findings of Disequilibrium of Unknown Origin
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Jae Yong Go, Jung Im Seok, Dong Kuck Lee
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Res Vestib Sci. 2014;13(4):108-113.
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 Abstract
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- Background
and Objectives: Although disequilibrium is common type of dizziness
in older people, it is sometimes difficult to identify a specific cause for this
problem. The diffuse brain pathology including subcortical ischemia and atrophy
can be a cause for patients with disequilibrium of unknown cause. Aim of this
study is to identify the eye movements and neuroimaging features in patients with
disequilibrium. Materials and Methods: We performed a prospective investigation
in patients with disequilibrium of unknown cause. We collected information on
demographic characteristics and clinical features of disequilibrium. The impact
of dizziness on everyday life was assessed by 25-item dizziness handicap
inventory (DHI). Vestibular function test (VFT) includes smooth pursuit, saccade,
optokinetic nystagmus, and rotatory chair test. Subcortical white matter lesions
and brain atrophy were graded from brain magnetic resonance image (MRI).
Results
This study included 14 patients (12 female and 2 male), aged between
64 and 84 years, mean age 74.01±6.02 years. The score of DHI was 39.4±11.8
(20?58). Eye movements were abnormal in 13 patients and normal in only one
patient. The degree of subcortical ischemia was mild in 7, moderate in 4, and
severe in 3 patients. Ventricular brain ratio was 0.23±0.03. However, there was
no significant relationship between MRI findings and the degree of oculomotor
alterations (result of VFT). Conclusion: Patients with disequilibrium of unknown
cause are usually elderly women. Alterations in oculomotor movements and
diffuse brain pathology including white matter lesions and atrophy were observed
in patients with disequilibrium of unknown cause.
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