Research in Vestibular Science

Hyun Ah Kim

11 Articles

Treatment of hemodynamic orthostatic dizziness/vertigo: Hyun Ah Kim; Res Vestib Sci. 2024;23(3):79-88. Published online September 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.017

137 View
9 Download

Abstract PDF: Orthostatic dizziness occurs when a person feels dizzy or lightheaded upon standing up. Hemodynamic orthostatic dizziness can result from autonomic dysfunction, such as orthostatic hypotension or postural tachycardia syndrome. The International Classification of Vestibular Disorders has established diagnostic criteria for hemodynamic orthostatic dizziness/vertigo. These criteria help clinicians understand the terminology associated with orthostatic dizziness/vertigo and differentiate it from dizziness caused by global brain hypoperfusion and other etiologies. Effective treatment involves interpreting the results of autonomic function tests, which can lead to improvements in orthostatic dizziness and help prevent falls related to this condition. This paper discusses general management strategies and specific treatments for orthostatic hypotension and postural tachycardia syndrome, highlighting the importance of tailored care based on the most recent clinical insights.

Prevalence and preferred medication for vestibular migraine in Menière’s disease: a multicenter retrospective cohort study in Korea: Dong-Han Lee, Hong Ju Park, Kyu-Sung Kim, Hyun Ji Kim, Jae-Yong Byun, Min-Beom Kim, Minbum Kim, Myung-Whan Suh, Jae-Hyun Seo, Jong Dae Lee, Eun-Ju Jeon, Myung Hoon Yoo, Seok Min Hong, Sung-Kwang Hong, Hyo-Jeong Lee, Jung Woo Lee, Se-Joon Oh, Hyun Ah Kim, Hyung Lee, Eek-Sung Lee, Eun-Jin Kwon, Seong-Hae Jeong, Jeong-Yoon Choi, Chang-Hee Kim; Res Vestib Sci. 2024;23(2):37-45. Published online June 14, 2024; DOI: https://doi.org/10.21790/rvs.2024.005

960 View
49 Download

Abstract PDF Supplementary Material: Objectives
The aim of this study is to categorize headaches associated with definite Menière’s disease (MD) according to diagnostic criteria, to determine their prevalence, and to investigate the preferred medication across participating centers.
Methods
Patients diagnosed with definite MD at 17 university hospitals in otolaryngology or neurology departments in Korea between January 1, 2021 to December 31, 2021 were retrospectively included. Data on the presence of accompanying vestibular migraine (VM), migraine or non-migraine headaches, and clinical information were collected. A survey was conducted to assess preferences for treatment drugs for vertigo and headache control in MD patients with headache.
Results
A total of 435 definite MD patients were included, with a mean age of 57.0±14.9 years. Among them, 135 (31.0%) had accompanying headaches, of whom 48 (11.0% of all definite MD patients) could be diagnosed with VM. The prevalence of comorbid VM (definite and probable) was significantly higher in females (41 of 288, 14.2%) than in males (7 of 147, 4.8%) (p<0.05). There was no significant difference in the prevalence of comorbid VM between unilateral and bilateral MD patients (10.8% and 13.6%, respectively) (p > 0.05). Benzodiazepines, antihistamines, and antiemetics were mainly preferred for acute vertigo control, while nonsteroidal anti-inflammatory drugs, acetaminophen, and triptans were preferred for acute headache control, and topiramate, propranolol, and calcium channel blockers were mainly preferred for headache prevention.
Conclusions
VM is not uncommon in patients with definite MD in Korea. Further research is needed to understand the differences in headache prevalence and preferred medications across different centers.

Complete ocular tilt reaction with subjective visual vertical tilt in a patient with a medial prefrontal cortex lesion: a case report: Hyung Lee, Hyun Ah Kim; Res Vestib Sci. 2024;23(1):24-27. Published online March 15, 2024; DOI: https://doi.org/10.21790/rvs.2023.136

889 View
15 Download

Abstract PDF: A 61-year-old male patient undergoing chemotherapy for esophageal cancer presented with symptoms of rightward tilting while both sitting and walking. A neurological examination revealed a head tilt, skew deviation with hypertrophy of the left eye, and a rightward shift in his gait. No spontaneous nystagmus was observed, and the vestibulo-ocular reflex was normal. Magnetic resonance imaging of the head revealed a suspected metastatic lesion in the right medial prefrontal cortex. Following the initiation of levetiracetam treatment, the patient demonstrated marked improvement, with the resolution of both head tilt and skew deviation within 1 month. Traditionally, the ocular tilt reaction has been attributed to unilateral or asymmetric dysfunction of the graviceptive pathways extending from the utricle to the upper midbrain lesions. However, this case highlights the potential involvement of the prefrontal cortex in the ocular tilt reaction. Further research is warranted on the role of the prefrontal cortex within the vestibular system.

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

4,117 View
67 Download

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.

Diagnostic Criteria and Differential Diagnosis of Hemodynamic Orthostatic Dizziness/Vertigo: Hyun Ah Kim, Ji-Soo Kim; Res Vestib Sci. 2020;19(2):35-41. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.35

5,609 View
190 Download
1 Crossref

Abstract PDF

We summarized recent diagnostic criteria for hemodynamic orthostatic dizziness/vertigo included in the International Classification of Vestibular Disorders (ICVD) in this paper. The aim of defining diagnostic criteria of hemodynamic orthostatic dizziness/vertigo is to help clinicians to understand the terminology related to orthostatic dizziness/vertigo and to distinguish orthostatic dizziness/vertigo due to global brain hypoperfusion from that caused by other etiologies. Detailed history taking and measurements of orthostatic blood pressure and heart rate are important for the screening and documentation of orthostatic hypotension or postural tachycardia syndrome to establish the diagnosis of hemodynamic orthostatic dizziness/vertigo.

Citations

Citations to this article as recorded by

Posterior Inferior Cerebellar Artery Stenosis Presenting as Recurrent Orthostatic Dizziness
Seongjin Jeon, Ji-Yun Park, Jong-min Lee, Seulgi Hong
Research in Vestibular Science.2022; 21(2): 53. CrossRef

The Effect, Compliance and Satisfaction of Customized Vestibular Rehabilitation: A Single Center Experience: Hyung Lee, Hyun Ah Kim; Res Vestib Sci. 2019;18(1):14-18. Published online March 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.1.14

5,544 View
107 Download
2 Crossref

Abstract PDF

Objectives
Over the last decades, numerous studies on the effect of vestibular rehabilitation (VR) have been reported in western countries, but there has been no report about real experiences of customized VR in Korea. The aim of this study was to analyze of the efficacy, compliance and satisfaction in patients with acute and chronic dizziness.
Methods
Patients with dizziness were treated with a customized VR at least 4 weeks. Subjects were assessed before and after at least 4 weeks of customized VR for visual analogue scale (VAS) and disability scale (DS). Patients were asked to score the satisfaction of their treatment as 1 (very poor) to 5 (excellent). Compliance to exercise program were graded as 1 (regularly performed), 2 (frequently performed), or 3 (rarely performed).
Results
Thirty-two patients with dizziness were included. Diagnosis of patients were vestibular migraine (n=5), Meniere’s disease (n=2), vestibular neuritis (n=10), persistent perceptual positional dizziness (n=10), bilateral vestibulopathy (n=3), and central dizziness (n=2). Mean VAS and DS before VR were 15.3 and 2.4, respectively. Mean VAS and DS after VR were 4.5 and 0.7, respectively. Significant improvements in VAS and DS were observed after VR (p=0.00). Mean treatment satisfaction score was 3.3±1.0 and mean compliance score was 2.3±0.8. Satisfaction to VR showed positive correlation with patient’s compliance. (p=0.00, r=0.644)
Conclusions
Significant improvements were seen in symptom and disability in patients with acute and chronic dizziness after customized VR. Patients showed moderate compliance to exercise program and overall satisfaction was fair.

Citations

Citations to this article as recorded by

A Survey of Educational, Clinical Background in Vestibular Rehabilitation Therapy of Korean Physical Therapists
Migyoung Kweon, Youn Bum Sung
The Journal of Korean Academy of Physical Therapy .2023; 30(2): 65. CrossRef
Factors Associated with Patient Satisfaction in Customized Vestibular Exercise: A Pilot Study
Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi
Research in Vestibular Science.2019; 18(3): 71. CrossRef

맞춤전정재활운동의 효과, 순응도와 만족도: 단일 병원 경험: Hyung Lee, Hyun Ah Kim; Received February 19, 2019 Accepted March 11, 2019 Published online March 11, 2019; [Accepted]

981 View
0 Download

Abstract: Background
Over the last decades, numerous studies on the effect of Vestibular rehabilitation (VR) have been reported in western countries, but there has been no report about real experiences of customized VR in Korea. Objectives: The aim of this study was to analyze of the efficacy, compliance and satisfaction in patients with acute and chronic dizziness. Methods: Patients with dizziness were treated with a customized VR at least 4 weeks. Subjects were assessed before and after at least 4 weeks of customized VR for visual analog scale (VAS) and disability scale (DS). Patients were asked to score the satisfaction of their treatment as 1 (very poor) to 5 (excellent). Compliance to exercise program were graded as 1 (regularly performed), 2 (frequently performed) or 3 (rarely performed). Results: 32 patients with dizziness were included. Diagnosis of patients were vestibular migraine (n=5), Meniere’s disease (n=2), vestibular neuritis (n=10), persistent perceptual positional dizziness (n=10), bilateral vestibulopathy (n=3) and central dizziness (n=2). Mean VAS and DS before VR were 15.3 and 2.4, respectively. Mean VAS and DS after VR were 4.5 and 0.7, respectively. Significant improvements in VAS and DS were observed after VR. (p=0.00) Mean treatment satisfaction score was 3.3± 1.0 and mean compliance score was 2.3 ± 0.8. Satisfaction to VR showed positive correlation with patient’s compliance. (p=0.00, r=0.644) Conclusion: Significant improvements were seen in symptom and disability in patients with acute and chronic dizziness after customized VR. Patients showed moderate compliance to exercise program and overall satisfaction was fair.

Laboratory Management Status of Vestibular Function Test in Korea: Tae Su Kim, Mi Joo Kim, Byung-Kun Kim, Hyun Ah Kim, Dae Woong Bae, Miran Bae, Seong-Cheon Bae, Eeksung Lee, Eun-Ju Jeon; Res Vestib Sci. 2018;17(4):160-166. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.160

6,913 View
157 Download
1 Crossref

Abstract PDF Supplementary Material

Objectives
This study was conducted to assess the current management status of the vestibular function test laboratories in Korea.
Methods
Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires.
Results
Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.

Citations

Citations to this article as recorded by

The impact examination of the head tilt size on the subjective visual vertical (SVV) among the normal individuals with ages ranged from 18 to 35 years
Mahmoud Rezvani Amin, Hadi Behzad
Hearing, Balance and Communication.2022; 20(2): 129. CrossRef

Evaluation of Adrenergic Function: Tilt-Table and Valsalva Test: Hyung Lee, Hyun Ah Kim; Res Vestib Sci. 2018;17(1):8-12. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.8

13,016 View
263 Download
1 Crossref

Abstract PDF

Orthostatic dizziness is a common dizziness syndrome characterized by nonvertiginous lightheadedness when patients rise to stand from a sitting or supine position. Orthostatic dizziness is commonly believed to derive from orthostatic hypotension (OH) or postural tachycardia syndrome (POTS). Tilt-table test and Valsalva maneuver are standardized methods for evaluating of adrenergic autonomic function and essential for diagnosis of OH and POTS. We described the guidelines and interpretations of the tilt-table test and Valsalva maneuver.

Citations

Citations to this article as recorded by

Interpretation of Autonomic Function Test
Kee Hong Park, Eun Hee Sohn
Journal of the Korean Neurological Association.2021; 39(2): 61. CrossRef

Evaluation of adrenergic function: Hyung Lee, Hyun Ah Kim; Received January 12, 2018 Accepted March 6, 2018 Published online March 6, 2018; [Accepted]

1,332 View
2 Download

Abstract: Orthostatic dizziness is a common dizziness syndrome characterized by non-vertiginous lightheadedness when patients rise to stand from a sitting or supine position. Orthostatic dizziness is commonly believed to derive from orthostatic hypotension (OH) or postural tachycardia syndrome (POTS). Tilt table test and Valsalva maneuver are standardized methods for evaluating of adrenergic autonomic function and essential for diagnosis of OH and POTS. We described the guidelines and interpretations of the tilt table test and Valsalva maneuver.

Near Faint and Autonomic Symptoms: Hyun Ah Kim; Res Vestib Sci. 2013;12:S41-S45. Published online June 1, 2013

1,104 View
18 Download

Abstract PDF: Orthostatic or autonomic dizziness is a common complaint in patient who seeking dizzy clinic. Patients with autonomic dizziness presented their dizziness as nonvertiginous dizziness, light-headedness, or fogginess in the head, which are usually exacerbated by physical exertion (but not specific changes in head position), straining (e.g., the Valsalva manuver), and orthostatic challenges. Orthostatic hypotension and postural orthostatic tachycardia syndrome are two common causes of autonomic dizziness. Because the vestibular system influences both respiratory and cardiovascular control, damage to the central or peripheral vestibular system also can cause to compromise the ability to adjust breathing and blood pressure during movement and changes in posture. Here the author reviews the clinical features of autonomic dizziness from various causes.

Author index