Research in Vestibular Science

Volume 20 (3); September 2021

Reviews

Medical Treatment of Nonvascular Central Vertigo: Seo-Young Choi, Kwang-Dong Choi; Res Vestib Sci. 2021;20(3):75-80. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.75

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Abstract PDF: Central vertigo is the common symptom resulting from abnormalities in the central nervous system, caused by various diseases, which include neurodegenerative, vascular, inflammation, infection, tumor, paraneoplastic, toxic, or metabolic disorders. Since the treatment of central vertigo depends on the causes, an accurate diagnosis should be preceded the treatment through a detailed neurotologic examination and laboratory evaluation. Also, it is important to identify and document the neurologic findings accompanied by central vertigo, because some medication focuses on the ocular motor abnormalities as nystagmus or saccadic intrusion. Here, we will review the medical treatment for central vertigo.

Understanding Vestibular Information Processing in Velocity-Storage Circuit and Application to Interpreting Clinical Manifestation of Vestibular Disorders: Jeong-Yoon Choi; Res Vestib Sci. 2021;20(3):81-92. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.81

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Abstract PDF: The velocity-storage circuit comprised of bilateral vestibular nucleus complexes, commissural fiber, and nodulus and uvula functions in refining the raw vestibular signal to estimate rotational velocity, gravity direction, and inertia. In this review, we pursued the functional significance of this velocity-storage circuit and how this physiologic knowledge could help us understand the clinical symptoms and signs of patients with vestibular disorders.

Original Articles

Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo: Jung-Yup Lee, In-Buhm Lee, Min-Beom Kim; Res Vestib Sci. 2021;20(3):93-100. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.93

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Abstract PDF

Objectives
This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB).
Methods
A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS＞0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results.
Results
There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (p＜0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation.
Conclusions
We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.

Citations

Citations to this article as recorded by

Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver
Christine C. Little, Zachary G. Schwam, Marc Campo, James Gurley, Bryan Hujsak, Maura K. Cosetti, Jennifer Kelly
Otology & Neurotology Open.2022; 2(3): e014. CrossRef
Gait and Postural Control Characteristics among Individuals with Benign Paroxysmal Positional Vertigo: A Scoping Review
Haziqah Nasruddin, Maria Justine, Haidzir Manaf
Malaysian Journal of Medicine and Health Sciences.2022; 18(s15): 377. CrossRef

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?: Yong-Hwi An, Hyun Joon Shim; Res Vestib Sci. 2021;20(3):101-107. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.101

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Abstract PDF

Objectives
This study was performed to determine characteristics and the prognostic values in idiopathic sudden sensorineural hearing loss (SSNHL) with comorbid ipsilateral canal paresis (CP) and/or benign paroxysmal positional vertigo (BPPV).
Methods
Of the 338 patients with a diagnosis of idiopathic SSNHL, 29 patients (8.6%) with CP and 24 patients (7.1%) with BPPV were recruited and compared to 23 patients with SSNHL and vertigo but without CP or BPPV. The patients were evaluated for their initial hearing threshold, type of canal involved, response to repositioning maneuvers, and hearing outcome for 6 months.
Results
Patients with CP (+) BPPV (‒) showed lower pure-tone averages than those with CP (‒) BPPV (+) on initial and follow-up audiograms. The improvement in pure-tone averages was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (+) group. The improvement in speech discrimination scores was less in the CP (+) BPPV (‒) group than in the CP (‒) BPPV (‒) group. BPPV most commonly involved the posterior canal (15 of 24, 62.5%), followed by the horizontal canal (13 of 24, 54.2%). Three of 24 patients (12.5%) had recurrences of BPPV.
Conclusions
CP is a more serious sign for hearing recovery than BPPV, although both CP and BPPV are negative prognostic indicators of auditory function in SSNHL. Concurrent CP and/or BPPV in SSNHL suggest combined damage to the vestibule and may indicate severe and widespread labyrinthine damage, leading to a poor prognosis.

Citations

Citations to this article as recorded by

Re-fixation Saccade at Video-Head Impulse Test in Patients with Sudden Sensorineural Hearing Loss
Dong Hyuk Jang, Sun Seong Kang, Hyun Joon Shim, Yong-Hwi An
Research in Vestibular Science.2023; 22(2): 46. CrossRef

Case Reports

Superior Semicircular Canal Dehiscence Syndrome Manifested as Menière’s Disease: A Case Report: Byeong Jin Kim, Yun Na Yang, Chan Mi Lee, Eun Jung Lee; Res Vestib Sci. 2021;20(3):108-112. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.108

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Abstract PDF: The absence of a temporal bone overlying the superior semicircular canal causes superior semicircular canal dehiscence (SSCD). The vestibular symptom of SSCD syndrome (SCDS) is vertigo and audiologic symptoms include autophony, hyperacusis, and ear fullness. A 52-year-old man presented with left-sided unilateral hearing loss, aural fullness, and recurrent spinning-type vertigo. He had positive Hennebert sign and mixed-type hearing loss, with a prominent low-frequency air-bone gap. These symptoms reminded us of SCDS, and computed tomography (CT) revealed SSCD. However, the patient had not experienced vertigo until 1 week prior to the visit. In addition, the audiogram revealed fluctuation of hearing, which was aggravated when the vestibular symptoms manifested. Vertigo might be due to Menière’s disease rather than SCDS and SSCD was incidentally detected on CT. According to reviews, this is no reported case of SCDS manifested as Menière’s disease, so we report this case with a brief review of the literature.

Ocular Flutter in Parainfectious Meningoencephalitis: A Case Report: In-Ho Yoon, Seung-Hoon Yun, Bong-Hui Kang; Res Vestib Sci. 2021;20(3):113-117. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.113

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Abstract PDF Supplementary Material: Ocular flutter is a rare, horizontal eye movement disorder characterized by intermittent bursts of conjugate horizontal saccades without intersaccadic intervals. It can occur in various clinical conditions such as metabolic dysfunction, infection and paraneoplastic syndrome. Herein, a 50-year-old male showed ocular flutter in parainfectious meningoencephalitis and immunoglobulin therapy led to an improvement of symptoms. This case can improve the understanding of the pathological mechanisms of ocular flutter.

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