-
New Proposal of Functional Status of Vestibular System Based on Vestibular Function Tests Findings in Dizzy Patients with Normal Caloric Response
-
Hye Youn Youm, Yang Sun Cho, Sung Hwa Hong, Won Ho Chung
-
Res Vestib Sci. 2011;10(4):121-128.
-
-
-
 Abstract
 PDF
- Background and Objectives: Vestibular function tests are very useful in diagnosing dizzy patients. Among them, bithermal caloric test is most commonly used test for localizing their permanent vestibular loss. However, it causes much discomfort to the patients with non-physiologic stimuli. In addition, it doesn't represent the present functional status of vestibular system. Therefore, normal caloric result does not accurately correspond to normal vestibular function in dizzy patients. Currently, rotation chair test and dynamic posturography have been introduced adjunctly to assess vestibular function accompanied by bithermal caloric test. It has not been elucidated for their specific role in diverse settings of vestibular disorders. So we planned this study to evaluate clinical usefulness of rotation chair test, videonystagmography and computerized dynamic posturogr-phy in dizzy patients with normal caloric response. Materials and Methods: We reviewed clinical records of 46 patients who met their inclusion criteria. They were categorized into five subgroups according to abnormal vestibular function test findings. Results: In each subgroup, we hypothesized its clinical relevance, possible mechanism of dizz-iness and presumed diagnosis. Five categories are as below; visual dependency, imbalance of vestibular tones, chronic peripheral vestibulopathy, abnormality in the vestibulospinal tract and abnormality of oculomotor system. Conclusion: We suggest new classification of abnormal vestibular functional status in dizzy patients with normal caloric results. These are comparable according their clinical features and thought to be helpful in managing and counseling each patient.
-
Effects of Medical Treatment on Meniere's disease
-
Won Ho Chung, Hyeok Jun Lee, Byung soo Hong, Hyun Jong Lee, Sung Hwa Hong, Yang Sun Cho
-
J Korean Bal Soc. 2003;2(1):113-120.
-
-
-
Abstract
PDF
- Objectives
In Meniere's disease, medical treatment using diuretics has been the mainstream of management. But the effects of medical treatment are very difficult to evaluate because of many variables. Authors tried to investigate the effects of diuretics on Meniere's disease through the change of symptoms.
Materials and Method: From January, 1995 to December, 2000, the twenty patients with definite Meniere's disease who has been followed up over 24 months were retrospectively reviewed. They had no history of previous medication, and were managed with diuretics for the first time. The change of frequency of vertigo, the threshold of pure tone audiometry, type of audiogram were analyzed at each period during 6 month before treatment, during 6 month at 1, 2 and 4 years after treatment.
Results
The ratio of sex was 1:1(male 10, female 10), the average age of diagnosis was 53.9 year old, and the average follow up duration was 39.3 month. By medical treatment, vertigo symptom was significantly controlled in 56.2% at 2 year after treatment. Among 20 patients, 5 patients failed to medical treatment and underwent the sac decompression (N=1) and intratympanic gentamicin injection (N=4). The change of pure tone audiometry was from 34.5 dB before treatment to 38 dB at 24 months and 44.2 dB at 48 months after treatment. The most type of audiometry was flat type and flat type was increased with time.
Conclusion
In Meniere's disease, the medical treatment controlled significantly the vertigo frequency in 50~60%. But the hearing threshold was aggravated with time after treatment despite of medical treatment.
-
The clinical characteristics of dizzy patients with normal vestibular function tests
-
Won Ho Chung, Eun Guk Bang, Sung Hwa Hong, Chi Kyou Lee, Hyun Seok Lee
-
J Korean Bal Soc. 2002;1(2):259-265.
-
-
-
Abstract
PDF
- Background
and Objectives : Dizziness is a very common complaint in every day practice. The prevalence of dizziness ranges from 1.8 % in young adults to 30% in the elderly. The sensitivity of vestibular function tests is limited. It was reported that the sensitivity of electronystagmography for diagnosing peripheral vestibular disorders was variable, ranging from 46 to 74%. The objective of this study is to analyse the causes and clinical characteristics of dizzy patients who show normal vestibular function tests.
Materials and methods : From January 1999 to June 2001, 375 dizzy patients with normal vestibular function tests(mean age, 49.7 years; range, 8 to 79 years) were assessed with the medical records and typed questionnaires about dizziness.
Results
: Dizzy patients with normal vestibular function tests were attributed to an unknown cause in 20.0% of patients, benign paroxysmal positional vertigo in 19.5%, migrainous dizziness in 11.7%, psychogenic dizziness in 10.4%, Meniere's disease in 9.6% and vertebrobasilar insufficiency in 7.2%.
Conclusion
: Dizzy patients with normal vestibular function tests can be evaluated by careful history taking and combined multidisciplinary approach with neurologist, psychiatrist and cardiologist and strict diagnostic criteria are necessary.
-
Outcome of canalith repositioning maneuver in Benign Paroxysmal Positional Vertigo
-
Young Jun Chung, Jong Yoon Choi, Won Ho Chung, Sung Hwa Hong
-
J Korean Bal Soc. 2002;1(1):118-123.
-
-
-
Abstract
PDF
- Background
and Objectives : Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of peripheral vestibular disorder and canalith repositioning procedure (CRP) has been popularly used as its treatment. While CRP has been advocated by some as a treatment of choice for BPPV, others have had less uniform results for this disorder. The purpose of this study is to evaluate the effectiveness of the CRP and to define the role of the CRP in BPPV.
Materials and Methods : From January, 1999 to September, 2001, 123 patients diagnosed as BPPV were included in this study. Each patient was undergone by personal history taking and Dix-Hallpike maneuver and supine head turning test for diagnosis. CRP was applied on all the patients and the patients visited OPD 1week later for evaluation.
Results
: The mean age was 51.8 year old in males, and 52.7 year old in females. The most common cause of the disorder was idiopathic and the second common cause was post-traumatic. Posterior semicircular canal was the most common involved site and horizontal, anterior semicircular canal in order. After the initial CRP, successful results were obtained in 90 of the 123 patients (75.6%). Recurrence rate was 31 of the 123 patients and among them, 3patients recurred in different canal.
Conclusion
: Careful observation of the nystagmus is necessary for correct identification of the canal which is involved, and that to perform the appropriate treatment. Although BPPV is known as a self-limited disorder, CRP can help to induce remission of the vertiginous symptoms in short period.
|
KBS
