Research in Vestibular Science

Volume 17 (2); June 2018

Review

Autonomic Dysfunction in Dizziness Clinic: Eun Bin Cho, Ki-Jong Park; Res Vestib Sci. 2018;17(2):37-43. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.37

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Orthostatic dizziness is a common type of dizziness. In general, orthostatic dizziness is provoked by standing or tilting, and subsided by supine position. The patient with orthostatic intolerance complains multiple symptoms such as dizziness, palpitation, lightheadness, fatigue and rarely syncope. Common orthostatic intolerance is orthostatic hypotension (classic, initial, transient, and delayed orthostatic hypotension) and postural orthostatic tachycardia syndrome. Transcranial Doppler is a noninvasive technique that provides real-time measurement of cerebral blood flow velocity. It can be useful for understanding the relationship between orthostatic symptoms and cerebral autoregulatory function. The reciprocal causal relationship between vestibular and autonomic dysfunction should always be kept in mind.

Citations

Citations to this article as recorded by

A Study on the Characteristics of Patients Treated for Dizziness with Jeoreongchajeonja-tang: A Retrospective Analysis of 63 Cases
Nu-ri Jung, Ki-tae Kim, Seon-mi Shin, Heung Ko
The Journal of Internal Korean Medicine.2019; 40(6): 1122. CrossRef
Pitfalls in the Diagnosis of Vertigo
Hyun Ah Kim, Hyung Lee
Journal of the Korean Neurological Association.2018; 36(4): 280. CrossRef

Original Articles

Hyper-response of Cervical Vestibular Evoked Myogenic Potential in Patients with Meniere Disease: A Preliminary Study: Soyeon Yoon, Mi Joo Kim, Minbum Kim; Res Vestib Sci. 2018;17(2):44-48. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.44

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Abstract PDF

Objectives
The purpose of this study is to investigate the hyper-responsiveness of cervical vestibular-evoked myogenic potential (cVEMP) in patients with Meniere disease (MD), and to compare the result of cVEMP between probable and definite MD group.
Methods
A total of 110 patients satisfied with probable MD and definite MD criteria, which is recently formulated by the Classification Committee of the Bárány Society, were included. An interpeak amplitude and interaural amplitude difference (IAD) ratio of both ears was measured. The abnormal response of ipsi-lesional cVEMP was categorized into 2 groups; hyper-response and hypo-response. Chi-square test and Mann-Whitney U-test were used for statistical analysis.
Results
In the probable MD and definite MD group, the mean IAD was 25.24%±17.79% and 53.82%±34.98%, respectively (p＜0.01). The abnormal response of cVEMP at the affected ear was more frequent in the definite MD group, compared to the probable MD group (32/40 vs. 13/36, p＜0.01). However, hyper-response was more frequently observed in the patients with probable MD, compared to the patients with definite MD (13/36 vs. 3/40, p＜0.01).
Conclusion
Hyper-response of cVEMP was more frequently observed in the early probable MD patients. It might be an early sign of MD, related with the saccular hydrops, which can help the early detection and treatment.

Citations

Citations to this article as recorded by

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
Research in Vestibular Science.2021; 20(3): 108. CrossRef
Characteristics of Nystagmus during Attack of Vestibular Migraine
Soyeon Yoon, Mi Joo Kim, Minbum Kim
Research in Vestibular Science.2019; 18(2): 38. CrossRef

The Clinical Efficacy of Vestibular Function Tests in Patients with Acute Unilateral Vestibulopathy: Bong-Hui Kang, Jae-Il Kim; Res Vestib Sci. 2018;17(2):49-54. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.49

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Abstract PDF: Objectives
Aim of this study is to investigate the clinical efficacy of the vestibular function tests (VFTs) and the predictability of lesion side of vestibular asymmetry parameters in acute unilateral peripheral vestibulopathy.
Methods
Medical records and results of VFTs (caloric, rotatory chair, and head impulse tests) of 57 patients with acute unilateral vestibulopathy were reviewed retrospectively. The VFTs were examined within 7 days after the clinical onset.
Results
For the caloric test, 74% showed significant canal paresis and the predictability of lesion side was 88%. For the sinusoidal harmonic acceleration test, 91% had low gain in at least 1 Hz, phase lead showed 70%, 89% showed phase asymmetry and the predictability of lesion side was 90%. For velocity step test, 67% had abnormal Tc asymmetry and the predictability of lesion side was 95%. In bedside head impulse test (HIT), abnormal catch up saccades were observed in 89% and the predictability of lesion side was 100%. For the video HIT, cover or overt catch-up saccades were observed in 95% and the predictability of lesion side was 100%. One hundred percent (100%) had low gain on the video HIT, but the lesion sides were uncertain because of bilateral involvements or artifacts.
Conclusions
The most important things in the diagnosis of acute unilateral vestibulopathy are typical clinical symptoms and spontaneous nystagmus. A combination of rotatory, caloric, and HITs will result in a more complete examination of the vestibular system. Among them, HIT is recommended as the best tool in acute unilateral vestibulopathy.

Is the Auditory Brainstem Response Diagnostic for Vestibular Paroxysmia?: Ju Han Lee, Sung-Kwang Hong, Hyung-Jong Kim, Hyo-Jeong Lee; Res Vestib Sci. 2018;17(2):55-59. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.55

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Abstract PDF

Objectives
Vestibular paroxysmia (VP) of the eighth cranial nerve is characterized by recurrent auditory and vestibular disturbances when a proximal part of the eighth cranial nerve is continuously pressed by a vessel. A detailed history and several ancillary diagnostic tools, such as tinnitogram, caloric test, auditory brainstem response (ABR) and magnetic resonance imaging, are used for diagnosis of VP. Among them, although Møller criteria using ABR is a simple method, the previous study is insufficient. Therefore, this study aimed to evaluate ABR’s diagnostic value of VP.
Methods
ABR records of the 14 patients (patient group) who were diagnosed with VP and 45 patients (as control) who were diagnosed with only tinnitus were reviewed retrospectively. We analyzed the differences in Møller criteria between 2 groups.
Results
Mean age of the patient group was 52.9 years old and the control group was 55.4 years old. As compared with the control group, there were no significant differences of Møller 3 criteria contents (peak II wave amplitude＜33% [35.7% vs. 15.5%, p=0.133], interpeak latency I–III ≥2.3 msec [42.8% vs. 35.5%, p=0.622]), Contralateral interpeak latency III–V ≥2.2 msec (0% vs. 4.4%, p=1.000) in patient group.
Conclusion
There was no significant difference of ABR parameters according to the Møller criteria between patient and control groups.

Citations

Citations to this article as recorded by

Application of ABR in pathogenic neurovascular compression of the 8th cranial nerve in vestibular paroxysmia
Huiying Sun, Xu Tian, Yang Zhao, Hong Jiang, Zhiqiang Gao, Haiyan Wu
Acta Neurochirurgica.2022; 164(11): 2953. CrossRef
The Effects of Different Reference Methods on Decision-Making Implications of Auditory Brainstem Response
Zhenzhen Liu, Xin Wang, Mingxing Zhu, Yuchao He, Lin Li, Li Chen, Weimin Huang, Zhilong Wei, Shixiong Chen, Yan Chen, Guanglin Li, Plácido R. Pinheiro
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
The Effects of Random Stimulation Rate on Measurements of Auditory Brainstem Response
Xin Wang, Mingxing Zhu, Oluwarotimi Williams Samuel, Xiaochen Wang, Haoshi Zhang, Junjie Yao, Yun Lu, Mingjiang Wang, Subhas Chandra Mukhopadhyay, Wanqing Wu, Shixiong Chen, Guanglin Li
Frontiers in Human Neuroscience.2020;[Epub] CrossRef

Case Reports

Superficial Siderosis with Peripheral Dizziness: Report of 2 Cases: Tae-Hoon Kim, Jin-Hyuk Huh, Moon-Suh Park, Jae-Yong Byun; Res Vestib Sci. 2018;17(2):60-66. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.60

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Abstract PDF

Superficial siderosis (SS) of the central nervous system is a rare disease, which is caused by the accumulation of iron from the hemoglobin in the superficial layer of the brain, spinal cord, and central parts of cranial nerves. The etiology of SS is the accumulation of hemosiderin in the subarachnoid space due to chronic or repeated hemorrhage resulting in progressive and irreversible neurological dysfunction. The cause of the disease is aneurysm, trauma, tumor, and vascular malformation. In most cases, the cause of bleeding is unknown. Clinical features include sensorineural hearing loss, cerebellar ataxia, and myelopathy. Until now, magnetic resonance imaging (MRI) has only been diagnosed and there is no standardized treatment. We will investigate clinical features and MRI findings of SS disease in the central nervous system using 2 patient cases.

Citations

Citations to this article as recorded by

A Case of Patient with Bilateral Cochleovestibular Function Loss due to Infratentorial Superficial Siderosis
Gyuman Lee, Youngmin Mun, Dae Bo Shim
Research in Vestibular Science.2023; 22(3): 83. CrossRef

Postprandial Dizziness/Syncope Relieved by Alfa-Glucosidase Inhibitor: A Case Report: Hakyeu An, Seong-Hae Jeong, Hyun Jin Kim, Eun Hee Sohn, Ae Young Lee, Jae Moon Kim; Res Vestib Sci. 2018;17(2):67-70. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.67

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Abstract PDF: A 74-year-old man presented with positional vertigo and prandial dizziness and syncope. He had experienced episodes of frequent dizziness and loss of consciousness for several months. He underwent total gastrectomy with esophagojejunostomy and brown anastomosis 30 years ago. Thirteen years ago, subtotal colectomy with ileo-descending colostomy was done due to colon cancer. And he also had mitral valve replacement and maze operation due to severe mitral valve stenosis and atrial fibrillation. After cardiac operation, he has suffered from sudden dizziness with diaphoresis and chalky face, which usually occurs especially within 30 minutes from the onset of eating. Sometimes, this event was followed by several seconds of loss of consciousness, which caused recurrent events of falling. Neurological examination showed positional nystagmus compatible with benign paroxysmal positional vertigo arising from posterior semicircular canal of the right ear. The positional vertigo disappeared immediately after canalith repositioning maneuver. We tried to monitor vital signs and serum level of glucose during eating. Hyperglycemia (range, 210–466 mg/dL) was noted during eating, which was accompanied by postprandial and prandial hypotension, up to 60/40 mmHg. The patient was prescribed 100 mg of the alfa-glucosidase, acarbose to be taken half an hour before each meal. Eventually, the treatment with acarbose ameliorated the prandial dizziness and hypotension associated with hyperglycemia. Our patient suggests the acarbose could prevent postprandial dizziness and hypotension.

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