Research in Vestibular Science

Case Report

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.

안구된떨림을 보인 부감염성 수막뇌염: In-Ho Yoon, Seung-Hoon Yun, Bong-Hui Kang; Received August 9, 2021 Accepted September 3, 2021 Published online September 3, 2021; [Accepted]

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Abstract: 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-years-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.

Case Report

Atypical Presentation of Acute Vestibular Syndrome with Ramsay Hunt Syndrome: Bong-Hui Kang, Yong-Woo Lee, Jae-Il Kim; Res Vestib Sci. 2020;19(1):16-21. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.16

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Abstract PDF: Ramsay Hunt syndrome is an acquired paralysis of the face specifically caused by a varicella-zoster virus infection in the facial nerve. Other cranial nerves including vestibulo-cochlear disturbance can be affected. Herein we reported a case of Ramsay Hunt syndrome with atypical vestibular syndrome. Although central vestibular signs including direction changing post head-shaking nystagmus or normal head impulse test are generally meaningful, clinicians need to be careful to interpret them because some findings can be observed not only in cases of central disorders but also in peripheral disorders. Clinical findings such as distinct ear pain and close observation of vesicles are important to diagnose Ramsay Hunt syndrome.

Original Article

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.

The clinical efficacy of vestibular function tests in patients with acute unilateral vestibulopathy: Bong-Hui Kang, Jae-il Kim; Received April 19, 2018 Accepted May 30, 2018 Published online May 30, 2018; [Accepted]

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Abstract: 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 one 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%. 100% had low gain on the video HIT, but the lesion sides were uncertain because of bilateral involvements or artifacts.
Conclusion
The most important things in the diagnosis of acute unilateral vestibulopathy are typical clinical symptoms and spontaneous nystagmus. A combination of rotatory, caloric, and head impulse tests will result in a more complete examination of the vestibular system. Among them, head impulse test is recommended as the best tool in acute unilateral vestibulopathy.

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