Research in Vestibular Science

Clinical Significance and Update of Postural Orthostatic Tachycardia Syndrome: Jung A Park, Jae Han Park; Res Vestib Sci. 2022;21(1):1-5. Published online March 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.1.1

Abstract PDF: Postural orthostatic tachycardia syndrome (POTS) is a cerebrovascular autonomic dysfunction that is common in young women. POTS can cause dizziness due to orthostatic intolerance. In patients with orthostatic intolerance, it can be diagnosed when the heart rate increases by more than 30 beats per minute within 10 minutes of standing up through the head-up tilt test. However, even a neuro-otologist has difficulty in diagnosing POTS due to the high possibility of misdiagnosis if not paying attention. In this paper, the clinical symptoms, pathophysiology, diagnosis, and treatment of POTS are investigated. In addition, the latest knowledge of POTS is searched to help diagnose and treat POTS.

Abducens Nerve Palsy Associated with Ramsay-Hunt Syndrome: Hye Joo Rha, Jae Han Park; Res Vestib Sci. 2018;17(3):116-118. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.116

Abstract PDF: Ramsay-Hunt syndrome is an infectious disease caused by the varicella zoster virus. It is usually associated with facial and vestibulocochlear nerve palsy, but other cranial nerve dysfunction can be accompanied. We present a 68-year-old woman with abducens nerve palsy associated with Ramsay-Hunt syndrome. She showed abduction limitation of left eye with peripheral facial palsy and vestibulopathy of the left side. Varicella zoster virus polymerase chain reaction of cerebrospinal fluid was positive and internal auditory canal magnetic resonance imaging was revealed enhancement of labyrinthine segment of left facial nerve. Although abducens nerve palsy is uncommon feature of Ramsay-Hunt syndrome, but it can be developed by several different mechanisms.

Post Infectious Cerebellar Ataxia with Abnormal Brain Magnetic Resonance Imaging and Single Photon Emission Computed Tomography Findings: Hae Joo Rha, Jae Han Park; Res Vestib Sci. 2017;16(4):167-170. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.167

Abstract PDF: A 84-year-old woman presented with a two weeks history of dizziness, slurred speech and ataxia. The neurological exam showed spontaneous left beating nystagmus, horizontal gaze evoked nystagmus and limb ataxia. A few weeks earlier, she had an upper airway infection. Brain MRI revealed diffuse leptomeningeal enhancement in the both cerebellar hemisphere and brain single photon emission computed tomography (SPECT) showed hyperperfusion in both cerebellar hemisphere. Extensive laboratory studies with cerebrospinal fluid analysis did not reveal any etiologic factors. She was started on methylprednisolone (1 g/day for 7 days), gradually improved over the weeks. Post infectious cerebellar ataxia is a neurologic complication that occasionally follows systemic viral and bacterial infections. This case demonstrates that cerebellar abnormalities can be detected by brain magnetic resonance imaging and SPECT.

Positional Dizziness and Vertigo without Nystagmus and Orthostatic Hypotension: Jae Han Park; Res Vestib Sci. 2016;15(4):107-111. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.107

Abstract PDF: According to the Barany Society classification of vestibular symptoms, positional dizziness or vertigo is defined as dizziness or vertigo triggered by and occurring after a change of head position in space relative to gravity. Thus, positional dizziness or vertigo should be differentiated from orthostatic dizziness or vertigo, which is triggered by and occurs upon rising. Benign paroxysmal positional vertigo (BPPV) is the most common positional vertigo and accompanied by a characteristic paroxysmal positional nystagmus. But a problem occasionally encountered in clinical practice is the presence of a positive history of BPPV with a negative diagnostic maneuver for positional nystagmus. Orthostatic hypotension may be dependent upon various neurogenic and non-neurogenic disorders and conditions. Combination of non-pharmacological and pharmacological treatment improve orthostatic tolerance.

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