Research in Vestibular Science

Reviews

The Association between Dizziness and Anxiety: Update to the Treatment: Seo-Young Choi, Kwang-Dong Choi; Res Vestib Sci. 2022;21(2):40-45. Published online June 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.2.40

2,355 View
73 Download

Abstract PDF Supplementary Material: Anxiety, depression, or other psychiatric symptoms can be the primary cause of dizziness and the secondary complication of dizziness. Regardless of precedence or consequence, dizziness is closely associated with the psychiatric problem. On this ground, this chapter reviews the association between dizziness and anxiety and the treatment for dizziness with psychiatric symptoms.

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

2,988 View
102 Download

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.

Medical treatment of central vertigo: Kwang-Dong Choi, Seo-Young Choi; Received August 22, 2021 Accepted September 1, 2021 Published online September 1, 2021; [Accepted]

941 View
0 Download

Abstract: 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 must 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 therapy for central vertigo.

Case Reports

A Case of Spinocerebellar Ataxia Type 28: Jae-Hwan Choi, Eun Hye Oh, Seo Young Choi, Kwang-Dong Choi; Res Vestib Sci. 2021;20(1):33-36. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.33

3,418 View
133 Download

Abstract PDF: Spinocerebellar ataxia type 28 (SCA 28) is characterized by young-adult onset, very slowly progressive gait and limb ataxia, dysarthria, nystagmus, ptosis, and ophthalmoplegia. It is caused by a heterozygous pathogenic mutation in the AFG3L2. So far, approximately 80 cases with genetically-confirmed SCA 28 have been reported in the literature. We report a patient with mild gait ataxia and dysarthria who carried a known pathogenic mutation in the AFG3L2. This is the first report of genetically-confirmed SCA 28 in Korea.

Anti-GQ1b Antibody Syndrome Presenting with Severe Headache: Seo-Young Choi, Kyeung-Hae Kim, Jong Kuk Kim, Nam Jun Kim, Young Hee Kim, Kwang-Dong Choi; Res Vestib Sci. 2020;19(4):141-143. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.141

4,061 View
73 Download

Abstract PDF: Anti-GQ1b antibody syndrome, including Miller Fisher syndrome, Guillain-Barré syndrome with ophthalmoplegia, Bickerstaff’s brainstem encephalitis, and acute ophthalmoplegia without ataxia, has overlapped clinical symptoms and mostly associated with anti-GQ1b immunoglobulin (Ig) G antibody. We report two cases of anti-GQ1b antibody syndrome mainly presenting with a severe headache. The 60-year-old man was admitted for severe headache and gait disturbance. Neurological examination revealed limb and truncal ataxia, areflexia, nystagmus, and ophthalmoplegia. Serum IgG anti-GQ1b antibody was positive. He recovered after intravenous (IV) immunoglobulin and steroid. The 23-year-old man suffered from severe headache (visual analogue scale=10) within the periorbital area. Ophthalmoplegia with gaze-evoked nystagmus were revealed. Serum IgG anti-GQ1b and anti-GT1a antibodies were positive. Headache was improved by IV immunoglobulin and steroid. The pathophysiology of headache in anti-GQ1b antibody syndrome is largely unknown. The affected nerve or structures in the brainstem including the trigeminovascular system may induce intractable severe headache.

Original Articles

Satisfaction and Effect Research on Virtual Reality-Based Vestibular Exercise for the Elderly Patients with Chronic Unilateral Vestibulopathy: Kwang-Dong Choi, Seo-Young Choi; Res Vestib Sci. 2020;19(4):127-132. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.127

3,657 View
88 Download

Abstract PDF: Objectives
To survey the satisfaction of customized vestibular exercise using virtual reality system with mobile head-mounted display (HMD) in the elderly patients with chronic unilateral vestibulopathy, we analyzed questionnaires before and after exercise.
Methods
Sixteen patients (male, 6; median age, 69 years [interquartile range, 65–75 years]) with chronic unilateral vestibulopathy were prospectively enrolled from March 1 to December 31 in 2018. They exercised once a week for 20 to 25 minutes for 4 weeks using the HMD inserted the virtual reality exercise program. Dizziness visual analogue scale (DAS), Korean vestibular disorders activities of daily living scale (ADL), and visual vertigo analogue scale (VVAS) were performed before and after the exercise. After all of the program, the patients were surveyed to measure the satisfaction for the tool and effect of exercise.
Results
DAS, ADL, and VVAS were significantly improved after the vestibular exercise. No one answered unsatisfactory, and at least 62.5% of the patients satisfied the used tool and exercise program. The patients of 50% answered that they satisfied or very satisfied to the efficacy of exercise program. The patients who recovered VVAS more after the exercise were more satisfied to our tools and efficacy of exercise program.
Conclusions
Customized vestibular exercise using virtual reality system with HMD can not only improve dizziness and quality of life, but also made more satisfied to the elderly patients with chronic unilateral vestibulopathy.

Customized Vestibular Rehabilitation in the Patients with Bilateral Vestibulopathy: A Pilot Study in One Referred Center: Kwang-Dong Choi, Seo-Young Choi; Res Vestib Sci. 2019;18(3):64-70. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.64

5,003 View
107 Download

Abstract PDF: Objectives
Bilateral vestibulopathy is characterized with unsteadiness and oscillopsia when walking or standing, worsening in darkness and/or on uneven ground. To establish the effect of customized vestibular rehabilitation in bilateral vestibulopathy, we analyzed the questionnaires and functional status before and after treatment.
Methods
Among 53 patients with customized vestibular rehabilitation from January 1st to November 30th in 2018, 6 patients (3 males; median age, 71 years; range, 54–75 years) who regularly exercised with good compliance were retrospectively enrolled. They were educated and trained the customized vestibular rehabilitation once a month or two by a supervisor during 40 minutes, and then exercised at home for 30 minutes over 5 days in a week. Dizziness handicap inventory (DHI), Korean vestibular disorders activities of daily living scale (vADL), Beck’s depression index (BDI), test for dynamic visual acuity (DVA), and Timed Up and Go test (TUG) were performed before and after the customized vestibular rehabilitation.
Results
The patients exercised for median 5.5 months (range, 2–10 months) with the customized methods of vestibular rehabilitation, which included gaze and posture stabilization and gait control exercises. DHI score and TUG was improved after rehabilitation (DHI before vs. after rehabilitation=33 vs. 16, p=0.027, TUG before vs. after rehabilitation=12 vs. 10, p=0.026). BDI, DVA, and vADL scores did not differ between before and after treatment.
Conclusions
Customized vestibular rehabilitation can improve dizziness and balance state in bilateral vestibulopathy. The steady exercises adapted individual peculiarities is the most important for vestibular rehabilitation.

Customized vestibular rehabilitation in the patients with bilateral vestibulopathy: A pilot study in one referred center: Kwang-Dong Choi, Seo-Young Choi; Received June 12, 2019 Accepted August 20, 2019 Published online August 20, 2019; [Accepted]

1,067 View
0 Download

Abstract: Objective Bilateral vestibulopathy is characterized with unsteadiness and oscillopsia when walking or standing, worsening in darkness and/or on uneven ground. To establish the effect of customized vestibular rehabilitation in bilateral vestibulopathy, we analyzed the questionnaires and functional status before and after treatment.
Methods
Among 53 patients with customized vestibular rehabilitation from January 1st to November 30th in 2018, six patients (men = 3, age = 71 (median, range = 54~75)) who regularly exercised with good compliance were retrospectively enrolled. They were educated and trained the customized vestibular rehabilitation once a month or two by a supervisor during 40 minutes, and then exercised at home for 30 minutes over 5 days in a week. Dizziness Handicap Inventory (DHI), Korean vestibular disorders activities of daily living scale (vADL), Beck’s depression index (BDI), test for dynamic visual acuity (DVA), and timed up to go test (TUG) were performed before and after the customized vestibular rehabilitation.
Results
The patients exercised for 5.5 months (median, range= 2~10 months) with the customized methods of vestibular rehabilitation, which included gaze and posture stabilization and gait control exercises. DHI score and TUG was improved after rehabilitation (DHI before vs. after rehabilitation = 33 vs. 16, p = 0.027, TUG before vs. after rehabilitation = 12 vs. 10, p =0.026). BDI, DVA, and vADL scores did not differ between before and after treatment.
Conclusions
Customized vestibular rehabilitation can improve dizziness and balance state in bilateral vestibulopathy. The steady exercises adapted individual peculiarities is the most important for vestibular rehabilitation.

Case Report

Opsoclonus-Myoclonus Syndrome Associated with Scrub Typhus: You Jin Choi, Seo Young Choi, Jae-Hwan Choi, Kwang-Dong Choi; Res Vestib Sci. 2017;16(1):34-37. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.34

8,645 View
99 Download
3 Crossref

Abstract PDF

Scrub typhus is an infective acute febrile disorder caused by the intracellular parasite Orientia tsutsugamushi. Neurological manifestations of scrub typhus are meningoencephalitis, cerebellitis, transverse myelitis, papilledema, and cranial nerve palsy. However, opsoclonus-myoclonus syndrome associated with scrub typhus has been rarely reported. A 59-year-old man developed vertigo, nausea, vomiting, and imbalance following scrub typhus infection for eight days. Examination showed eschar at the axilla, decreased mentality, and opsoclonus- myoclonus syndrome. Video-oculography disclosed opsoclonus with an amplitude of 15°–20° and a frequency of 6–8 Hz. The serum antibody titers to Orientia tsutsugamushi were 1:5,120, and cerebrospinal fluid analysis revealed pleocytosis. Brain magnetic resonance imaging was normal. Neurological symptoms and signs completely improved by systemic steroid and antibiotics treatment. Various mechanisms including direct disseminating inflammation or indirect immune modulation may give rise to neurological complications following scrub typhus.

Citations

Citations to this article as recorded by

Scrub typhus meningoencephalitis presenting as opsoclonus myoclonus syndrome: A video-based case
Laxmikant Ramkumarsingh Tomar, Dhrumil Jatinbhai Shah, Utkarsh Agarwal, Atul Gogia, Anshu Rohatgi, CS Agrawal
Tropical Doctor.2022; 52(1): 192. CrossRef
Neurological Manifestations of Scrub Typhus
Sagar Basu, Ambar Chakravarty
Current Neurology and Neuroscience Reports.2022; 22(8): 491. CrossRef
Neurological facets of scrub typhus: A comprehensive narrative review
Divyani Garg, Abi Manesh
Annals of Indian Academy of Neurology.2021; 24(6): 849. CrossRef

Opsoclonus-Myoclonus Syndrome Associated with Scrub Typhus: You Jin Choi, Seo Young Choi, Jae-Hwan Choi, Kwang-Dong Choi; Received November 1, 2016 Accepted January 13, 2017 Published online January 13, 2017; [Accepted]

1,248 View
0 Download

Abstract: Scrub typhus is an infective acute febrile disorder caused by the intracellular parasite Orientia tsutsugamushi. Neurological manifestations of scrub typhus are meningoencephalitis, cerebellitis, transverse myelitis, papilledema, and cranial nerve palsy. However, opsoclonus-myoclonus syndrome associated with scrub typhus has been rarely reported. A 59-year-old man developed vertigo, nausea, vomiting, and imbalance following scrub typhus infection for eight days. Examination showed eschar at the axilla, decreased mentality, and opsoclonus-myoclonus syndrome. Video-oculography disclosed opsoclonus with an amplitude of 15-20° and a frequency of 6-8Hz. The serum antibody titers to Orientia tsutsugamushi were 1:5,120, and CSF analysis revealed pleocytosis. Brain MRI was normal. Neurological symptoms and signs completely improved by systemic steroid and antibiotics treatment. Various mechanisms including direct disseminating inflammation or indirect immune modulation may give rise to neurological complications following scrub typhus.

Symposium I

Ataxia and Diplopia: Jae-Deuk Seo, In Soo Moon, Kwang-Dong Choi; Res Vestib Sci. 2013;12:S31-S40. Published online June 1, 2013

1,702 View
36 Download

Abstract PDF: Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements, which may result from abnormalities in different parts of the nervous system including the cerebellum and its connecting pathway, proprioceptive sensory pathway, and vestibular system. In the diagnosis of disorders characterized by cerebellar ataxia, the mode of onset, rate of development, and degree of permanence of the ataxia are of particular importance. In adults, paraneoplastic and demyelinating cases account for the largest proportion of subacute onset, and hereditary forms are the usual cause of very slowly progressive and chronic ones. The last category of genetic ataxias now constitute a large and heterogeneous group for which the basis has been established in most cases. Misalignment of the visual axes-strabismus-causes the two images of a seen object to fall on noncorresponding areas of the two retinas, which usually causes diplopia, the sensation of seeing an object at two different locations in space. Accurate diagnosis of diplopia and strabismus require detailed history on the symptomatology and ocular motor examination consisting of assessment of the range of eye movements, subjective diplopia testing, and cover and alternate cover tests.

First
Prev
Page of 1
Next
Last

Search