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Ocular Vestibular Evoked Myogenic Potentials Produced by Stimulation With Bone-conducted Vibration in Healthy Subjects
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Tae Ho Yang, Sun Young Oh, Tae Woo Kim, Byoung Soo Shin, Jun Young Lee, Seul Ki Jeong, Man Wook Seo
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Res Vestib Sci. 2012;11(3):97-104.
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 Abstract
- Background and Objectives: To provide the empirical basis for using ocular vestibular evoked myogenic potentials (oVEMPs) in response to bone-conducted vibration (BCV) stimulation to indicate vestibular function in normal subjects. Materials and Methods: In response to bone-conducted tone burst (90 dB nHL and 100 dB nHL with frequencies 500 Hz and 1,000 Hz, the oVEMPs were measured in 45 healthy controls. The early negative component (n10) of the oVEMP to brief BCV of the forehead and at each mastoid process is recorded by surface electromyography electrodes just beneath the eyes. We used a hand-held vibrator (Bruel and Kjaer 4810 Mini-Shaker) placed on the forehead, in the midline at the hairline (Fz) and at each mastoid process and quantified the individual differences in n10 magnitude, latency and symmetry to Fz and mastoid BCV at each frequency. Results: In normal subjects, n10 responses were symmetrical in the two eyes during Fz and both mastoid stimuli and the latencies of the onset were consistent among subjects. Response rate is similar between Fz and mastoid stimuli. However, at each stimulation site, response rate is higher on 500 Hz than on 1,000 Hz stimulation. During the mastoid stimuli, the onset latency is slightly shorter and amplitude is larger than the Fz stimuli. The average amplitudes decreased with age and average latency (to peak) increased slightly with increasing age. Conclusion: Clear oVEMP responses to bone-conducted Fz and mastoid stimuli were evoked from normal subjects. It is concluded that bone-conducted stimuli as well as air conduction can evoke myogenic potentials from the ocular muscles.
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Downbeat, Gaze-evoked and Perverted Head-shaking Nystagmus Associated with Dapsone Toxicity
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Tae Woo Kim, Sun Young Oh, Ha Cheol Choi, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim
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Res Vestib Sci. 2009;8(2):161-163.
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- Dapsone is an agent commonly used to treat leprosy and its most common adverse effect is a hemolytic anemia. We present a patient who showed transient downbeat, bilateral horizontal gaze-evoked nystagmus (GEN), and perverted head-shaking nystagmus after taking a large dose of dapsone. These oculomotor abnormalities are assumed to be a reversible vestibulocerebellar dysfunction caused by over-dose of dapsone.
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Metronidazole-induced Reversible Cerebellopathy
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Ha Cheol Choi, Sun Young Oh, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim
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Res Vestib Sci. 2009;8(2):132-136.
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- Metronidazole is a nitroimidazole antibiotic used for anaerobic infections, protozoan infections, and Helicobacter pylori infections. It may produce rare but well known neurological adverse effects including peripheral neuropathy, encephalopathy, cerebellar dysfunction, and seizures. We describe three patients with metronidazole-induced reversible cerebellar dysfunctions characterized by abnormal oculomotor findings, dysmetria, and ataxia. The diagnosis of metronidazole toxicity was made clinically and supported by the brain MRI findings. The neurological signs and abnormal signal intensity on MRI resolved after discontinuation of metronidazole.
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Two Cases of Methyl Bromide Intoxication Mimicking Bickerstaff’s Brainstem Encephalitis
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Jin Young Seo, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim, Sun Young Oh
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J Korean Bal Soc. 2008;7(2):199-203.
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Abstract
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- Background: Methyl bromide is toxic to the central and peripheral nervous systems. Two patients with occupational exposure to this agent are described.
Case: Two cases of previously healthy young men were involved. They had worked in a fumigating plant spraying fruits using methyl bromide for several months before admission. They showed general weakness, severe ataxia, bilateral dysmetria and bilateral lateral gaze limitation. And gaze-evoked nystagmus was observed in one of them. Brain MRI showed symmetrically increased signal intensity lesions including the brainstem, cerebellum and splenium of corpus callosum. After conservative treatment, they gradually improved over the next few weeks.
Conclusions: Symmetry and topography of our patients’ clinical and radiographic abnormalities support the proposal that methyl bromide exposure can produce symptoms similar to Bickerstaff’s brainstem encephalitis.
Key words: Methyl bromide, Acute intoxication, Bickerstaff’s brainstem encephalitis
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Two Cases of Congenital Ocular Motor Apraxia Associated With Cerebellar Vermian Dysplasia
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Jin Young Seo, Yeon Hee Lee, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim, Sun Young Oh
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J Korean Bal Soc. 2008;7(1):63-67.
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- Congenital ocular motor apraxia is a rare syndrome characterized by rotational head thrusts that attempt to compensate for the lack of voluntary eye movements. We describe the clinical, oculographic and magnetic resonance imaging features of two children with congenital ocular motor apraxia.
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Novel Mutation in FRMD7 Gene in X-linked Congenital Nystagmus
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Sun Young Oh, Byoung Soo Shin, Man Wook Seo, Chang Seok Ki, Jeong Min Hwang, Ji Soo Kim
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J Korean Bal Soc. 2007;6(2):155-160.
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- Background and Objectives: Congenital nystagmus (CN) is an ocular oscillation that usually manifests during early infancy. To report a novel mutation in FERM domain containing 7 (FRMD7) gene in a Korean family with CN.
Materials and Methods: Genomic DNA was prepared from peripheral blood leukocytes and direct sequencing of the entire coding and adjacent intronic regions was performed to detect sequence variation of FRMD7 gene, where mutations were found recently in patients with familial CN. The family showed an X-linked pattern of inheritance without father-to-son transmission.
Results: Three family members with CN exhibited two sequence variations which were a novel mutation (c. 875T>C; Leu292Pro) and a polymorphism (c. 1403G>A; Arg468His, dbSNP rs#6637934). The proband was hemizygous for both variations and his mother and maternal grandmother were heterozygous carriers.
Conclusion: This study provides an additional evidence for mutations in FRMD7 as a common cause of X-linked CN and expands its mutation spectrum.
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Ocular Flutter Associated with a Thalamic Lesion
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Man Wook Seo
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J Korean Bal Soc. 2004;3(2):417-423.
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- Ocular flutter is a rare, horizontal eye movement disorder characterized by rapid saccadic oscillations. Previous reports have presented a relationship between ocular flutter syndrome and many conditions/diseases. However, it is surprising that there have been few reported cases in which there has been a clear anatomically localized lesion linked to ocular flutter. So the pathophysiological basis for ocular flutter syndrome is not understood yet. We have recently experienced a case of ocular flutter syndrome where the ocular flutter was associated with dysmetria, dysdiadochokinesia,
kinetic predominant tremor, and ataxia. The prodromal symptoms, self-limited illness course and cerebrospinal fluid (CSF) pleocytosis of our case suggest an infectious aetiology for this syndrome. Although most of the sequelae of infectious diseases represent more diffuse involvement of the nervous system, the predominant cerebellar
symptoms and signs associated with ocular flutter imply that the single responsible lesion of the present case might have been related to the cerebellum-associated neural circuits. Brain single photon emission computed tomography (SPECT) in the present case showed perfusion decrease in the left thalamus. The present case suggests that the cerebellar output circuit (dorsal vermis-fastigial nucleus-vestibular nucleus-thalamus-cortex) might be related to the
occurrence of ocular flutter. The description of this case may mprove the understanding of the pathological mechanisms of ocular flutter syndrome.
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