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The Analysis of Post Traumatic Benign Paroxysmal Positional Vertigo
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Chang Hyun Cho, Dong Kyu Kim, Gyu Cheol Han, Eun Jeong Lee, Joo Hyun Woo, Ju Hyoung Lee
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J Korean Bal Soc. 2005;4(1):17-25.
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 Abstract
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- Background
and Objectives :Benign paroxysmal positional vertigo (BPPV) has a lot of causes. Except idiopathic BPPV, the most common cause of BPPV was trauma. The aim of this study was to study its character, diagnosis, prognosis and treatment.
Materials and Method : We retrospectively collected the 14 patients by reviewing charts, analyzing vestibular function tests.
Results
: Post traumatic BPPV had characters different from idiopathic BPPV in patient' sex ratio and age distribution. The mean age of patients was 40 years old, men were 11 women were 3. In the mechanisms of trauma, traffic accidents were 11, assault was 1, and fall down were 2. In types, posterior semicircular canal were 10, horizontal semicircular canal were 4. In origins, cupulolithiasis were 8, canalolithiasis were 6. Treatment and prognosis were similar to those of idiopathic BPPV.
Conclusion
: But origin, diagnostic criteria, treatment and prognosis are identical with idiopathic BPPV. Therefore, in evaluating post traumatic BPPV patients, we need correct diagnosis and treatment together by history taking, physical examination and vestibular function tests. And by this, we can treat idiopathic BPPV accurately, reduce expense and time for patients to return daily life.
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The Optimization of Galvanic Vestibular Stimulation according to Evoked Nystagmus
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Gyu Cheol Han, Dong Kyu Kim, Ju Hyoung Lee, Chang Hyoun Cho, Dong Young Kim, Heung Eok Cha
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J Korean Bal Soc. 2004;3(2):386-394.
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Abstract
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- Background
and Objectives : The aim of this study were to observe the nystagmus of normal general populations on galvanic vestibular stimulation, to set a new korean standard for galvanic vestibular stimulation.
Materials and Method : We recruited 10 healthy adults and they were stimulated by 1,2,3 mA monaural monopolar, monaural bipolar, binaural monopolar, binaural bipolar galvanic vestibular stimulation through carbon-rubber electrode and Ag-AgCl electrode. We evaluated galvanic stimulating nystagmus and after galvanic stimulating nystagmus on sitting position through Frenzel goggle and video-nystagmography.
Results
: We detect stimulating and after-stimulating nystagmus on 1,2,3 mA monaural monopolar, monaural bipolar, binaural monopolar, binaural bipolar galvanic vestibular stimulation. The nystagmus on galvanic vestibular stimulation was directed to the negative electrode side and after-galvanic stimulating nystagmus was directed to opposite side. The greater current, the more occurrence of nystagmus was found. We detect nystagmus mostly on monaural bipolar vestibular stimulation through carbon-rubber electrode. We thought most effective Galvanic vestibular stimulation was
2 mA monaural bipolar vestibular stimulation through carbon-rubber electrode in consideration of increased pain and discomfort on 3 mA monaural bipolar vestibular stimulation in spite of high occurrence of nystagmus.
Conclusion
: Galvanic vestibular stimulation evoked different nystagmus according to stimulation, stimulated site. We thought 2 mA monaural bipolar vestibular stimulation through carbon-rubber electrode was most effective, stable galvanic stimulation. Specifity and sensitivity of 2 mA monaural bipolar vestibular stimulation were 100%, 100% respectively. Galvanic vestibular stimulation is useful to evaluate vestibular function.
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Retrospective Study of Magnetic Resonance Imaging & Vestibular Function Testing in Patients Suggestive of Central Vestibular Disorders
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Gyu Cheol Han, Ju Hyoung Lee, Dong Kyu Kim, Hee Young Hwang, Jin Myoung Heo
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J Korean Bal Soc. 2004;3(1):141-149.
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Abstract
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- Background
and Objectives : There were many tools to evaluate dizzy patients with various causes. Our aim was
to find the relationship between the magnetic resonance imaging(MRI) and vestibular function testing(VFT) in patients
who are supposed of central vestibular disorders and to evaluate their effects.
Materials and Methods : We selected 183 patients retrospectively by standardized questionnaires, physical
examinations ,chart reviews from 3,825 patients who visited otorhinolaryngology via department of emergency and out
patient clinic with chief complaints of dizziness. Among them, 13 patients were supposed to have MRI in relation to
dizziness. We analyzed the result of VFT, MRI findings and then classified them in according to lesion locations,
pathologic findings in MRI & optokinetic tests, caloric tests, step velocity tests, vestibulo-ocular tests, visual fixation
tests in VFT.
Results
: There were 9 ischemic findings, 1 hemorrhagic finding, 3 neoplasms in pathologic findings. There were
5 pons lesions, 4 cerebellum lesions, 3 thalamus lesions, 2 medulla lesions, 2 pituitary lesions and 1 caudate nucleus
lesions in locations.
Conclusions
: Dizzy patients visiting otorhinolaryngology OPD had 0.34%(13/3825) central origin vertigo, and
vascular disease is most common. Therefore we supported that careful readings of VFT findings in identifying central
vestibular disorders were valuable and might well represent the gold standard. MRI was an important tool for evaluating
the central nervous system, and we should use MRI to assess central vestibular dysfunction. We concluded MRI
correlated well with VFT findings of central vestibular dysfunction.
Key Words : Vestibular function testing, Magnetic resonance imaging, Dizziness
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Clinical Analysis of the Dizzy Patients in a Department of Emergency Medicine
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Gyu Cheol Han, Eun Jung Lee, Jong Su Ha, Dong Kyu Kim
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J Korean Bal Soc. 2003;2(2):206-210.
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Abstract
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and Objectives: The patient presenting to the emergency department with the complaint of dizziness is one of the most common as well as most challenging problems confronting the emergency physician today. Dizziness is a vague symptom of disease ranging from serious to benign. The differential diagnosis and proper management of dizziness in a department of emergency medicine are the most important things. We undertook this study to evaluate the character and clinical analysis of the dizzy patients and to discuss the significance and necessity of primary care in a department of emergency medicine.
Materials and Method: From September 1999 to October 2003, we sampled the 1,371 dizzy patients who visited the Emergency Department(ED). Of these patients, the 650 patients performed electronystagmography(ENG) and rotatory chair test were selected, except for the patients with loss of consciousness, known psychiatric disease or direct brain injury.
Results
The 650 patients were attributed to acute peripheral vestibulopathy in 88.5% (575 patients) of patients, benign paroxysmal positional vertigo in 9.5% (62 patients) of patients, central origin in 1.4% (9 patients) of patients, other organic origin in 0.6% (4 patients) of patients. In a retrospective analysis of patients with central origin, the symptoms estimated at central origin, for example, persistent headache, were found.
Conclusion
The exact diagnosis and management for the dizzy patients in a department of emergency medicine require the primary physician's concern and understanding for dizziness.
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KBS
