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Volume 10 (3); September 2011
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Review
Original Articles
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Clinical Characteristics of Pediatric Dizziness
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Jae Eun Kim, Kyu Sung Kim, Young Hyo Kim, Jeong Seok Choi, Hoseok Choi
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Res Vestib Sci. 2011;10(3):88-91.
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Abstract
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- Background and Objectives: Pediatric dizziness is difficult to diagnose because of the nonspecific nature of symptom, and difficulty in history taking, physical examination or diagnostic tests. The authors tried to analyze the proportion of diseases in children suffering from dizziness, and introduce cases with atypical clinical characteristics and uncommon diagnosis. Materials and Methods: The medical records of 53 pediatric patients suffering from dizziness were analyzed retrospectively. We analyzed the findings of history taking, physical examination for nystagmus and cerebellar function, pure tone audiogram and caloric tests in all patients. Results: Diagnosis of migrainous vertigo was most common (32.7%), followed by psychological cause (11.5%) and labyrinthitis due to the otitis media (7.7%). Cases of cerebellar hemangioblastoma, neurofibromatosis and drug intoxication were also found. Conclusion: The clinical characteristics and causative diseases of pediatric dizziness are different from those of adults. Appropriate history taking and diagnostic tests are improtant for differential diagnosis.
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Application of Force Sensitive Resistors on Evaluation of Vestibulospinal Reflex Induced by Galvanic Stimulation
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Sang Eon Park, Jin Hee Park, Min Sun Kim, Ho Choon Jeong, Byung Rim Park
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Res Vestib Sci. 2011;10(3):92-99.
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Abstract
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- Background and Objectives: Force sensitive resistors (FSR) were used to measure the body sway to galvanic vestibular stimulation (GVS), and compared with the response obtained from force platform in normal subjects. Materials and Methods: Bipolar galvanic stimulation was applied to the bilateral mastoid process with intensity of 0.5-1.5 mA and duration of 1 sec in 3 different head positions of forward, rightward, and leftward. Results: Elevation of anterior pressure curve and depression of posterior pressure curve resulting from forward body sway were recorded in both feet by FSR. Forward body sway induced forward deviation of the center of pressure in force platform. Elevation of pressure curve in left foot and depression of the curve in right foot resulting from leftward body sway were recorded by FSR. Leftward body sway induced left deviation of the center of pressure in force platform. Orientation of the body sway induced by GVS was directed towards the anode side in the head facing forwards. Leftward and backward body sway resulting from cathodal stimulation on left mastoid process in leftward rotation of the head position and leftward and forward body sway resulting from cathodal stimulation on left mastoid process in rightward rotation of the head position were recorded by both FSR and force platform. Reaction time of GVS did not show any significant difference between FSR and force platform. Conclusion: These results indicate that FSR could be used to evaluate the vestibulospinal reflex to GVS.
Case Reports
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An Atypical Case of Benign Paroxysmal Positional Vertigo of the Anterior Semicircular Canal
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Minbum Kim, Hyun Su Kim, Hee Nam Kim
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Res Vestib Sci. 2011;10(3):100-102.
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Abstract
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- Benign paroxysmal positional vertigo (BPPV) of anterior semicircular canal (ASC) is the rarest variant of BPPV, which is thought to be due to the anatomically superior position of ASC during most activities. This type of BPPV is currently diagnosed by detecting positional down-beating nystagmus in the Dix-Hallpike test. A 62-year-old female presented with positional vertigo, especially when sitting up. No nystagmus was induced by both Dix-Hallpike tests, however, positional down-beating nystagmus was observed with the left torsional component when sitting up from both Dix-Hallpike positions and supine position. After the reverse Epley maneuver, up-beating nystagmus was newly observed in the left Dix-Hallpike test, which was compatible with BPPV of the left posterior semicircular canal. This patient was thought to suffer from canalithiasis of the left ASC.
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Recording of Ictal Nystagmus in a Case of Syncope Presenting Vertigo
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Jin Woo Maeng, Sung Kwang Hong, Hyung Jong Kim, Hyo Jeong Lee
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Res Vestib Sci. 2011;10(3):103-106.
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Abstract
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- Prevalence of dizziness has been reported to be as high as nearly twenty percent and one half of these population had social handicap to some degree. The diagnostic approach of dizziness heavily relies on the premise that dizziness type predicts the underlying etiology-e.g, vertigo with vestibular causes and presyncope with cardiovascular causes. However, such symptomatological approach sometimes delays correct diagnosis as the presenting symptom of individual patient is typically vague to designate the type. In this paper, a case of a 57-year-old woman who has experienced recurrent rotatory vertigo of cardiovascular origin was discussed. When her head were turned to the left, a fast downbeat nystagmus following a slow upward eye deviation was recorded using video nystagmogram. Hence, we report this single case of syncope presented as peripheral vertigo type with literature review.