Research in Vestibular Science

Benign Paroxysmal Positional Vertigo Involving Multiple Semicircular Canals: Ji Yeon Chung, Hyo Jung Kim, Ji Soo Kim; Res Vestib Sci. 2014;13(1):1-6.

Abstract: Even though benign paroxysmal positional vertigo (BPPV) mostly affects a single semicircular canal (SCC), BPPV simultaneously involving more than one SCC is not rare. This multi-canal BPPV may either involve the same canals on both sides or simultaneously affect different canals on the same or on both sides. Since the SCCs can be involved in various combinations in one or both ears, multi-canal BPPVs pose diagnostic and therapeutic challenges. The different patterns of nystagmus induced during each positional maneuver should be differentiated from positional vertigo and nystagmus due to central lesions. It remains unknown which canal should be treated first and which maneuver should be adopted for multi-canal BPPVs. Furthermore, the optimal interval from treatment of a canal to another should be determined. The response to canalith repositioning maneuvers and recurrences do not differ between multi- and single canal BPPVs in spite of more frequent involvement of multiple canals in traumatic cases.

Clinical Characteristics and Course of Recurrent Vestibulopathy Following Diuretics Medication: Joon Seok Ko, Ho Yeop Kim, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2014;13(1):7-11.

Abstract: et, and the characteristics of vertigo. Results: Median follow-up was 29 months (range, 27−37 months). Patients had a mean age at onset of 48.2 years and a mean duration of 2.75 years. An obvious female predilection was found, and unilateral caloric paresis (≥25%) was seen in 23.3%. Of the 30 patients, symptoms resolved in 80% but were unchanged in 20%. No patient with RV developed a central nervous system disease or benign paroxysmal positional vertigo during follow-up. Conclusion: The present study shows that in the majority of cases, vertigo resolved following diuretics medication. In cases of the patients with severe or disabling recurrent vestibulopathy, the diuretics medication may be effective in reducing the frequency of vertigo attacks.

Two Cases of Cerebellar Hemangioblastoma with Isolated Vertigo: Jung Yup Lee, Jae Hyuk Lee, Min Beom Kim, Jae Ho Ban; Res Vestib Sci. 2014;13(1):12-18.

Abstract: Hemangioblastoma is solid or cystic benign vascular tumor that may arise anywhere in the body. It is rarely presented tumor accounting for only 1% to 2.5% of all intracranial neoplasms. Usually, hemangioblastoma is located in the cerebellum and posterior cranial fossa and it occurs in a variety of symptoms depending on where the tumor is located. The initial symptoms in 80% to 90% of hemangioblastoma patients are headache and vomiting due to elevated intracranial pressure, and also dizziness and balance problems are initially presented in about half of the patients. We experienced 2 cases of hemangioblastoma who presented with isolated vertigo. All of them initially showed unidirectional spontaneous nystagmus during head impulse test. Finally, hemangioblastoma of the cerebellum has been diagnosed on magnetic resonance imaging scan. In one case, the tumor was successfully removed by retrosigmoid approach and the other case was treated conservatively due to pregnancy.

Vestibular Paroxysmia in a 7-Year-Old Child: Seok Min Hong, Sung Ho Choi, Il Seok Park, Yong Bok Kim; Res Vestib Sci. 2014;13(1):19-23.

Abstract: Neurovascular cross-compression of the eighth cranial nerve is characterized by brief attacks of vertigo, unilateral audiologic symptoms such as tinnitus, ear fullness and hearing disturbance and relatively rare disease, in particular, in children. We report a 7-year-old female patient who presented with recurrent spontaneous vertigo, lasting 15 seconds and occuring up to 40 times per day and often associated with physical activity. Her symptoms were developed by hyperventilation. Associated aural symptoms are not founded. Magnetic resonance image showed the eighth cranial nerve compression caused by the vascular loop. She was treated with oxcarbazepine and showed improving symptoms. Therefore we report our clinical experience with a brief review of literature.

Upbeat Nystagmus in Association with Wall-Eyed Bilateral Internuclear Ophthalmoplegia: Duck Su Park, Yeo Jeong Kang, Tae Kyeong Lee, Kwang Ik Yang; Res Vestib Sci. 2014;13(1):24-27.

Abstract: A 54-year-old man presented with primary position upbeat nystagmus and wall-eyed bilateral internuclear ophthalmoplegia. He also showed bilateral limb ataxia and impaired horizontal gaze. Upbeat nystagmus obeyed Alexander’s law and attenuated by visual fixation and disappeared by convergence. Brain magnetic resonance imaging showed acute infarction in the bilateral paramedian midbrain involving the crossing of brachium conjunctivum. Multiple mechanisms including the interruption of central vestibulo-ocular projections from anterior canal may be postulated in upbeat nystagmus of this patient.

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