Research in Vestibular Science

Volume 14 (3); September 2015

Reviews

Vestibular Rehabilitation for Patients with Unilateral Peripheral Vestibular Deficit: Chang Geun Song, Sung Kwang Hong; Res Vestib Sci. 2015;14(3):61-66.

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Abstract PDF: Unilateral peripheral vestibular deficit can occur from a different etiology including viral infection, trauma, ear surgery or idiopathic. Patients with sudden unilateral vestibular deficit usually complain of whirling vertigo, postural imbalance and ipsilesional lateropulsion, which gradually recover over a few weeks by vestibular compensation mechanism. Vestibular rehabilitation therapy has been accepted as helpful exercise based training program with strong evidence for acceleration of vestibular compensation in unilateral vestibular deficit. Here the authors described the current issue regarding vestibular rehabilitation in unilateral vestibular hypofunction from the informative literature review.

Diagnostic Criteria for M?nier?’s Disease: Jose A Lopez-Escamez, John Careyb, Won Ho Chung, Joel A Goebeld, Mans Magnusson, Marco Mandala, David E Newman-Tokerg, Michael Strupp, Mamoru Suzuki, Franco Trabalzini, Alexandre Bisdorff; Res Vestib Sci. 2015;14(3):67-74.

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Abstract PDF: This paper presents diagnostic criteria for M?nier?’s disease jointly formulated by the Classification Committee of the B?r?ny Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology, the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery, and the Korean Balance Society. The classification includes two categories: definite M?ni?re's disease and probable Meni?re's disease. The diagnosis of definite M?ni?re's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium- frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable M?nier?'s disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

Original Articles

Role of the Cerebral Cortex on Vestibular Compensation Following Unilateral Labyrinthectomy in Rats: Hyun Kwang Ryoo, Seung Bum Yang, Min Sun Kim, Byung Rim Park; Res Vestib Sci. 2015;14(3):75-82.

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Abstract PDF: Objective: The cerebral cortex can modulate vestibular functions through direct control of neuronal activities in the vestibular nuclei. The purpose of this study was to investigate the effect of unilateral cortical lesion or cortical stimulation on static vestibular symptoms and vestibular nuclear activities at the acute stage of vestibular compensation following unilateral labyrinthectomy (UL) in rats.
Methods
The photothrombic ischemic injury using rose bengal was induced in the primary motor cortex or primary sensory cortex, and electrical stimulation was applied to the primary motor cortex, primary sensory cortex, or sencondary sensory cortex, respectively, in unilateral labyrinthectomized rats. Static vestibular symptoms including ocular movement and postural deficits, and expression of c-Fos protein in the medial vestibular nucleus (MVN) were measured.
Results
Lesion of the motor cortex produced a marked postural deficit with paralytic weakness in the hindlimb contralateral to UL. Number of spontaneous nystagmus in animals receiving cortical lesion was significantly increased 2, 6, and 12 hours after UL compared with animals being UL only. Lesion of the primary motor cortex or stimulation of the S2 sensory cortex decreased expression of c-Fos protein in MVN following UL compared with UL only group. Electrical stimulation of S2 sensory areas caused significant reduction of static vestibular symptoms and decreased expression of c-Fos protein in MVN 24 hours following UL.
Conclusion
The present results suggest that cerebral cortex involves in recovery of static vestibular symptoms during vestibular compensation following UL.

Long-Term Follow-Up of Patients with Benign Paroxysmal Positional Vertigo: Jin Yong Kim, Joon Seok Ko, Ho Joong Lee, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2015;14(3):83-86.

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Abstract PDF: Objective: Benign paroxysmal positional vertigo (BPPV) is one of most common peripheral vestibular disorders. The aim of this study was to identify recurrence in the long-term follow-up of patients with BPPV after successful canalith repositioning maneuvers, and to determine which factors contribute to recurrence.
Methods
The authors reviewed the medical records of 202 consecutive patients with BPPV during the period January 2002 to December 2004 and investigated 112 patients with BPPV treated over the same period. Finally, 71 patients were enrolled in this study. The estimated risk of recurrence used a Kaplan-Meier analysis. For long-term follow-up, patients were contacted by telephone for further information by one experienced doctor.
Results
A total of 71 patients with idiopathic BPPV fulfilled the inclusion criteria. Forty-two patients had posterior semicircular canal-BPPV and 29 patients lateral semicircular canal-BPPV. Recurrence rates in the posterior semicircular canal-and lateral semicircular canal-BPPV were 24% (18/42) and 41% (12/29), respectively (p＞0.05). Recurrence following successful treatment during a longterm follow-up period was 23 out of 30 patients within 1 year, 5 patients between 1 and 3 years, 1 patient at between 3 and 5 years, 1 patient after 5 years, respectively.
Conclusion
The authors found no significant difference between the posterior semicircular canal and lateral semicircular canal-BPPV regarding recurrence. Recurrence mostly occurred within the first 3 years (93%) following successful canalith repositioning procedure.

Clinical Analysis of Positional Vertigo without Nystagmus at Initial Examinations: Kyu Ho Lee, Jihun Park, Hyung Min Lee, Sung Hoon Ryu, Su Kyoung Park, Jiwon Chang; Res Vestib Sci. 2015;14(3):87-92.

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Abstract PDF: Objective: Patients with benign paroxysmal positional vertigo (BPPV) visit clinics with typical position evoked vertigo. However, typical nystagmus are concealed according to many factors We evaluated the demographic, clinical and nystagmographic features of patients, who visited clinics with typical BPPV symptoms but did not have positional test evoked nystagmus.
Methods
Among 306 patients with history of positional vertigo, we excluded 252 patients who had positional test evoked nystagmus on video Frenzel glass in clinics, and analyzed 54 patients who did not have positional test evoked nystagmus. We divided 54 patients into two groups; patients without subjective vertigo in positional test and patients with subjective vertigo in positional test. We analyzed the serial nystagmographic findings, causes, duration of disease, previous history of medical or rehabilitation treatments, coexisting vestbular disorders, recovery time and recurrence.
Results
Etiology, history of previous treatment, coexisting vestibular disorders and recurrence did not differ statistically in both groups. However, the nystagmographic features were significantly different in both groups.
Conclusion
When patient has positional test evoked vertigo, repeated positional maneuver seemed to increase the expression of positional nystagmus.

Case Report

Bilateral Benign Paroxysmal Positional Vertigo Occurred during Dancing Rehearsal: Dong Gu Hur, Joon Seok Ko, Jin Yong Kim, Seong Ki Ahn; Res Vestib Sci. 2015;14(3):93-96.

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Abstract PDF: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vestibular vertigo. The etiology of BPPV is unidentified in 50%?70% of patients. However in secondary BPPV, the etiologies are well known a head injury as an example. And it has been reported that even minor head trauma can evoke BPPV. The authors experienced a case of bilateral BPPV occurred during a dancing rehearsal in a school thereby we report the case with a review of the related literatures.

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