It is known that endolymphatic hydrops is a pathophysiologic mechanism of Meniere’s disease, while the detailed role is not fully clarified. Study for endolymphatic hydrops mainly represents a pathologic histologic finding found only in the post-mortem examination of temporal bone, so endolymphatic hydrops animal models have played important role in terms of understanding how hydrops affects the function of the inner ear. Numerous challenges with diverse animals and techniques have been tried to reveal the possible pathophysiology of endolymphatic hydrops and develop an effective treatment. This review shows historical background and technical advances in experimental animal model for endolymphatic hydrops and Meniere’s disease.
Persistent postural-perceptual dizziness (PPPD) was derived from phobic postural vertigo and chronic subjective dizziness. Two key physical symptoms of PPPD are postural unsteadiness and visually induced dizziness. Although the underlying mechanism of PPPD is still enigmatic, the prognosis is good with adequate treatment. In this paper, diagnostic criteria, pathophysiology and treatment regarding PPPD will be reviewed.
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A Case Report of Persistent Postural-Perceptual Dizziness Treated with Korean Medicine Min-hwa Kim, Gi-yoon Heo, Hee-kyung Kang, I-rang Nam, Maria Kim, In Lee, Jung-nam Kwon, So-yeon Kim, Young-ju Yun, Jun-yong Choi, Chang-woo Han, So-jung Park, Jin-woo Hong The Journal of Internal Korean Medicine.2022; 43(4): 769. CrossRef
Pitfalls in the Diagnosis of Vertigo Hyun Ah Kim, Hyung Lee Journal of the Korean Neurological Association.2018; 36(4): 280. CrossRef
Objective: Cervical vestibular evoked myogenic potential (cVEMP) is thought to be assessing the function of the saccule and inferior vestibular nerve. Therefore, cVEMP indirectly reflects the function of the posterior semicircular canal. Recently, the video head impulse test (vHIT) is considered as useful clinical tool to detect each semicircular canal dysfunction. Goal of this study was to evaluate and compare the results of cVEMP with posterior canal plane of vHIT (p-vHIT).
Methods Retrospectively, we compared the results of cVEMP with p-vHIT in 43 patients who visited with dizziness. We analyzed the inter-test agreement of cVEMP with p-vHIT.
Results Positive asymmetry of cVEMP was present in 37.2% (16/43), and no responses of both ears were identified in 16.3% (7/43). In p-vHIT analysis, unilateral positive was 27.9% (12/43), bilateral positive was 11.6% (5/43) and negative in both sides was 60.5% (26/43). The inter-test agreement between cVEMP and p-vHIT was 75.8% (25/33) as we considered even in lesion side. And, Fleiss’s kappa value showed a fair to good agreement (kappa value=0.559). In bilateral no response group (7 patients) in cVEMP, variable additional information could be obtained using p-vHIT.
Conclusion cVEMP and p-vHIT showed relatively lower inter-test agreement than expected. But, p-vHIT could be easily performed, and give additional information for differential diagnosis.
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Clinical Characteristics of the Patients with Dizziness after Car Accidents Young Min Hah, Chul Won Yang, Sang Hoon Kim, Seung Geun Yeo, Moon Suh Park, Jae Yong Byun Korean Journal of Otorhinolaryngology-Head and Nec.2017; 60(8): 390. CrossRef
Periodic alternating nystagmus (PAN) is a spontaneous horizontal jerky nystagmus that reverses its direction periodically with a quiescent interval. PAN has been reported in acquired and congenital forms. The main lesion site of the acquired form of PAN has been attributed to the caudal brainstem or cerebellum. Herein we report a 63-year-old male patient with Meniere’s disease, who presented PAN during a vertigo attack. The patient demonstrated no abnormality on neurologic evaluation and brain imaging, which is different feature compared to the central or congenital form of PAN. It should be kept in mind that peripheral vestibular disorders such as Meniere’s disease can produce PAN.
In some dizzy patients the apogeotropic direction changing positional nystagmus (DCPN) can be caused by a central disorder such as a mass lesion near the fourth ventricle or infaction. We have recently encountered a patient who showed a central DCPN mimicing a horizontal canal cupulolithiasis benign paroxysmal positional vertigo (BPPV). A 4.1 cm sized tumor was filling the fourth ventricle before the operation. When the head was turned to the left side vigorous right beting nystagmus was found. When the head was turned to the right side vigorous left beting nystagmus was found. But unlinke the typical horizontal canal BPPV, bowing and lying down position did not elicit any nystagmus. In order to see if the central DCPN was a transient finding or a persistent finding, we checked the nystagmus 3 weeks after the first testing. The same pattern of nystagmus was found again. The video head impulse test gain of all six canals were within the normal limit. In this article we discuss the points how to suspect a central DCPN in such cases.
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The Effect, Compliance and Satisfaction of Customized Vestibular Rehabilitation: A Single Center Experience Hyung Lee, Hyun Ah Kim Research in Vestibular Science.2019; 18(1): 14. CrossRef
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Labyrinthine fistula refers to a condition caused by an abnormal connection between the inner ear and surrounding structures. Most cases of that occur as a result of a complication brought about by cholesteatoma. It may also be generated by long repeated infections of a mastoid cavity that has been exposed to the outside after canal wall down mastoidectomy (CWDM). The infection is usually repeated for several years or decades after surgery. Therefore, labyrinthine fistula after CWDM is known as a late complication. In this case, labyrinthine fistula occurred in two months after surgery due to postoperative infection. Although cholesteatoma was removed after CWDM and the horizontal semicircular canal (HSCC) was not damaged during the operation, this labyrinthine fistula was thought to develop very early after surgery. Two months after surgery, the patient complained of dizziness, we identified the opened bony labyrinth and damaged endosteum of the HSCC in the patient.
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A Case of Labyrinthitis Ossificans Presenting as an Intractable Benign Paroxysmal Positional Vertigo Dong Hyun Kim, Jae Moon Sung, Hwi Kyeong Jung, Chang Woo Kim Research in Vestibular Science.2017; 16(3): 92. CrossRef