Research in Vestibular Science

Dizziness after Traumatic Brain Injury: Neurological Aspects: Young Seo Kim, Seon Jae Im, Hak Seung Lee; Res Vestib Sci. 2019;18(3):59-63. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.59

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Abstract PDF: Vertigo, dizziness, and disequilibrium are common symptoms following concussion or traumatic brain injury. Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine preventative medications. This paper reviews the neurological causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

Customized Vestibular Rehabilitation in the Patients with Bilateral Vestibulopathy: A Pilot Study in One Referred Center: Kwang-Dong Choi, Seo-Young Choi; Res Vestib Sci. 2019;18(3):64-70. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.64

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Abstract PDF: Objectives
Bilateral vestibulopathy is characterized with unsteadiness and oscillopsia when walking or standing, worsening in darkness and/or on uneven ground. To establish the effect of customized vestibular rehabilitation in bilateral vestibulopathy, we analyzed the questionnaires and functional status before and after treatment.
Methods
Among 53 patients with customized vestibular rehabilitation from January 1st to November 30th in 2018, 6 patients (3 males; median age, 71 years; range, 54–75 years) who regularly exercised with good compliance were retrospectively enrolled. They were educated and trained the customized vestibular rehabilitation once a month or two by a supervisor during 40 minutes, and then exercised at home for 30 minutes over 5 days in a week. Dizziness handicap inventory (DHI), Korean vestibular disorders activities of daily living scale (vADL), Beck’s depression index (BDI), test for dynamic visual acuity (DVA), and Timed Up and Go test (TUG) were performed before and after the customized vestibular rehabilitation.
Results
The patients exercised for median 5.5 months (range, 2–10 months) with the customized methods of vestibular rehabilitation, which included gaze and posture stabilization and gait control exercises. DHI score and TUG was improved after rehabilitation (DHI before vs. after rehabilitation=33 vs. 16, p=0.027, TUG before vs. after rehabilitation=12 vs. 10, p=0.026). BDI, DVA, and vADL scores did not differ between before and after treatment.
Conclusions
Customized vestibular rehabilitation can improve dizziness and balance state in bilateral vestibulopathy. The steady exercises adapted individual peculiarities is the most important for vestibular rehabilitation.

Factors Associated with Patient Satisfaction in Customized Vestibular Exercise: A Pilot Study: Hye Soo Ryu, Min Young Lee, Jae Yun Jung, Ji Eun Choi; Res Vestib Sci. 2019;18(3):71-77. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.71; Retraction in: Res Vestib Sci 2020;19(4):149

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Benign Paroxysmal Positional Vertigo after Yoga Practice: Soo-Hyun Soh, Hak Seung Lee; Res Vestib Sci. 2019;18(3):78-82. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.78

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Abstract PDF: A 57-year-old woman presented with sudden onset of whirling vertigo associated with nausea and vomiting. The neurological examination showed left-beating horizontal nystagmus on the lying-down test and right-beating horizontal nystagmus on the head bending test. Geotropic direction-changing horizontal nystagmus was demonstrated on both sides during the supine roll test. Benign paroxysmal positional vertigo (BPPV) was the most common vestibular disorder in patients after head trauma. The authors experienced a case of right horizontal canal BPPV occurred after a yoga practice, thereby we report the case with a review of the related literatures.

Two Cases of Pediatric Pneumolabyrinth with Traumatic Tympanic Membrane Perforation after Penetrating Injury: Yeon Seok You, Ji Hoon Koh, Byeong Jin Kim, Eun Jung Lee; Res Vestib Sci. 2019;18(3):83-86. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.83

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Abstract PDF: Pneumolabyrinth is an uncommon condition in which air is present in the vestibule or cochlear. It is rarely found, even in otic capsule violating fractures or in transverse fracture of the temporal bone. So far, there is no consensus on management of pneumolabyrinth. We describe 2 new cases of pneumolabyrinth by penetrating injury with traumatic tympanic membrane perforation. They presented whirling vertigo with moderate conductive hearing loss. Temporal bone computed tomography clearly demonstrated the presence of air in the vestibule and cochlear.

Arnold-Chiari Type 1 Malformation Mimicking Benign Paroxysmal Positional Vertigo: Young Chul Kim, Chae Dong Yim, Hyun Jin Lee, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2019;18(3):87-90. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.87

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Abstract PDF: Arnold-Chiari malformation type 1 is a congenital disease characterized by herniation of the cerebellar tonsils through the foramen magnum. Most common clinical symptom is pain, including occipital headache and neck pain, upper limb pain exacerbated by physical activity or valsalva maneuvers. Various otoneurological manifestations also occur in patients with the disease, which has usually associated with dizziness, vomiting, dysphagia, poor hand coordination, unsteady gait, numbness. Patients with Arnold-Chiari malformation may develop vertigo after spending some time with their head inclined on their trunk. Positional and down-beating nystagmus are common forms of nystagmus in them. We experienced a 12-year-old female who presented complaining of vertigo related to changes in head position which was initially misdiagnosed as a benign paroxysmal positional vertigo.

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