Research in Vestibular Science

Volume 19 (1); March 2020

Review

Vestibular Responses to Gravity Alterations: Nguyen Nguyen, Gyutae Kim, Kyu-Sung Kim; Res Vestib Sci. 2020;19(1):1-5. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.1

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Abstract PDF: Due to the adaptation to environments on Earth, various health-related issues are raised when exposed to different circumstances in space. Of environmental factors in space, gravity alteration has been considered as one of critical environmental changes. The primary inner organ to detect the gravity change is the vestibular system, especially otolith organs, and some limited researches have conducted to understand its mechanical and physiological properties. However, the related consequences were not consistent in despite of well description in systemic effects ranged from the peripheral vestibular system to the central nervous system. Here, we revisited the neuronal and behavioral effects of the gravity alteration on the relevant organs through this review. By representing previous studies for the gravity effects on the peripheral and central vestibular system, this review would provide the concrete understanding of the vestibular responses to the gravity alteration. Also, the physiological responses are expected to provide the useful resources to understand the systemic vestibular responses under the gravity alteration.

Original Article

Does 125-Hz Pure-Tone Thresholds Have Prognostic Value in Patients with Sudden Sensorineural Hearing Loss and Vertigo?: Yong-Hwi An, Hyun Joon Shim; Res Vestib Sci. 2020;19(1):6-11. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.6

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Abstract PDF: Objectives
To analyze 125-Hz pure-tone thresholds in dizzy patients with sudden sensorineural hearing loss (SSNHL) and to investigate the relationship between 125-Hz thresholds and the prognosis of SSNHL with vertigo.
Methods
Hearing and vestibular function tests including 125-Hz pure-tone were performed in 132 patients with SSNHL and 65 subjects with normal hearing. Audiometric follow-up was performed at 6 months after initial visit. Intergroup and intragroup comparison of 125 Hz was made between SSNHL and control groups.
Results
Twenty-four patients (18.2%) had normal thresholds at 125 Hz in SSNHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing threshold at 250 and 500 Hz≥30 dB had normal threshold at 125 Hz. There was no significant relationship between 125-Hz threshold and results of vestibular function test. There was no correlation between 125-Hz threshold and hearing recovery in SSNHL group.
Conclusions
There might be no need to assess 125-Hz pure-tone threshold in patients with SSNHL, because it is enough to evaluate thresholds of 250 and 500 Hz for low frequency.

Case Reports

Positional Hemiseesaw Nystagmus in Ataxia with Oculomotor Apraxia Type 2 due to a Novel Senataxin Gene Mutation: A New Phenotype: Sung-Hee Kim, Ja-Hyun Jang, Ji-Soo Kim; Res Vestib Sci. 2020;19(1):12-15. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.12

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1 Crossref

Abstract PDF Supplementary Material

Ataxia with ocular motor apraxia type 2 (AOA2) is an autosomal recessive disorder that is characterized by adolescent-onset gait ataxia, peripheral neuropathy, ocular apraxia, and cerebellar atrophy. A 19-year-old male with AOA2 from a novel SETX mutation showed distinct oculomotor abnormalities that included spontaneous and gaze-induced downbeat nystagmus, impaired smooth pursuit, and reversed catch-up saccades during horizontal head impulse tests, as well as peripheral neuropathy involving the lower extremities and mild slowing of frontal processing. He also showed positional hemiseesaw nystagmus in the supine and straight head-hanging positions. Positional hemiseesaw nystagmus is a new manifestation of hereditary cerebellar ataxia and may be explained by a gravity-dependent position-induced error in estimating the tilt in the roll plane due to dysfunction of the tilt-estimator circuit.

Citations

Citations to this article as recorded by

A Case of AOA2 With Compound Heterozygous SETX Mutations
Hee Jin Chang, Ryul Kim, Minchae Kim, Jangsup Moon, Man Jin Kim, Han-Joon Kim
Journal of Movement Disorders.2022; 15(2): 178. CrossRef

Atypical Presentation of Acute Vestibular Syndrome with Ramsay Hunt Syndrome: Bong-Hui Kang, Yong-Woo Lee, Jae-Il Kim; Res Vestib Sci. 2020;19(1):16-21. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.16

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Abstract PDF: Ramsay Hunt syndrome is an acquired paralysis of the face specifically caused by a varicella-zoster virus infection in the facial nerve. Other cranial nerves including vestibulo-cochlear disturbance can be affected. Herein we reported a case of Ramsay Hunt syndrome with atypical vestibular syndrome. Although central vestibular signs including direction changing post head-shaking nystagmus or normal head impulse test are generally meaningful, clinicians need to be careful to interpret them because some findings can be observed not only in cases of central disorders but also in peripheral disorders. Clinical findings such as distinct ear pain and close observation of vesicles are important to diagnose Ramsay Hunt syndrome.

A Case of Tumarkin Otolithic Crisis Treated with Intratympanic Gentamicin Injection: Soo Hyun Joo, Hong-Ju Kim, Hyun-Ji Kim, Kyu-Sung Kim; Res Vestib Sci. 2020;19(1):22-28. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.22

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Abstract PDF: Tumarkin otolithic crisis is an abrupt attack of falling without loss of consciousness because of peripheral vestibular disorders. It occurs without warning in patients with late stage or end-stage of Meniere’s disease. It is an otologic emergency due to the risk of fall down injury, and has been treated with labyrinthectomy, vestibular neurectomy, and intratympanic gentamicin injection. Many reports have reported the efficacy of intratympanic injection of gentamicin (ITIG) as chemical ablation. We report a 58-year-old man with Tumarkin otolothic crisis from Meniere’s disease who presented with sudden drop attack while driving a taxi. He has suffered from recurrent rotatory vertigo accompanied by fluctuating hearing loss and tinnitus in the right ear for years. Despite medical treatment over the next 2 months, he experienced three more sudden drop attacks. He got chemical ablation with ITIG and remains without sudden drop attack until fourteen months later. Tumarkin otolithic crisis is a life-threatening otologic emergency. What we have experienced in this case is that for the safety and quality of life of the patient who suffers from Tumarkin otolithic crisis, aggressive vestibular function ablation with high dose ITIG is necessary.

Delayed Audio-Vestibular Symptoms in Spontaneous Intracranial Hypotension: Han-Sol Choi, Jae-Myung Kim, Hong Chan Kim, Hyong-Ho Cho, Seung-Han Lee; Res Vestib Sci. 2020;19(1):29-33. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.29

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Abstract PDF: Intracranial hypotension (IH) is a neurological disorder characterized by orthostatic headache due to cerebrospinal fluid (CSF) volume depletion. IH usually results from CSF leak caused by either spontaneous or traumatic dural injury and may also present nausea, neck stiffness, tinnitus or dizziness. We experienced a 52-year-old woman presenting with acute spontaneous vertigo, tinnitus and hearing impairment on both ears with right side predominancy which mimicked Meniere’s disease. Video-oculography revealed spontaneous left-beating nystagmus which was modulated by position change. There was binaural low-frequency sensorineural hearing loss (SNHL) in pure tone audiometry. Other neuro-otologic evaluations including caloric test, vestibular evoked myogenic potential, video head impulse tests were unremarkable. Of interest, she had been treated of orthostatic headache due to spontaneous IH 10 days before admission. Taken together the clinical and laboratory findings, audio-vestibular symptoms of the patient were thought to be related with insufficient treatment of IH. After massive hydration and bed rest, her symptoms were markedly improved and SNHL was also disappeared in the follow-up pure tone audiometry. IH should be considered as a differential diagnosis in dizzy patient with tinnitus, hearing impairment even the typical orthostatic headache is not accompanied.

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