Research in Vestibular Science

Volume 19 (2); June 2020

Reviews

Diagnostic Criteria and Differential Diagnosis of Hemodynamic Orthostatic Dizziness/Vertigo: Hyun Ah Kim, Ji-Soo Kim; Res Vestib Sci. 2020;19(2):35-41. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.35

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We summarized recent diagnostic criteria for hemodynamic orthostatic dizziness/vertigo included in the International Classification of Vestibular Disorders (ICVD) in this paper. The aim of defining diagnostic criteria of hemodynamic orthostatic dizziness/vertigo is to help clinicians to understand the terminology related to orthostatic dizziness/vertigo and to distinguish orthostatic dizziness/vertigo due to global brain hypoperfusion from that caused by other etiologies. Detailed history taking and measurements of orthostatic blood pressure and heart rate are important for the screening and documentation of orthostatic hypotension or postural tachycardia syndrome to establish the diagnosis of hemodynamic orthostatic dizziness/vertigo.

Citations

Citations to this article as recorded by

Posterior Inferior Cerebellar Artery Stenosis Presenting as Recurrent Orthostatic Dizziness
Seongjin Jeon, Ji-Yun Park, Jong-min Lee, Seulgi Hong
Research in Vestibular Science.2022; 21(2): 53. CrossRef

Persistent Postural-Perceptual Dizziness: Overview and Diagnostic Criteria: Sung-Hee Kim; Res Vestib Sci. 2020;19(2):42-48. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.42

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Abstract PDF: Persistent postural perceptual dizziness (PPPD) is a chronic functional vestibular disorder that manifests with 3 or more months of dizziness, nonspinning vertigo, and unsteadiness. These main symptoms are exacerbated by upright posture, active or passive self-motion, and exposure to visual stimuli. PPPD is usually precipitated by illnesses that cause vertigo, dizziness, or unsteadiness. The common precipitants are acute or episodic peripheral vestibular diseases including vestibular neuritis, Meniere disease, or benign paroxysmal positional vertigo. PPPD is not a diagnosis of exclusion. An abnormal finding on examination or laboratory testing does not necessarily exclude a diagnosis of PPPD. This article reviewed the Bárány Society’s diagnostic criteria for PPPD in detail and discussed directions of future investigations.

Original Articles

Influence of Otoliths on the Vestibulo-Ocular Reflex in Horizontal Canal Benign Paroxysmal Positional Vertigo: Hee Soo Yoon, Jae Yeong Jeong, Jae Ho Chung, Ha Young Byun, Chul Won Park, Seung Hwan Lee; Res Vestib Sci. 2020;19(2):49-54. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.49

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Abstract PDF: Objectives
The aim of the study was to evaluate the possible alteration of the vestibulo-ocular reflex (VOR) in patients with horizontal canal benign paroxysmal positional vertigo (h-BPPV) using the video head impulse test (vHIT).
Methods
This was a prospective case-control study of BPPV patients. We includeed 133 patients with h-BPPV who underwent the vHIT prior to the positioning test. The control group consisted of 76 normal subjects who also underwent the vHIT. The vHIT parameters of gain and asymmetry were assessed, and clinical parameters such as treatment duration, number of canalith reposition maneuvers executed and recurrence rates were evaluated. The VOR and clinical parameters were compared between the h-BPPV and control group. The VOR parameters of h-BPPV canalolithiasis were also compared with those of cupulolithiasis.
Results
The mean age of the patients was 56.5 years and the male to female ratio was 1:2.02. Of the patients, 75 were diagnosed as having the canalolithiasis type of h-BPPV, while the other 58 had the cupulolithiasis type. The mean vHIT gains of the ipsi-lesional horizontal canal plane were 1.13 and 1.15 in the h-BPPV and control group, respectively (p=0.564). However, the asymmetry of the VOR was significantly higher in the h-BPPV than the control group (p=0.013), while the gains and asymmetries of the vHIT in the canalolith and cupulolith types were not significantly different (p=0.454, p=0.826).
Conclusions
The asymmetry of VOR is significantly elevated in the cupulolith type of hBPPV.

Comparison of Predictive Parameters between the Video Head Impulse Test and Caloric Test: Chun Han, Seung Won Paik, Hui Joon Yang, Sang Yoo Park, Ji Hyeon Lee, Young Joon Seo; Res Vestib Sci. 2020;19(2):55-61. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.55

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Abstract PDF

Objectives
The aim of this paper was to determine if a correlation exists between video head impulse test (vHIT) and electronystagmography with caloric test (ENG). More specifically, comparison of covert and overt value from vHIT test with cold and warm stimulation value from ENG test.
Methods
Retrospective study of our single institue from the period of January 2015 to January 2017 enrolled 91 patients. Patients were divided into 3 groups by their diagnosis of either vestibular neuritis (VN), Meniere disease, or sudden sensorineural loss with vertigo accordingly. Each of the patients’ both ENG and vHIT data were recorded and parameters were evaluated.
Results
VN group was the only group to show a significant correlation between canal paresis (CP) with covert and overt saccades. Further analysis was done in the VN group and result showed covert saccade showing a larger area under the receiver operation characteristic curve value (0.77) compared to overt saccades (0.70), implying that covert saccade is a more accurate parameter for the prediction of the CP value. Furthermore, a positive correlation was seen between the gain value and the cold caloric stimulation value as well as between warm caloric stimulation value.
Conclusions
The value of our study lies in the fact that we have attempted to find a correlation between different parameters of 2 different vestibular tests. We concluded that the evaluation of overt nystagmus by the bedside head thrust test is inappropriate for predicting CP, and a vHIT is required to accurately evaluate vestibular function.

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A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test
Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng
Research in Vestibular Science.2023; 22(2): 34. CrossRef

Normative Vestibular-Ocular Reflex Gain Values for the Vertical Semicircular Canals: Louise Hag, Emil Riis Abrahamsen, Dan Dupont Hougaard; Res Vestib Sci. 2020;19(2):62-70. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.62

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Abstract PDF Supplementary Material

Objectives
To determine normative vestibular-ocular-reflex (VOR) gain values for the vertical semicircular canals (SCCs) within a Danish cohort of healthy adults. Normative data regarding the vertical SCCs are sparse. Assessing the function of all 6 SCCs is important, as some vestibular diseases may selectively affect specific SCCs.
Methods
A prospective cross-sectional study of 60 subjects aged 18–65 years with no previous vestibular disorders. All subjects underwent complete examination of all 6 SCCs with EyeSeeCam video head impulse test (vHIT) system.
Results
Mean VOR gain values of the right anterior and left posterior canal were 1.46 and 1.43 respectively. For the left anterior and right posterior canals, mean VOR gain values were 0.96 and 0.97 respectively.
Conclusions
Our results suggest that mean VOR gain is close to 1.4 in the right anterior and left posterior plane and close to one for the left anterior and right posterior plane when testing the vertical SCCs in healthy adults with the EyeSeeCam vHIT system.

Citations

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Changes in vestibular-related responses to combined noisy galvanic vestibular stimulation and cerebellar transcranial direct current stimulation
Tsubasa Mitsutake, Hisato Nakazono, Tomoyuki Shiozaki, Daisuke Fujita, Maiko Sakamoto
Experimental Brain Research.2024; 242(1): 99. CrossRef
Comprehensive Normative Data for Objective Vestibular Tests
Suman Narayana Swamy, Pradeep Yuvaraj, Nupur Pruthi, Kandavel Thennarasu, Aravind Kumar Rajasekaran
Cureus.2023;[Epub] CrossRef
A Study on the Evaluation of Brainstem Dysfunction in Rapid Eye Movement Sleep Behavior Disorder Using Video Nystagmography
Young Hun Kim, Jeongho Park, Seung Ho Choo, Hyunjin Jo, Dae-Won Seo, Byung-Euk Joo, Eun Yeon Joo
Journal of the Korean Neurological Association.2023; 41(4): 293. CrossRef
A Wearable Wireless Magnetic Eye-Tracker, In-Vitro and In-Vivo Tests
Giuseppe Bevilacqua, Valerio Biancalana, Mario Carucci, Roberto Cecchi, Piero Chessa, Aniello Donniacuo, Marco Mandalá, Leonardo Stiaccini, Francesca Viberti
IEEE Transactions on Biomedical Engineering.2023; 70(12): 3373. CrossRef

Clinical Characteristics of Sudden Sensorineural Hearing Loss Accompanying Benign Paroxysmal Positional Vertigo: Sung Min Park, Bin Kwon, Sung Won Li, Seok Min Hong, Sung Kyun Kim; Res Vestib Sci. 2020;19(2):71-78. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.71

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Abstract PDF

Objectives
Idiopathic unilateral sudden sensorineural hearing loss (SSNHL) with simultaneous benign paroxysmal vertigo (BPPV) is known to be associated with poor hearing recovery. We aimed to investigate clinical findings in patients with SSNHL with BPPV and analyze prognostic factors including presence of BPPV related to hearing outcome.
Methods
We retrospectively reviewed the electronic medical data of 14 patients with concurrent SSNHL and BPPV (combined group). We selected 52 patients without BPPV as a control group who have matched initial threshold of pure tone audiometry and age of each patient in the combined group. We evaluated clinical characteristics of all participants and compared hearing outcomes between the 2 groups. A multivariate logistic regression analysis was performed to investigate the factors related to hearing recovery.
Results
Initial mean pure tone audiometry (PTA) threshold of combined group was 90.36±26.2 dB. Posterior canal was most commonly involved (n=7, 50%), and 8 (57%) patients showed abnormal video head impulse test results. There was no significant difference between hearing recovery rates of combined and control group (p=0.237) and mean pure tone audiometry threshold changes were not significantly different between the 2 groups (p=0.942). Old age (≥60 years), high initial PTA threshold (＞90 dB), and obesity (body mass index ≥ 25 kg/m²) were poor prognostic predictors.
Conclusions
There was no difference between hearing outcomes of combined group and profound SSNHL only group. BPPV was not a significant prognostic factor of SSNHL patients.

Citations

Citations to this article as recorded by

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Research in Vestibular Science.2021; 20(3): 101. CrossRef

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