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Volume 21 (2); June 2022
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Reviews
The Interaction of Hypertension for Vertigo in Audiovestibular Medicine Clinic
Adaobi Elizabeth Osuji
Res Vestib Sci. 2022;21(2):29-39.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.29
  • 11,685 View
  • 264 Download
AbstractAbstract PDF
As the first audiovestibular medicine physician in the University of Port Harcourt Teaching Hospital, Nigeria, a keen observation revealed that a sizeable proportion of the adult patients presenting to our audiovestibular medicine clinic with vertigo are either known hypertensives, or hypertensives yet to have a formal diagnosis. This aroused an ardent curiosity to find the raison d’être, and to shed light on this pathological association between vertigo and hypertension. In line with this, it became imperative to highlight the dynamics of interaction, and pathophysiology behind the role of hypertension in vertigo.
The Association between Dizziness and Anxiety: Update to the Treatment
Seo-Young Choi, Kwang-Dong Choi
Res Vestib Sci. 2022;21(2):40-45.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.40
  • 2,331 View
  • 72 Download
AbstractAbstract PDFSupplementary Material
Anxiety, depression, or other psychiatric symptoms can be the primary cause of dizziness and the secondary complication of dizziness. Regardless of precedence or consequence, dizziness is closely associated with the psychiatric problem. On this ground, this chapter reviews the association between dizziness and anxiety and the treatment for dizziness with psychiatric symptoms.
Original Article
Canal Dysfunction Detected by Video Head Impulse Test in Patients with Vestibular Migraine and Its Relationship with Symptomatic Improvement
Ji Won Choi, Won Sub Lim, Sung Seok Ryu, Yeonjoo Choi, Sang Hun Lee, Seung Cheol Ha, Hong Ju Park
Res Vestib Sci. 2022;21(2):46-52.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.46
  • 2,243 View
  • 51 Download
AbstractAbstract PDF
Objectives
Video head impulse test (vHIT) can evaluate function of the vestibuloocular reflex for high frequency range of head rotation. We aimed to characterize the abnormal patterns of canal dysfunction by vHIT in vestibular migraine (VM) and evaluate the relationship between the presence of canal dysfunction and symptomatic improvement.
Methods
Eighty-seven patients with VM were included. Abnormality of vHIT at the initial examination was determined by the vHIT gain and the degrees of the corrective saccades at each canal and each side. The relationship between the abnormal patterns and the symptomatic improvement (no need for preventive medication) after modification of life styles and preventive medications for 1, 3, and 6 months was evaluated.
Results
Abnormal vHIT of the lateral canal was 13.8% when determined by the gain criteria and 31.0% when based on both gain and corrective saccade, regardless of the side. Abnormal vHIT of the superior and posterior canals were 18.4% and 27.6%, regardless of the side. Abnormal vHIT at any canal and side was observed in 47%. Patients showed symptomatic improvement in 29.9%, 71.3%, and 88.5% after modification of life styles and preventive medications for 1, 3, and 6 months. Abnormal vHIT results of canals were significantly related to the poor response to preventive mediations.
Conclusions
Prolonged preventive medication was required for symptomatic improvement in VM patients when vHIT results of any canals were abnormal, suggesting that peripheral vestibular abnormality is closely related to the pathophysiology of vestibular migraine.
Case Reports
Posterior Inferior Cerebellar Artery Stenosis Presenting as Recurrent Orthostatic Dizziness
Seongjin Jeon, Ji-Yun Park, Jong-min Lee, Seulgi Hong
Res Vestib Sci. 2022;21(2):53-56.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.53
  • 2,506 View
  • 34 Download
AbstractAbstract PDF
We report a unique case of vertebrobasilar transient ischemic attacks manifesting as isolated, recurrent, orthostatic dizziness with posterior inferior cerebellar artery (PICA) stenosis. A 57-year-old male patient without past medical history, presented with brief orthostatic dizziness for 2 weeks. There was no associated nausea, vomiting, diplopia, or weakness. On neuro-otologic examination, the patient did not show spontaneous, positional, or gaze-evoked nystagmus. Vestibular function tests such as caloric test, head impulse test, video-oculography, and tilt table test were normal. Brain diffusion-weighted images showed multiple small high signal intensities in the bilateral cerebellar hemispheres. Brain magnetic resonance angiography revealed hypoplasia of the right vertebral artery without focal intracranial focal stenosis. Four-vessel cerebral angiogram showed severe stenosis at the right PICA artery. Our patient’s clinical scenario appears unique hemodynamic spells without symptoms or signs of posterior circulation ischemia. Physicians should also consider cerebrovascular ischemic when the patient suffers repeated orthostatic dizziness that is not explained clinically.
A Case of Pontine Infarction with Facial Palsy and Vertigo Confused with Ramsay Hunt Syndrome
Jae Seon Park, Sang Hyun Kim, Jung-Yup Lee, Min-Beom Kim
Res Vestib Sci. 2022;21(2):57-62.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.57
  • 2,887 View
  • 51 Download
AbstractAbstract PDF
Facial palsy can be caused by central and peripheral causes, and it can also be caused by brain tumors or infarction. A 59-year-old male, who lost his right hearing 13 years ago due to Ramsay Hunt syndrome, visited our hospital with facial palsy and dizziness. Initial brain diffusion-weighted magnetic resonance imaging (MRI) showed no abnormal findings, and recurrent Ramsay Hunt syndrome or a neoplastic lesion in the internal auditory canal was suspected. After hospitalization, the patient was administered high-dose steroids, and the videonystagmography showed direction-changing gaze-induced nystagmus, so a brain MRI reexamination was scheduled. While waiting for MRI, the patient complained of neurological symptoms such as diplopia, and right lower pontine infarction was diagnosed on MRI. The patient was transferred to the neurologic department and was discharged on the 10th day after conservative treatment. During the 1-year follow-up, pontine infarction did not recur, and neurological symptoms such as facial palsy gradually improved.
Essay
The XXXI Bárány Society Meeting: An Attendance Report
Dong-Han Lee, Myung-Whan Suh
Res Vestib Sci. 2022;21(2):63-65.   Published online June 15, 2022
DOI: https://doi.org/10.21790/rvs.2022.21.2.63
  • 1,711 View
  • 31 Download
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Res Vestib Sci : Research in Vestibular Science