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- Volume 3 (1); June 2004
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Symposiums
- Basics of Eye Movements and Nystagmus
- Tae-Kyeong Lee, M.D.
- J Korean Bal Soc. 2004;3(1):7-24.
- 1,961 View
- 31 Download
- Control of Postural and Autonomic Function by the Vestibular System
- Byung Rim Park, M.D.
- J Korean Bal Soc. 2004;3(1):25-31.
- 1,890 View
- 5 Download
- Nystagmus in Peripheral Vestibular Disease
- Seung-Chul Lee, M.D.
- J Korean Bal Soc. 2004;3(1):32-35.
- 1,903 View
- 11 Download
- Central Nystagmus
- Kwang-Dong Choi, M.D
- J Korean Bal Soc. 2004;3(1):36-45.
- 1,583 View
- 9 Download
- Other Nystagmus
- Ki-Bum Sung, M.D., P
- J Korean Bal Soc. 2004;3(1):46-56.
- 1,711 View
- 5 Download
- Diagnostic Approach to Dizziness
- Chung-Ku Rhee, M.D.1
- J Korean Bal Soc. 2004;3(1):59-63.
- 1,905 View
- 16 Download
- Benign Paroxysmal Positional Vertigo
- Gyu Cheol Han, M.D.1
- J Korean Bal Soc. 2004;3(1):64-74.
- 1,670 View
- 4 Download
- Dizziness of Vestibular Nerve Disorder
- Ja-Won Koo, M.D.1
- J Korean Bal Soc. 2004;3(1):88-94.
- 1,925 View
- 7 Download
- Central Nervous System Disorders Presenting as Vertigo
- Hyung Lee, M.D.
- J Korean Bal Soc. 2004;3(1):95-101.
- 1,608 View
- 7 Download
- Migraine Related Dizziness, Psychogenic Dizziness and Vestibular Epilepsy
- Byung-Kun Kim, M.D.
- J Korean Bal Soc. 2004;3(1):102-111.
- 1,564 View
- 10 Download
Original Articles
- Vestivbular Influences on Cardiovascular Control: Implications for Astronauts and Otolarynhologists
- Bill Yates
- J Korean Bal Soc. 2004;3(1):115-122.
- 1,407 View
- 4 Download
- Drug Delivery System in Meniere's Disease
- Hiroshi Yamashita
- J Korean Bal Soc. 2004;3(1):125-126.
- 1,941 View
- 6 Download
Reviews
- Central Positional Nystagmus from Focal Brain Lesion
- Ja Won Koo, Kwang Dong Choi, So Young Moon, Seong Ho Park, Ji Soo Kim
- J Korean Bal Soc. 2004;3(1):129-135.
- 2,048 View
- 11 Download
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Abstract
PDF - Department of Otolaryngology, Head and Neck Surgery1, and Neurology2, Seoul National University Bundang Hospital,
Seoul National University College of Medicine, Seongnam, Korea
Background and Objectives : Central positional nystagmus is induced by positional changes from brainstem or
cerebellar lesions. Differentiation central from peripheral positional nystagmus is important in clinical practice. To
delineate characteristics of the positional nystagmus observed in central lesions, we analyzed the parameters of
positional nystagmus from focal brain lesions.
Materials and Methods : Ten patients with central positional nystagmus were recruited from the dizziness clinic
of Seoul National University Bundang Hospital. All the patients had focal brainstem or cerebellar lesions documented
by magnetic resonance imaging. The nystagmus was observed with and without fixation by using Frenzel glasses or
Video Goggles. The nystagmus was videotaped or recorded with video-oculography. Provoking positional maneuvers,
direction, latency, duration, phase reversal, and fatigue phenomenon of the nystagmus were analyzed.
Results
: Of the 10 patients, seven had infarctions in the lateral medulla or inferior cerebellum while two experienced cerebellar hemorrhage and remaining one showed a compression of the ventrolateral medulla by cavernous malformation of the vertebral artery. The directions of the positional nystagmus were variable depending on the lesions and provoking maneuvers. Most patients exhibited direction-changing nystagmus without latency, direction-reversal and fatigue phenomenon. However, some of the patients also showed patterns of nystagmus characteristic of peripheral positional nystagmus. In two of the four patients with infarction in the territory of medial posterior inferior cerebellar artery, the positional nystagmus was the only abnormal findings.
Conclusions
: Central positional nystagmus may share many characteristics with peripheral type of positional nystagmus. In individual cases, the patterns of nystagmus should be interpreted with caution in differentiating central from peripheral positional nystagmus. Considering the isolated positional nystagmus in some patients with caudal cerebellar lesions, systematic positional maneuvers should be applied to all the patients with vertigo Key Words : Positional nystagmus, Medulla, Cerebellum
- Recurrent Episodic Vertigo Controlled by Phenytoin Sodium
- Chung Ku Rhee, Yong Won Chung, Ji Sun Kim, Joon Sik Yoon, Yang Hee Oh
- J Korean Bal Soc. 2004;3(1):136-140.
- 1,830 View
- 5 Download
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Abstract
PDF
- Background
: Many patients with symptom of recurrent episodic vertigo can neither be diagnosed nor treated. The purpose of this study is to review clinical features of a group of patients with recurrent episodic vertigo that is not defined to specific diagnosis of vertigo and to test the effectiveness of phenytoin sodium in the patients.
Method
& Material : 11 of 32 patients with recurrent vertigo not defined to specific diagnostic category of vertigo who visited dizziness center of a tertiary care university hospital from November 1995 to April 2004 were studied. The patient's charts were reviewed retrospectively. A thorough otolaryngologic and neurotologic evaluation was performed in every case to determine the specific cause of dizziness. Vestibular function test, hearing test, magnetic resonance imaging of brain, electroencephalogram, and 24 hour Holter EKG monitoring were performed in all cases. Consultations to psychiatrist and neurologist were obtained. All patients were treated with phenytoin sodium.
Result
: The results of the vestibular function test, audiogram, MRI of brain, electroencephalogram, 24-hr holter monitoring were normal. Any definitive diagnosis could not be reached to this group. Vertigo was controlled by phenytoin sodium in all 11 cases.
Conclusion
: We report a group of patients with recurrent episodic vertigo that is not defined to any specific diagnosis of vertigo. The vertigo symptom was controlled successfully by phenytoin sodium. This patients were diagnosed as benign episodic vertigo as a separate disease entity. Key Words : Vertigo, Phenytoin sodium, Episodic
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