Research in Vestibular Science

A Case of Partial Oculomotor Nerve Palsy Caused by Vascular Compression in Idiopathic Intracranial Hypertension: Seol-Won Lee, Seung-Bae Hwang, Byoung Soo Shin, Man Wook Seo, Sun-Young Oh; Res Vestib Sci. 2017;16(3):97-100. Published online September 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.3.97

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Abstract PDF: Pupil-involving oculomotor nerve palsy (ONP) is frequently associated with compressive lesion such as intracranial aneurysm originating from the posterior communicating arteries. Vascular variant of posterior intracranial circulation is regarded as an uncommon cause and association between these vascular variants and intracranial hypertension has not been reported. We present an 18-year-old girl with pupil-involving ONP combined with idiopathic intracranial hypertension who revealed compression of oculomotor nerve by a vascular variant of superior cerebellar artery (SCA). This is a rare case of an ONP attributed to compressive effect from an aberrant SCA affected by intracranial hypertension.

A case of partial oculomotor nerve palsy caused by vascular compression in idiopathic intracranial hypertension: Seol-Won Lee, Seung-Bae Hwang, Byoung Soo Shin, Man Wook Seo, Sun-Young Oh; Received May 25, 2017 Accepted August 9, 2017 Published online August 9, 2017; [Accepted]

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Abstract: Pupil-involving oculomotor nerve palsy (ONP) is frequently associated with compressive lesion such as intracranial aneurysm originating from the posterior communicating arteries. Vascular variant of posterior intracranial circulation is regarded as an uncommon cause and association between these vascular variants and intracranial hypertension has not been reported. We present an 18-year old girl with pupil-involving ONP combined with idiopathic intracranial hypertension who revealed compression of oculomotor nerve by a vascular variant of superior cerebellar artery (SCA). This is a rare case of an ONP attributed to compressive effect from an aberrant SCA affected by intracranial hypertension.

Ocular Vestibular Evoked Myogenic Potentials Produced by Stimulation With Bone-conducted Vibration in Healthy Subjects: Tae Ho Yang, Sun Young Oh, Tae Woo Kim, Byoung Soo Shin, Jun Young Lee, Seul Ki Jeong, Man Wook Seo; Res Vestib Sci. 2012;11(3):97-104.

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Abstract PDF: Background and Objectives: To provide the empirical basis for using ocular vestibular evoked myogenic potentials (oVEMPs) in response to bone-conducted vibration (BCV) stimulation to indicate vestibular function in normal subjects. Materials and Methods: In response to bone-conducted tone burst (90 dB nHL and 100 dB nHL with frequencies 500 Hz and 1,000 Hz, the oVEMPs were measured in 45 healthy controls. The early negative component (n10) of the oVEMP to brief BCV of the forehead and at each mastoid process is recorded by surface electromyography electrodes just beneath the eyes. We used a hand-held vibrator (Bruel and Kjaer 4810 Mini-Shaker) placed on the forehead, in the midline at the hairline (Fz) and at each mastoid process and quantified the individual differences in n10 magnitude, latency and symmetry to Fz and mastoid BCV at each frequency. Results: In normal subjects, n10 responses were symmetrical in the two eyes during Fz and both mastoid stimuli and the latencies of the onset were consistent among subjects. Response rate is similar between Fz and mastoid stimuli. However, at each stimulation site, response rate is higher on 500 Hz than on 1,000 Hz stimulation. During the mastoid stimuli, the onset latency is slightly shorter and amplitude is larger than the Fz stimuli. The average amplitudes decreased with age and average latency (to peak) increased slightly with increasing age. Conclusion: Clear oVEMP responses to bone-conducted Fz and mastoid stimuli were evoked from normal subjects. It is concluded that bone-conducted stimuli as well as air conduction can evoke myogenic potentials from the ocular muscles.

Downbeat, Gaze-evoked and Perverted Head-shaking Nystagmus Associated with Dapsone Toxicity: Tae Woo Kim, Sun Young Oh, Ha Cheol Choi, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim; Res Vestib Sci. 2009;8(2):161-163.

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Abstract PDF: Dapsone is an agent commonly used to treat leprosy and its most common adverse effect is a hemolytic anemia. We present a patient who showed transient downbeat, bilateral horizontal gaze-evoked nystagmus (GEN), and perverted head-shaking nystagmus after taking a large dose of dapsone. These oculomotor abnormalities are assumed to be a reversible vestibulocerebellar dysfunction caused by over-dose of dapsone.

Metronidazole-induced Reversible Cerebellopathy: Ha Cheol Choi, Sun Young Oh, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim; Res Vestib Sci. 2009;8(2):132-136.

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Abstract PDF: Metronidazole is a nitroimidazole antibiotic used for anaerobic infections, protozoan infections, and Helicobacter pylori infections. It may produce rare but well known neurological adverse effects including peripheral neuropathy, encephalopathy, cerebellar dysfunction, and seizures. We describe three patients with metronidazole-induced reversible cerebellar dysfunctions characterized by abnormal oculomotor findings, dysmetria, and ataxia. The diagnosis of metronidazole toxicity was made clinically and supported by the brain MRI findings. The neurological signs and abnormal signal intensity on MRI resolved after discontinuation of metronidazole.

Two Cases of Methyl Bromide Intoxication Mimicking Bickerstaff’s Brainstem Encephalitis: Jin Young Seo, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim, Sun Young Oh; J Korean Bal Soc. 2008;7(2):199-203.

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Abstract PDF: Background: Methyl bromide is toxic to the central and peripheral nervous systems. Two patients with occupational exposure to this agent are described. Case: Two cases of previously healthy young men were involved. They had worked in a fumigating plant spraying fruits using methyl bromide for several months before admission. They showed general weakness, severe ataxia, bilateral dysmetria and bilateral lateral gaze limitation. And gaze-evoked nystagmus was observed in one of them. Brain MRI showed symmetrically increased signal intensity lesions including the brainstem, cerebellum and splenium of corpus callosum. After conservative treatment, they gradually improved over the next few weeks. Conclusions: Symmetry and topography of our patients’ clinical and radiographic abnormalities support the proposal that methyl bromide exposure can produce symptoms similar to Bickerstaff’s brainstem encephalitis. Key words: Methyl bromide, Acute intoxication, Bickerstaff’s brainstem encephalitis

Two Cases of Congenital Ocular Motor Apraxia Associated With Cerebellar Vermian Dysplasia: Jin Young Seo, Yeon Hee Lee, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim, Sun Young Oh; J Korean Bal Soc. 2008;7(1):63-67.

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Abstract PDF: Congenital ocular motor apraxia is a rare syndrome characterized by rotational head thrusts that attempt to compensate for the lack of voluntary eye movements. We describe the clinical, oculographic and magnetic resonance imaging features of two children with congenital ocular motor apraxia.

Third Nerve Palsy in Idiopathic Hypereosinophilic Syndrome: Report of Two Cases: Mi Hye Lim, Byoung Soo Shin, Young Hyun Kim, Sun Young Oh; J Korean Bal Soc. 2007;6(2):234-238.

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Abstract PDF: The idiopathic hypereosinophilic syndrome (IHES) is a heterogenous spectrum of disorders, characterized by a long lasting hypereosinophilia without identifiable underlying cause and by the presence of various end-organ dysfunction. The neurologic manifestations of IHES can be encephalopathy, organic psycho syndrome and polyneuropathy and in rare cases polymyositis. Central nervous system involvement is the second mostclinically important complication of the hypereosinophilic syndrome as it is associated with chronic disability and a poor prognosis. In this report, we describe two patients of IHES who presented anisolated third nerve palsy with pupillary involvement and were improved by corticosteroid therapy. They satisfied the criteria of IHES and the third cranial nerve was the only site of neurologic involvement. Early recognition of neurologic involvement in IHES and prompt treatment could lead to good outcome.

Novel Mutation in FRMD7 Gene in X-linked Congenital Nystagmus: Sun Young Oh, Byoung Soo Shin, Man Wook Seo, Chang Seok Ki, Jeong Min Hwang, Ji Soo Kim; J Korean Bal Soc. 2007;6(2):155-160.

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Abstract PDF: Background and Objectives: Congenital nystagmus (CN) is an ocular oscillation that usually manifests during early infancy. To report a novel mutation in FERM domain containing 7 (FRMD7) gene in a Korean family with CN. Materials and Methods: Genomic DNA was prepared from peripheral blood leukocytes and direct sequencing of the entire coding and adjacent intronic regions was performed to detect sequence variation of FRMD7 gene, where mutations were found recently in patients with familial CN. The family showed an X-linked pattern of inheritance without father-to-son transmission. Results: Three family members with CN exhibited two sequence variations which were a novel mutation (c. 875T>C; Leu292Pro) and a polymorphism (c. 1403G>A; Arg468His, dbSNP rs#6637934). The proband was hemizygous for both variations and his mother and maternal grandmother were heterozygous carriers. Conclusion: This study provides an additional evidence for mutations in FRMD7 as a common cause of X-linked CN and expands its mutation spectrum.

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