Research in Vestibular Science

Differential Diagnosis of the Acute Vestibular Syndrome: Sung-Hee Kim; Res Vestib Sci. 2021;20(1):7-16. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.7

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Abstract PDF: Acute vestibular syndrome refers to the rapid onset of vertigo, nausea, vomiting, and unsteady gait. Acute unilateral vestibular neuritis is the most common cause of acute vestibular syndrome. However, vascular lesions involving the brainstem and cerebellum also produce acute vestibular syndrome even without other neurologic deficits. The vestibular nucleus or nucleus prepositus hypoglossi in the dorsal portion of the brainstem, cerebellar structures including flocculus, tonsil, and nodulus, and cerebellar peduncle can produce isolated vertigo and imbalance when damaged. Early recognition of the pseudo-vestibular neuritis of the vascular etiology is warranted for clinicians.

Vascular Origin of Central Vertigo: Brainstem: Sun-Uk Lee; Res Vestib Sci. 2021;20(1):1-6. Published online March 11, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.1.1

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Various neurotologic findings can be observed in stroke involving the brainstem. Analyses of the neurotologic findings are important in brainstem stroke since it can have negative diffusion-weighted image, as well as, presenting with acute vestibular syndrome in isolation without any associated neurologic deficits. In this review we discuss the neurotologic findings from lesion involving (1) the medial vestibular nucleus, (2) nucleus prepositus hypoglossi, (3) inferior cerebellar peduncle, (4) medial longitudinal fasciculus, (5) rostral interstitial nucleus of the medial longitudinal fasciculus, (6) interstitial nucleus of Cajal, and (7) middle and (8) superior cerebellar peduncles. It is important to recognize these specific neurotologic findings depending on the neural structures involved that may guide early detection and proper management.

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A Case of Ramsay Hunt Syndrome Showing Central Findings due to Brainstem Involvement
Min Hyuk Lee, Min-Beom Kim
Research in Vestibular Science.2023; 22(4): 120. CrossRef

Developmental Venous Anomalies of the Brainstem Associated with Spontaneous Vertigo: A Case Report: Min Pyo Hong, Young Kyun Hur, Yeon Su Jeong, Gi-Sung Nam; Res Vestib Sci. 2020;19(4):133-137. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.133

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Abstract PDF: Developmental venous anomalies (DVAs), previously known as central nervous system venous angioma, are the commonly encountered benign vascular malformations. Unlike cerebellar DVAs, isolated brainstem DVAs is a rare condition, and there have been limited case reports of symptomatic and uncomplicated DVAs of the brainstem described in the literature. We present the exceptional case of spontaneous vertigo accompanied by moderate temporal headache associated with pontine DVAs. To the best of our knowledge, this is one of the first documented cases of DVAs as a possible cause of spontaneous recurrent vertigo.

Is the Auditory Brainstem Response Diagnostic for Vestibular Paroxysmia?: Ju Han Lee, Sung-Kwang Hong, Hyung-Jong Kim, Hyo-Jeong Lee; Res Vestib Sci. 2018;17(2):55-59. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.55

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Abstract PDF

Objectives
Vestibular paroxysmia (VP) of the eighth cranial nerve is characterized by recurrent auditory and vestibular disturbances when a proximal part of the eighth cranial nerve is continuously pressed by a vessel. A detailed history and several ancillary diagnostic tools, such as tinnitogram, caloric test, auditory brainstem response (ABR) and magnetic resonance imaging, are used for diagnosis of VP. Among them, although Møller criteria using ABR is a simple method, the previous study is insufficient. Therefore, this study aimed to evaluate ABR’s diagnostic value of VP.
Methods
ABR records of the 14 patients (patient group) who were diagnosed with VP and 45 patients (as control) who were diagnosed with only tinnitus were reviewed retrospectively. We analyzed the differences in Møller criteria between 2 groups.
Results
Mean age of the patient group was 52.9 years old and the control group was 55.4 years old. As compared with the control group, there were no significant differences of Møller 3 criteria contents (peak II wave amplitude＜33% [35.7% vs. 15.5%, p=0.133], interpeak latency I–III ≥2.3 msec [42.8% vs. 35.5%, p=0.622]), Contralateral interpeak latency III–V ≥2.2 msec (0% vs. 4.4%, p=1.000) in patient group.
Conclusion
There was no significant difference of ABR parameters according to the Møller criteria between patient and control groups.

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Application of ABR in pathogenic neurovascular compression of the 8th cranial nerve in vestibular paroxysmia
Huiying Sun, Xu Tian, Yang Zhao, Hong Jiang, Zhiqiang Gao, Haiyan Wu
Acta Neurochirurgica.2022; 164(11): 2953. CrossRef
The Effects of Different Reference Methods on Decision-Making Implications of Auditory Brainstem Response
Zhenzhen Liu, Xin Wang, Mingxing Zhu, Yuchao He, Lin Li, Li Chen, Weimin Huang, Zhilong Wei, Shixiong Chen, Yan Chen, Guanglin Li, Plácido R. Pinheiro
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef
The Effects of Random Stimulation Rate on Measurements of Auditory Brainstem Response
Xin Wang, Mingxing Zhu, Oluwarotimi Williams Samuel, Xiaochen Wang, Haoshi Zhang, Junjie Yao, Yun Lu, Mingjiang Wang, Subhas Chandra Mukhopadhyay, Wanqing Wu, Shixiong Chen, Guanglin Li
Frontiers in Human Neuroscience.2020;[Epub] CrossRef

Associated Symptoms in Dizziness: Hearing Loss and Tinnitus: Mi Na Park, Myung-Whan Suh; Res Vestib Sci. 2013;12:S16-S23. Published online June 1, 2013

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Abstract PDF: Dizziness is one of the most common complaint leading patients to visit their primary care physicians in older people. Despite its frequency, symptoms of dizziness can be difficult for the physician to categorize. Also many dizzy patients have hearing loss. The evaluation of patients with dizziness depends on not only the history of dizziness, physical findings but also basic laboratory tests such as audiometry, electrocochleogram, Cochlear hydrops analysis masking procedure, auditory brainstem response. Based on these considerations, this article outlines the interpretation of basic audiologic tests which is fundamental in evaluating dizzy patients.

A Case of inferior vestibular schwannoma which was lately diagnosed due to normal hearing level: Chang Jae Choi, Hyung Jin Chun, Hak Chun Lee, Sung Won Chae; J Korean Bal Soc. 2008;7(2):213-217.

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Abstract PDF: Vestibular schwannoma is a benign tumor arising from the Schwann cells in the vestibular nerve. It causes unilateral hearing loss, tinnitus, vertigo and unsteadiness. The most common symptom is reduced hearing on the affected side. In most cases patients present complaining of hearing impairment or vertigo from which the otologist can get a clue to diagnose vestibular schwannoma. We experienced an unusual case of 45-year-old woman presented with recurrent mild dizziness without any hearing loss so the patient initially diagnosed with recurrent vestibulopathy. However, subsequent neurotologic evaluation and posterior fossa MRI scanning confirmed diagnosis of huge vestibular schwannoma originated from inferior vestibular nerve. Key words: Vestibular schwannoma, Dizziness, Hearing loss, Auditory brainstem response

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

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