Journal articles on the topic 'Vestibular'
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1
Panichi, R., M. Faralli, R. Bruni, A. Kiriakarely, C. Occhigrossi, A. Ferraresi, A. M. Bronstein, and V. E. Pettorossi. "Asymmetric vestibular stimulation reveals persistent disruption of motion perception in unilateral vestibular lesions." Journal of Neurophysiology 118, no. 5 (November 1, 2017): 2819–32. http://dx.doi.org/10.1152/jn.00674.2016.
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Self-motion perception was studied in patients with unilateral vestibular lesions (UVL) due to acute vestibular neuritis at 1 wk and 4, 8, and 12 mo after the acute episode. We assessed vestibularly mediated self-motion perception by measuring the error in reproducing the position of a remembered visual target at the end of four cycles of asymmetric whole-body rotation. The oscillatory stimulus consists of a slow (0.09 Hz) and a fast (0.38 Hz) half cycle. A large error was present in UVL patients when the slow half cycle was delivered toward the lesion side, but minimal toward the healthy side. This asymmetry diminished over time, but it remained abnormally large at 12 mo. In contrast, vestibulo-ocular reflex responses showed a large direction-dependent error only initially, then they normalized. Normalization also occurred for conventional reflex vestibular measures (caloric tests, subjective visual vertical, and head shaking nystagmus) and for perceptual function during symmetric rotation. Vestibular-related handicap, measured with the Dizziness Handicap Inventory (DHI) at 12 mo correlated with self-motion perception asymmetry but not with abnormalities in vestibulo-ocular function. We conclude that 1) a persistent self-motion perceptual bias is revealed by asymmetric rotation in UVLs despite vestibulo-ocular function becoming symmetric over time, 2) this dissociation is caused by differential perceptual-reflex adaptation to high- and low-frequency rotations when these are combined as with our asymmetric stimulus, 3) the findings imply differential central compensation for vestibuloperceptual and vestibulo-ocular reflex functions, and 4) self-motion perception disruption may mediate long-term vestibular-related handicap in UVL patients. NEW & NOTEWORTHY A novel vestibular stimulus, combining asymmetric slow and fast sinusoidal half cycles, revealed persistent vestibuloperceptual dysfunction in unilateral vestibular lesion (UVL) patients. The compensation of motion perception after UVL was slower than that of vestibulo-ocular reflex. Perceptual but not vestibulo-ocular reflex deficits correlated with dizziness-related handicap.
2
Tien, Hui-Chi, and Fred H. Linthicum. "Histopathologic Changes in the Vestibule after Cochlear Implantation." Otolaryngology–Head and Neck Surgery 127, no. 4 (October 2002): 260–64. http://dx.doi.org/10.1067/mhn.2002.128555.
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OBJECTIVE: The study goal was to determine the histopathologic changes of the vestibular end organs after cochlear implantation and to relate them to clinical performance. STUDY DESIGN: To differentiate the effect of implantation from the disease process that originally destroyed the hearing, 11 pairs of temporal bones from unilateral implantees were studied with light microscopy to compare the vestibular damage in the implanted ears with that in the nonimplanted ears. RESULTS: Significant histopathologic damage of the vestibular end organs was noted in 6 patients (54.5%). The major histopathologic findings were fibrosis in the vestibule, saccule membrane distortion, new bone formation, and reactive neuromas. The scala vestibuli involvement, as a result of damage to the osseous spiral lamina or basilar membrane in cochlear basal turn, was highly correlated with vestibular damage (75%). CONCLUSIONS: Although the clinical incidence of balance disturbance after cochlear implantation is low, damage of the vestibular end organs may occur and be asymptomatic. Keeping the electrode array in the scala tympani will minimize vestibular damage.
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Sudhoff, Holger, Hans Björn Gehl, Ercan Boga, Stefan Müller, Katharina Wilms, Sven Mutze, and Ingo Todt. "Stapes Prosthesis Length: One Size Fits All?" Audiology and Neurotology 24, no. 1 (2019): 1–7. http://dx.doi.org/10.1159/000494915.
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Background: The insertion of the stapes piston into the vestibule provides the physical basis for a successful stapedotomy. In routine clinical practice, two different ways to handle prosthesis length are performed: (1) an individualized measurement of the stapes prosthesis length or (2) a standard prosthesis length for all cases. Objective: The objective of this study was to compare both ways of handling prosthesis length and the effect of these methods on insertional prosthesis depth. Material and Method: We retrospectively evaluated 39 patients after performing a stapedotomy for radiologically estimated vestibular stapes prosthesis insertion depth. The individual measured length data were hypothetically changed to a standard length of 4.75, 5, 5.25, and 5.5 mm, and the insertion depths were compared. Results: The individually measured prosthesis lengths led to an insertion depth between 0.2 and 1.6 mm (mean 0.74 mm). The ratio of insertion depth/vestibular depth was between 8 and 59.1% (mean 26.6%). The different assumed standard lengths led to different rates of the vestibulum positions and possible bony contacts at the vestibulum floor. Conclusion: The individual measurement led to a zero rate of the vestibulum positions of stapes prosthesis pistons with a low insertion depth/vestibular depth ratio.
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Lee, Ju-Young, and Jeong-Yoon Choi. "Anatomic and Physiologic Properties and Clinical Manifestations ofVestibulo-Autonomic Reflexes." Journal of the Korean Neurological Association 40, no. 4 (November 1, 2022): 287–95. http://dx.doi.org/10.17340/jkna.2022.4.1.
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The vestibular nervous system senses linear and angular acceleration upon the head during postural change and generates vestibular nerve activity changes. The autonomic nervous system regulates involuntary physiologic processes throughout the peripheral and central nervous systems. The vestibular and autonomic systems interplay throughout several brain regions to maintain homeostasis during the postural changes, called vestibulo-autonomic reflex. In this review, we first contemplated the anatomic and physiologic properties of vestibulo-autonomic reflex, focusing on the relationship between vestibular and cardiovascular systems and between the vestibular and respiratory systems and the role of the brainstem and cerebellum on the vestibulo-autonomic reflex. Then, we summarized the autonomic dysfunction reported in patients with various vestibular disorders, such as acute unilateral vestibulopathy, benign paroxysmal positional vertigo, Meniere’s disease, and persistent perceptual postural dizziness. Finally, we described the mechanism of autonomic manifestation in vestibular disorders in detail using the recently proposed mechanism of vestibular syncope integrating the vestibular system, brainstem and cerebellum, and autonomic system functions.
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Wang, Yue, and Qi Guo. "Progress in Research on Vestibular Rehabilitation Therapy." Infection International 5, no. 4 (December 1, 2016): 119–24. http://dx.doi.org/10.1515/ii-2017-0142.
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AbstractThe deterioration of vestibular function is a side effect of numerous diseases of the inner ear. Vertigo is the most common symptom of vestibular dysfunction. Vestibule-suppressing drugs can control symptoms but impede the rehabilitation of vestibular function. Surgical treatment can effectively resolve vestibular dysfunction associated with some progressive diseases, including tumors. However, unilateral vestibular function remains permanently damaged after surgery, causing problems like vertigo and imbalance. To enhance the understanding of Vestibular rehabilitation therapy, this paper presents a summary of the progress in research on Vestibular rehabilitation therapy for patients with vestibular dysfunction.
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Saadat, Daryoush, Dennis P. O'Leary, Jack L. Pulec, and Hiroya Kitano. "Comparison of Vestibular Autorotation and Caloric Testing." Otolaryngology–Head and Neck Surgery 113, no. 3 (September 1995): 215–22. http://dx.doi.org/10.1016/s0194-5998(95)70109-5.
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The two most common stimuli of the vestibular system for diagnostic purposes are caloric and rotational head movements. Caloric stimulation, by delivering thermal energy to the lateral semicircular canal, is a well-studied method of vestibular testing, and its clinical usefulness has been established. Vestibular autorotation testing uses high-frequency (2 to 6 Hz), active head movements to stimulate the horizontal and vertical vestibulo-ocular reflex to produce measurable eye movements that can be used to calculate gain and phase. We compared the alternate bilateral bithermal caloric results with the vestibular autorotation test results obtained from 39 patients with peripheral vestibular disorders and from 10 patients with acoustic neuroma. In the peripheral disorder group, only 2 of 14 patients with equal caloric response (<20% reduced vestibular response) had a normal vestibular autorotation test result. No patients with a reduced vestibular response greater than 21% had a normal vestibular autorotation test result. In the acoustic neuroma group, four patients had a normal reduced vestibular response, but all patients had an abnormal vestibular autorotation test result. We conclude that testing both the horizontal and vertical vestibulo-ocular reflexes in their physiologic frequency range with the vestibular autorotation test provides additional information that could be missed by conventional caloric testing. Therefore high-frequency rotational testing is a valuable addition to the vestibular test battery.
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Abe, Chikara, Kunihiko Tanaka, Chihiro Awazu, and Hironobu Morita. "Galvanic vestibular stimulation counteracts hypergravity-induced plastic alteration of vestibulo-cardiovascular reflex in rats." Journal of Applied Physiology 107, no. 4 (October 2009): 1089–94. http://dx.doi.org/10.1152/japplphysiol.00400.2009.
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Recent data from our laboratory demonstrated that, when rats are raised in a hypergravity environment, the sensitivity of the vestibulo-cardiovascular reflex decreases. In a hypergravity environment, static input to the vestibular system is increased; however, because of decreased daily activity, phasic input to the vestibular system may decrease. This decrease may induce use-dependent plasticity of the vestibulo-cardiovascular reflex. Accordingly, we hypothesized that galvanic vestibular stimulation (GVS) may compensate the decrease in phasic input to the vestibular system, thereby preserving the vestibulo-cardiovascular reflex. To examine this hypothesis, we measured horizontal and vertical movements of rats under 1-G or 3-G environments as an index of the phasic input to the vestibular system. We then raised rats in a 3-G environment with or without GVS for 6 days and measured the pressor response to linear acceleration to examine the sensitivity of the vestibulo-cardiovascular reflex. The horizontal and vertical movement of 3-G rats was significantly less than that of 1-G rats. The pressor response to forward acceleration was also significantly lower in 3-G rats (23 ± 1 mmHg in 1-G rats vs. 12 ± 1 mmHg in 3-G rats). The pressor response was preserved in 3-G rats with GVS (20 ± 1 mmHg). GVS stimulated Fos expression in the medial vestibular nucleus. These results suggest that GVS stimulated vestibular primary neurons and prevent hypergravity-induced decrease in sensitivity of the vestibulo-cardiovascular reflex.
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Silva, Tatiana Rocha, Luciana Macedo de Resende, and Marco Aurélio Rocha Santos. "Potencial evocado miogênico vestibular ocular e cervical simultâneo em indivíduos normais." CoDAS 28, no. 1 (February 2016): 34–40. http://dx.doi.org/10.1590/2317-1782/20162015040.
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RESUMO Objetivo: Caracterizar o registro e analisar os resultados do potencial evocado miogênico vestibular cervical e ocular combinado em indivíduos sem queixas auditivas e vestibulares. Métodos: Participaram da pesquisa 30 indivíduos sem queixa auditiva e com audição dentro dos padrões de normalidade. A coleta de dados foi realizada por meio do potencial evocado miogênico vestibular cervical e ocular registrados simultaneamente. Resultados: Houve diferença entre as orelhas direita e esquerda para a amplitude das ondas P13 e N23 do potencial evocado miogênico vestibular cervical e para a latência da onda N10 do potencial evocado miogênico vestibular ocular. No gênero feminino não houve diferença entre as orelhas direita e esquerda para a amplitude das ondas P13, N23, N10, P15, interamplitude no potencial evocado miogênico vestibular cervical e interamplitude no potencial evocado miogênico vestibular ocular e para a latência das ondas P13, N23, N10 e P15. No gênero masculino houve diferença entre as orelhas direita e esquerda para a amplitude da onda P13. Conclusão: Os resultados do potencial evocado miogênico vestibular cervical e ocular combinado foram consistentes, uma vez que as respostas geradas pelos potenciais evocados miogênicos vestibulares apresentaram morfologia, latência e amplitude adequadas, o que permite a avaliação da via vestibular ipsilateral descendente e da via vestibular contralateral ascendente.
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Böhmer, Andreas, and Ugo Fisch. "Clinical Pathophysiology of Vestibular Neurectomy." Otolaryngology–Head and Neck Surgery 112, no. 1 (January 1995): 183–88. http://dx.doi.org/10.1016/s0194-59989570318-7.
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This study attempts to characterize the residual vestibular function remaining after incomplete supralabyrinthine vestibular neurectomy performed for disabling vertigo. Patients with bilateral vestibular neurectomy had preserved horizontal vestibulo-ocular reflexes in response to high angular accelerations with gain enhancement over time. A torsional down-beating spontaneous nystagmus and an important tilt of the subjective vertical were observed when the remaining eighth nerve was sectioned after homolateral incomplete supralabyrinthine vestibular neurectomy. These findings suggest that a reorganization of vestibular reflexes may occur after incomplete supralabyrinthine vestibular neurectomy if afferents of the inferior vestibular branch are partially spared. The vestibular function after incomplete supralabyrinthine vestibular neurectomy does not affect the postoperative control of vertiginous attacks and may have positive effects in case of deterioration of the contralateral inner ear.
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Furman, Joseph M., Li-Chi Hsu, Susan L. Whitney, and Mark S. Redfern. "Otolith-ocular responses in patients with surgically confirmed unilateral peripheral vestibular loss." Journal of Vestibular Research 13, no. 2-3 (October 1, 2003): 143–51. http://dx.doi.org/10.3233/ves-2003-132-309.
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The chronic effects of unilateral peripheral vestibular loss (UPVL) are influenced by vestibular compensation. This study documents the balance-related symptoms and quantitative vestibular laboratory testing of 20 patients with surgically confirmed UPVL. Included are measures of the semicircular canal-ocular reflex, the otolith-ocular reflex, and both static and dynamic semicircular canal-otolith-interaction. This study differs from previous studies of patients with UPVL in that a large number of patients with surgically confirmed lesions were tested with three types of off-vertical axis rotation, several of the patients had anatomically preserved superior vestibular nerves, and self-perceived level of disability related to dizziness and imbalance were available. Results confirmed previously reported changes in the vestibulo-ocular reflex of patients with UPVL. Also, there was no apparent effect of anatomically preserving the superior vestibular nerve during surgical resection of vestibular schwannomas based on either subjective or objective measures of vestibular dysfunction. Further, there were no apparent correlations between subjective measures of dizziness and imbalance and objective measures of vestibulo-ocular function. These results have clinical implications for the management of patients with unilateral vestibular loss and provide insights into the process of vestibular compensation especially with respect to the otolith-ocular reflex.
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Newlands, Shawn D., and Min Wei. "Tests of linearity in the responses of eye-movement-sensitive vestibular neurons to sinusoidal yaw rotation." Journal of Neurophysiology 109, no. 10 (May 15, 2013): 2571–84. http://dx.doi.org/10.1152/jn.00930.2012.
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The rotational vestibulo-ocular reflex in primates is linear and stabilizes gaze in space over a large range of head movements. Best evidence suggests that position-vestibular-pause (PVP) and eye-head velocity (EHV) neurons in the vestibular nuclei are the primary mediators of vestibulo-ocular reflexes for rotational head movements, yet the linearity of these neurons has not been extensively tested. The current study was undertaken to understand how varying magnitudes of yaw rotation are coded in these neurons. Sixty-six PVP and 41 EHV neurons in the rostral vestibular nuclei of 7 awake rhesus macaques were recorded over a range of frequencies (0.1 to 2 Hz) and peak velocities (7.5 to 210°/s at 0.5 Hz). The sensitivity (gain) of the neurons decreased with increasing peak velocity of rotation for all PVP neurons and EHV neurons sensitive to ipsilateral rotation (type I). The sensitivity of contralateral rotation-sensitive (type II) EHV neurons did not significantly decrease with increasing peak velocity. These data show that, like non-eye-movement-related vestibular nuclear neurons that are believed to mediate nonlinear vestibular functions, PVP neurons involved in the linear vestibulo-ocular reflex also behave in a nonlinear fashion. Similar to other sensory nuclei, the magnitude of the vestibular stimulus is not linearly coded by the responses of vestibular neurons; rather, amplitude compression extends the dynamic range of PVP and type I EHV vestibular neurons.
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Demer, Joseph L. "Evaluation of Vestibular and Visual Oculomotor Function." Otolaryngology–Head and Neck Surgery 112, no. 1 (January 1995): 16–35. http://dx.doi.org/10.1016/s0194-59989570301-2.
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The visual system interacts synergistically with the vestibular system. A normally functioning vestibulo-ocular reflex is necessary but not sufficient for optimum visual acuity during head motion. Studies of dynamic visual acuity, the acuity achieved during relative motion of visual targets or of the observer, indicate that motion of images on the retina markedly compromises vision. The vestibulo-ocular reflex normally provides a substantial measure of stabilization of the retina during head movements, but purely vestibular compensatory eye movements are not sufficiently precise for optimal vision under all circumstances. Other mechanisms, including visual tracking, motor preprogramming, prediction, and mental set, interact synergistically to optimize the gain (eye velocity divided by head velocity) of compensatory head movements. All of these mechanisms are limited in their capacity to produce effective visual-vestibular interaction at higher rotational frequencies and velocities. It is under these conditions that vestibular deficits give rise to symptoms of oscillopsia. Patients having vestibular lesions exploit mechanisms of visual-vestibular interaction to compensate by substitution for deficient vestibular function. Thus, for accurate topographic clinical diagnosis of vestibular lesions, testing conditions should isolate purely vestibular responses. This may be done by testing reflex eye movements during passively generated rotations in darkness, or perhaps by testing during other types of motion under conditions of extreme frequency and velocity sufficient to attenuate the effects of visual-vestibular interaction. This article reviews clinical tests of vestibular function in relation to synergistic interactions with vision.
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Lev-Sagie, Ahinoam, Osnat Wertman, Yoav Lavee, and Michal Granot. "Vestibular Anatomic Localization of Pain Sensitivity in Women with Insertional Dyspareunia: A Different Approach to Address the Variability of Painful Intercourse." Journal of Clinical Medicine 9, no. 7 (June 27, 2020): 2023. http://dx.doi.org/10.3390/jcm9072023.
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The pathophysiology underlying painful intercourse is challenging due to variability in manifestations of vulvar pain hypersensitivity. This study aimed to address whether the anatomic location of vestibular-provoked pain is associated with specific, possible causes for insertional dyspareunia. Women (n = 113) were assessed for “anterior” and “posterior” provoked vestibular pain based on vestibular tenderness location evoked by a Q-tip test. Pain evoked during vaginal intercourse, pain evoked by deep muscle palpation, and the severity of pelvic floor muscles hypertonicity were assessed. The role of potential confounders (vestibular atrophy, umbilical pain hypersensitivity, hyper-tonus of pelvic floor muscles and presence of a constricting hymenal-ring) was analyzed to define whether distinctive subgroups exist. Q-tip stimulation provoked posterior vestibular tenderness in all participants (6.20 ± 1.9). However, 41 patients also demonstrated anterior vestibular pain hypersensitivity (5.24 ± 1.5). This group (circumferential vestibular tenderness), presented with either vestibular atrophy associated with hormonal contraception use (n = 21), or augmented tactile umbilical-hypersensitivity (n = 20). The posterior-only vestibular tenderness group included either women with a constricting hymenal-ring (n = 37) or with pelvic floor hypertonicity (n = 35). Interestingly, pain evoked during intercourse did not differ between groups. Linear regression analyses revealed augmented coital pain experience, umbilical-hypersensitivity and vestibular atrophy predicted enhanced pain hypersensitivity evoked at the anterior, but not at the posterior vestibule (R = 0.497, p < 0.001). Distinguishing tactile hypersensitivity in anterior and posterior vestibule and recognition of additional nociceptive markers can lead to clinical subgrouping.
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Talkowski, Michael E., Mark S. Redfern, J. Richard Jennings, and Joseph M. Furman. "The Role of Attention in Vestibular Processing." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 46, no. 3 (September 2002): 255–59. http://dx.doi.org/10.1177/154193120204600308.
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This study investigated the hypothesis that vestibular processing is facilitated by attention, and that suppression of the vestibule-ocular reflex will lead to dual-task interference in a secondary information processing task. Twelve patients with surgically confirmed absent unilateral vestibular function and twelve healthy age-matched controls participated in this study. All subjects underwent vestibular stimulation through two different types of rotational conditions, one a semicircular canal stimulus and the other an otolith stimulus, two different visual conditions (darkness and fixation of a laser point) and pursuit tracking of a moving laser point. Subjects also performed one of three different secondary information processing tasks (IPT) while undergoing the vestibular condition. The results of this study showed that dual-task interference occurs during vestibular stimulation in both patients and healthy controls, and this interference was more pronounced in patients during more complex IPTs. The results also found no overall difference in performance of a secondary cognitive task when subjects suppressed the vestibule-ocular reflex by fixating during rotation. These results may suggest that cognitive processing is a necessary component for integration of vestibular information, and this requirement may be greater in patients with unilateral vestibular loss.
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Barakat, Khaled, and Aya Ali. "Thermoplastic Vestibuloplasty: A Novel Technique for Treatment of Lip and Cheek Adhesion." Craniomaxillofacial Trauma & Reconstruction 7, no. 4 (December 2014): 258–62. http://dx.doi.org/10.1055/s-0034-1375171.
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Lip and cheek adhesion to the opposing alveolus with complete or partial loss of the vestibular dimension represents a challenging problem for reconstruction. It usually occurs due to primary inadequate vestibular soft tissue repair following complicated trauma cases, burns, and lesions of the oral cavity. Surgical removal of scar tissue and creation of new vestibule is complicated by readhesion between the opposing connective tissue surfaces. Skin grafts and acellular dermal matrix represent the most dominant modalities used to treat deficient vestibule dimensions, but they are difficult to fix and lack the required stability during healing. Several devices have been created in an attempt to keep the tissues apart but their complex anchorage methods seriously reduced their reliability and usage. We devised a simple and reliable technique “thermoplastic vestibuloplasty” (TV) that benefit from the inherent reepithelialization capabilities of the oral mucosa to prevent readhesion and to resurface the created vestibule with its exact tissue color and texture. In total, 10 patients suffering from complete or partial lip or cheek adhesion with concomitant loss of vestibule were surgically treated by excising scar tissue and creating a new vestibule, followed by TV technique. Pre and posttreatment results were compared in terms of vestibular length, lip or cheek mobility, and change by time in vestibular length from 2 weeks up to 3 months. Moreover, the patient satisfaction and outcomes were measured using visual analogue scale score. All patients tolerated the procedure without complication. The mean vestibule length and mobility significantly increased from 3.8 + 0.6 mm to 11.4 + 1.4 mm ( p < 0.001) and from 0.3 to 2 ( p < 0.001), respectively. Regarding the stability of the achieved vestibular length it decreased by 14% when compared from 2 weeks to 3 months postoperatively. TV technique is a new simple and reliable technique that can effectively prevent readhesion of opposing connective tissue surfaces until intrinsic reepithelialization can resurface the newly created vestibular tissues forming a stable vestibular length with excellent color and texture.
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Fetter, Michael, Hans-Christoph Diener, and Johannes Dichgans. "Recovery of Postural Control After an Acute Unilateral Vestibular Lesion in Humans." Journal of Vestibular Research 1, no. 4 (October 1, 1991): 373–83. http://dx.doi.org/10.3233/ves-1991-1405.
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Postural control during stance was investigated using the EQUITEST® system in 10 patients during recovery after an acute unilateral vestibular lesion and was compared to the time course of recovery of the static and dynamic vestibulo-ocular imbalance. During the acute phase the patients showed a characteristic pattern with normal upright stance as long as at least one accurate sensory input (visual or somatosensory) was provided and severe postural disturbances when they had to rely primarily on vestibular afferences. Both static vestibulo-ocular and vestibulo-spinal balance recovered very fast, showing basically normal results on postural testing within about 2 weeks after the lesion. Thereafter, no pathological pattern was detectable during postural testing even in patients with persistent complete unilateral vestibular lesions. Reflexive postural responses to unexpected rapid displacements of the support surface seemed not to be influenced by vestibular imbalance even in the acute phase of the lesion.
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Bonnard, Åsa, Eva Karltorp, and Luca Verrecchia. "Vestibular Loss in Children Affected by LVAS and IP2 Malformation and Operated with Cochlear Implant." Audiology Research 13, no. 1 (February 9, 2023): 130–42. http://dx.doi.org/10.3390/audiolres13010013.
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This is a single center cohort study regarding the prevalence of vestibular loss in hearing impaired children affected by large vestibular aqueduct syndrome (LVAS) with incomplete cochlear partition malformation type II (IP2), fitted with cochlear implant (CI). Twenty-seven children received CI operations at 0.4–13 years on one or both ears and tested for vestibular loss with head impulse test, video head impulse test, mini ice-water test and cervical VEMP. Vestibular loss was found in 19% of operated ears and in 13.9% of non-operated ears. The difference was not statistically significant and was not significantly modified by age at implantation, age at testing, sex, presence of SLC26A4 gene mutation or bilaterality. However, the presence of anatomic anomalies at the level of the vestibulum or semicircular canals was significantly associated with a higher incidence of vestibular loss in CI operated children but not in those non-operated. No other factors, such as the surgical access, the electrode type, the presence of Gusher perioperatively, or post-operative vertigo modified significantly the prevalence of vestibular loss. In conclusion, LVAS/IP2 appears to be the major determinant of vestibular loss in these children, with a less obvious impact of CI, excluding the cases with vestibulum/canal anomalies: this group might have a higher risk for vestibular loss after CI surgery.
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Macaulay, Timothy R., Scott J. Wood, Austin Bollinger, Michael C. Schubert, Mark Shelhamer, Michael O. Bishop, Millard F. Reschke, and Gilles Clément. "Comparison of Asymmetry between Perceptual, Ocular, and Postural Vestibular Screening Tests." Brain Sciences 13, no. 2 (January 23, 2023): 189. http://dx.doi.org/10.3390/brainsci13020189.
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Background: A better understanding of how vestibular asymmetry manifests across tests is important due to its potential implications for balance dysfunction, motion sickness susceptibility, and adaptation to new environments. Objective: We report the results of multiple tests for vestibular asymmetry in 32 healthy participants. Methods: Asymmetry was measured using perceptual reports during unilateral centrifugation, oculomotor responses during visual alignment tasks, vestibulo-ocular reflex gain during head impulse tests, and body rotation during stepping tests. Results: A significant correlation was observed between asymmetries of subjective visual vertical and verbal report during unilateral centrifugation. Another significant correlation was observed between the asymmetries of ocular alignment, vestibulo-ocular reflex gain, and body rotation. Conclusions: These data suggest that there are underlying vestibular asymmetries in healthy individuals that are consistent across various vestibular challenges. In addition, these findings have value in guiding test selection during experimental design for assessing vestibular asymmetry in healthy adults.
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Talkowski, M. E., M. S. Redfern, J. R. Jennings, and J. M. Furman. "Cognitive Requirements for Vestibular and Ocular Motor Processing in Healthy Adults and Patients with Unilateral Vestibular Lesions." Journal of Cognitive Neuroscience 17, no. 9 (September 2005): 1432–41. http://dx.doi.org/10.1162/0898929054985419.
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This study investigated the role of cognition in the vestibulo-ocular reflex (VOR) and ocular pursuit using a dual-task paradigm in patients with unilateral peripheral vestibular loss and healthy adults. We hypothesized that cognitive resources are involved in successful processing and integration of vestibular and ocular motor sensory information, and this requirement would be greater in patients with vestibular dys-function. Sixteen well-compensated patients with surgically confirmed absent unilateral peripheral vestibular function and 16 healthy age-and sex-matched controls underwent seven combinations of vestibular-only, visual-only, and visual-vestibular stimuli while performing three different information processing tasks. Visual-vestibular stimuli included a semi-circular canal and an otolith stimulus provided through seated chair rotations; fixation on a laser target and sinusoidal smooth pursuit while still; and fixation on a head-fixed laser target during chair rotations. The information processing tasks were three different auditory reaction time (RT) tasks: (1) simple RT (2) disjunctive RT, and (3) choice RT. Our results showed increases in RTs in both patients and controls under all vestibular-only stimulation conditions and during ocular pursuit. Patients showed greater increases in RTs during vestibular stimulation and the more complex disjunctive and choice RT tasks. No differences between the groups were found during the visual-only or visual-vestibular interaction conditions. These results reveal interference between vestibulo-ocular processing and a concurrent RT task, suggesting that the VOR and the ocular motor system are dependent upon cognitive resources to some extent, and thus, are not fully automatic systems. We speculate that this interference with cognition occurs as a result of the sensory integration required for resolving inputs from multiple sensory streams. The particularly large decrement in information processing task performance of the patients compared with controls during vestibular stimulation suggests that compensation for unilateral vestibular loss requires continued cognitive resources.
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Silva, Viviane Passarelli Ramin, Luiz Henrique Martins Castro, and Marcelo Calderaro. "Vestibular migraine." Arquivos de Neuro-Psiquiatria 80, no. 5 suppl 1 (May 2022): 232–37. http://dx.doi.org/10.1590/0004-282x-anp-2022-s111.
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ABSTRACT Vestibular migraine (VM) remains an underdiagnosed condition, often mistaken with brainstem aura. VM is defined by recurrent vestibular symptoms in at least 50% of migraine attacks. Diagnosis is established by clinical criteria based on the International Classification of Headache Disorders (ICHD-3). Estimated prevalence of VM is 1 to 2.7% of the adult population. Vestibular symptoms usually appear after the headache. VM pathophysiology remains poorly understood. Vertigo may occur before, during, after the migraine attack, or even independently, and may last seconds to hours or days. Pathophysiological mechanisms for VM are still poorly understood and are usually extrapolated from migraines. Differential diagnoses include Ménière's disease, benign paroxysmal positional vertigo, brainstem aura, transient ischemic attack, persistent perceptual postural vertigo, and episodic type 2 ataxia. Specific treatment recommendations for vestibular migraine are still scarce.
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Kim, Jin-Dong. "Neurophysiology of Vestibular Compensation." Audiology and Speech Research 19, no. 1 (January 31, 2023): 1–16. http://dx.doi.org/10.21848/asr.220082.
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Vestibular compensation is the process by which patients achieve functional recovery after vestibular lesions, and can be divided into static compensation and dynamic compensation. The first stage, static static compensation, consists of eliminating static symptoms (i.e., spontaneous nystagmus and skew deviation) by rebalancing the tonic neural activity in the vestibular nuclei. The second stage, dynamic compensation is much more subtle, takes longer, and involves a central recalibration of the response properties of the vestibulo-ocular reflex (VOR) (i.e., timing and gain) in order to restore the compensatory actions of the VOR to pre-impairment levels. This review is to introduce the normal vestibular function in humans to understand the neurophysiology of vestibular compensation after vestibular lesions, and to review the effects of various types of lesions and the clinical findings in various stages of compensation after each type of lesion. Vestibular compensation is most effective for unilateral vestibular dysfunctions in which tonic neural activity of the vestibular nucleus is rebalanced to achieve static compensation. Adaptive changes in tonic neural activity occur in the normal vestibular pathways to achieve dynamic compensation. In other types of vestibular lesions, vestibular compensation is possible, but not as effective.
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Schubert, Michael C., and Lloyd B. Minor. "Vestibulo-ocular Physiology Underlying Vestibular Hypofunction." Physical Therapy 84, no. 4 (April 1, 2004): 373–85. http://dx.doi.org/10.1093/ptj/84.4.373.
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AbstractThe vestibular system detects motion of the head and maintains stability of images on the fovea of the retina as well as postural control during head motion. Signals representing angular and translational motion of the head as well as the tilt of the head relative to gravity are transduced by the vestibular end organs in the inner ear. This sensory information is then used to control reflexes responsible for maintaining the stability of images on the fovea (the central area of the retina where visual acuity is best) during head movements. Information from the vestibular receptors also is important for posture and gait. When vestibular function is normal, these reflexes operate with exquisite accuracy and, in the case of eye movements, at very short latencies. Knowledge of vestibular anatomy and physiology is important for physical therapists to effectively diagnose and manage people with vestibular dysfunction. The purposes of this article are to review the anatomy and physiology of the vestibular system and to describe the neurophysiological mechanisms responsible for the vestibulo-ocular abnormalities in patients with vestibular hypofunction.
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Zhou, Guangwei, and L. Clarke Cox. "Vestibular Evoked Myogenic Potentials." American Journal of Audiology 13, no. 2 (December 2004): 135–43. http://dx.doi.org/10.1044/1059-0889(2004/018).
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Vestibular evoked myogenic potential (VEMP) testing is a relatively new diagnostic tool that is in the process of being investigated in patients with specific vestibular disorders. In this review, we will outline the history and provide a current review of VEMP research. Briefly, the VEMP is a biphasic response elicited by loud clicks or tone bursts recorded from the tonically contracted sternocleidomastoid muscle. Current data suggest that the VEMP is a vestibulo-collic reflex whose afferent limb arises from acoustically sensitive cells in the saccule, with signals conducted via the inferior vestibular nerve. We will review the history of the response and detail the anatomy and physiology associated with the test. We will discuss specific VEMP applications in the diagnosis of Meniere's disease, vestibular schwannoma, vestibular hypersensitivity disorders, vestibular neuritis, multiple sclerosis, and other brainstem lesions.
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Barbosa, Ana Carla Lima, Ilka do Amaral Soares, and Elizângela Dias Camboim. "Frequência de alteração vestibular em bombeiros militares de Alagoas." Revista CEFAC 16, no. 5 (October 2014): 1443–55. http://dx.doi.org/10.1590/1982-0216201414513.
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OBJETIVOS:investigar a frequência de alterações vestibulares em bombeiros de Alagoas e suas queixas.MÉTODOS:realizaram-se anamnese e avaliação audiológica, desclassificando da amostra os sujeitos com perda auditiva. Em seguida foi realizada a manobra de Dix-Hallpike e vectoeletronistagmografia. Aplicou-se o Teste Qui-Quadrado e Exato de Fisher para análise estatística, com significância de 5% (p=0,050).RESULTADOS:compuseram a amostra 26 sujeitos do gênero masculino (86,7%) e 4 feminino (13,3%), com idade variando entre 24 e 35 anos. Destes, 13 sujeitos (43,4%) apresentaram exame vestibular normal, enquanto os demais (56,6%) apresentaram alteração na prova calórica, com maior ocorrência de disfunção vestibular periférica seguida de disfunção vestibular periférica deficitária unilateral. Não houve diferença estatisticamente significante quanto à presença de alteração vestibular nem quanto à classificação dessas alterações. Comprovou-se significante diferença para queixa de tontura entre os gêneros, sendo o feminino mais propenso a apresentá-la. Não houve diferença estatisticamente significante quanto à queixa de tontura entre as faixas etárias avaliadas, havendo, entretanto, uma tendência maior para os indivíduos de idade mais elevada a apresentarem. Não houve relação estatisticamente significante entre disfunção vestibular e queixas de tontura, manifestações auditivas nem antecedentes patológicos.CONCLUSÕES:não foi encontrada uma relação estatisticamente relevante entre o grupo estudado e a alteração vestibular. Todavia, entre os bombeiros que apresentaram alteração, houve maior ocorrência de disfunção vestibular periférica seguida de disfunção vestibular periférica deficitária unilateral, sem diferença estatisticamente significante entre elas. Os bombeiros apresentaram queixas de tontura, manifestações auditivas e antecedentes patológicos sem relação estatisticamente significante com as disfunções vestibulares identificadas.
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Kanashiro, Aline Mizuta Kozoroski, Cristiana Borges Pereira, Antonio Carlos de Paiva Melo, and Milberto Scaff. "Diagnóstico e tratamento das principais síndromes vestibulares." Arquivos de Neuro-Psiquiatria 63, no. 1 (March 2005): 140–44. http://dx.doi.org/10.1590/s0004-282x2005000100025.
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Os objetivos deste estudo foram identificar as síndromes vestibulares mais comuns nos ambulatórios de vertigem, suas características clínicas e semiológicas, e observar a resposta ao tratamento específico. Foram estudados retrospectivamente 515 pacientes atendidos em ambulatórios de duas instituições e avaliados aspectos da anamnese, exame físico e a resposta ao tratamento. As síndromes mais freqüentes foram: vertigem de posicionamento paroxística benigna (VPPB) (28,5%), vertigem postural fóbica (11,5%), vertigem central (10,1%), neurite vestibular (9,7%), doença de Menière (8,5%), enxaqueca (6,4%). Houve boa resposta ao tratamento nos pacientes com enxaqueca (78,8%), VPPB (64%), neurite vestibular (62%), doença de Menière (54,5%) e paroxismia vestibular (54,5%), enquanto pacientes com nistagmo para baixo e vestibulopatia bilateral não tiveram resposta satisfatória (52,6% e 42,8% respectivamente). As síndromes vestibulares foram diagnosticadas através da anamnese e exame físico com testes clínicos específicos para avaliação da função vestibular. A identificação destas síndromes permitiu o tratamento adequado levando a uma boa evolução.
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Lee, Sun-Uk, Hyo-Jung Kim, and Ji-Soo Kim. "Bilateral Vestibular Dysfunction." Seminars in Neurology 40, no. 01 (January 14, 2020): 040–48. http://dx.doi.org/10.1055/s-0039-3402066.
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AbstractBilateral vestibular dysfunction (BVD) refers to hypofunction of the vestibular nerves or labyrinths on both sides. Patients with BVD present with dizziness, oscillopsia, and unsteadiness, mostly during locomotion, which worsen in darkness or on uneven ground. Although aminoglycoside ototoxicity, Meniere's disease, infection, and genetic disorders frequently cause BVD, the etiology remains undetermined in up to 50% of the patients. The diagnosis of BVD requires both symptoms and documentation of deficient vestibulo-ocular reflex function using head-impulse, bithermal caloric, and rotatory chair tests. Since various neurologic and systemic disorders may present with BVD, clinicians should be cautious not to overlook the symptoms and signs of central nervous system and systemic involvements. Vestibular rehabilitation, application of vibrotactile and auditory feedbacks, and vestibular prosthesis can aid the patients with BVD along with the correction of the underlying causes.
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Dy, Alexander Edward S., Akinori Kashio, Chisato Fujimoto, Makoto Kinoshita, Yayoi S. Kikkawa, Yujiro Hoshi, Kazunori Igarashi, Tsukasa Uranaka, Shinichi Iwasaki, and Tatsuya Yamasoba. "Vestibular Imaging and Function in Patients With Inner Ear Malformation Presenting With Profound Hearing Loss." OTO Open 6, no. 3 (July 2022): 2473974X2211289. http://dx.doi.org/10.1177/2473974x221128912.
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Objective Vestibular impairment has been observed in patients with congenital hearing loss, but little is known about the vestibular anatomy and function of those in this group with inner ear malformations. This study aims to investigate the association between vestibulocochlear anatomy and vestibular function test results in children with inner ear malformations. Study Design Case series with chart review. Setting Pediatric patients with inner ear malformations presenting with bilateral profound hearing loss at a tertiary hospital from 1999 to 2017. Methods Ears were classified into subgroups based on anatomic abnormalities seen on computed tomography imaging. Cervical vestibular evoked myogenic potential (cVEMP), rotatory chair, and caloric test results were obtained and collated. Descriptive and inferential statistics were calculated. Results Of 82 ears, 29.3% had incomplete partition type II malformation, the most common type. The second-most common type was isolated vestibular organ anomaly (20.7%), which is not included in currently accepted categories. Most ears exhibited abnormal vestibular function. Abnormal vestibule volume was associated with a nonreactive cVEMP ( P < .001). Radiologically abnormal lateral semicircular canals were associated with abnormal caloric and rotatory chair results ( P < .001). Conclusion With a relatively large number of cases of isolated vestibular organ anomaly not only in our study but also in previous publications, we suggest that this category be added to the subsets of inner ear malformations. Abnormal vestibule volume was significantly associated with a nonreactive cVEMP finding. The majority of patients with hearing loss secondary to inner ear malformations have abnormal vestibular function test results.
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Pompeiano, Ottavio. "Noradrenergic influences on the cerebellar cortex: Effects on vestibular reflexes under basic and adaptive conditions." Otolaryngology–Head and Neck Surgery 119, no. 1 (July 1998): 93–105. http://dx.doi.org/10.1016/s0194-5998(98)70178-0.
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Experiments performed either in decerebrate cats or in intact rabbits have shown that functional inactivation of the cerebellar anterior vermis or the flocculus decreased the basic gain of the vestibulospinal or the vestibulo-ocular reflex, respectively. These findings were attributed to the fact that a proportion of the vermal or floccular Purkinje cells, which are inhibitory in function, discharge out of phase with respect to the vestibulospinal or the vestibulo-ocular neurons during sinusoidal animal rotation, thus exerting a facilitatory influence on the gain of the vestibular reflexes. Intravermal injection of a β-noradrenergic agonist slightly increased the gain of the vestibulospinal reflex, whereas the opposite result was obtained after injection of β-antagonists. Similarly, intrafloccular injection of a β-noradrenergic agonist slightly facilitated the gain of the vestibulo-ocular reflex in darkness (but not in light), whereas a small decrease of the reflex occurred after injection of a β-antagonist. It was postulated that the noradrenergic system acts on Purkinje cells by enhancing their amplitude of modulation to a given labyrinth signal, thus increasing the basic gain of the vestibular reflexes. The Purkinje cells of the cerebellar anterior vermis and the flocculus also exert a prominent role on the adaptation of vestibulospinal and vestibulo-ocular reflexes, respectively. In particular, intravermal or intrafloccular injection of β-noradrenergic antagonists decreased or suppressed the adaptive capacity of the vestibulospinal and vestibulo-ocular reflexes that always occurred during sustained out-of-phase neck-vestibular or visual-vestibular stimulation, whereas the opposite result was obtained after local injection of a β-noradrenergic agonist. The noradrenergic innervation of the cere-bellar cortex originates from the locus coeruleus complex, whose neurons respond to vestibular, neck, and visual signals. It was postulated that this structure acts through β-adrenoceptors to increase the expression of immediate-early genes, such as c- fos and Jun-B, in the Purkinje cells during vestibular adaptation. Induction of immediate-early genes could then represent a mechanism by which impulses elicited by sustained neck-vestibular or visuovestibular stimulation are transduced into long-term biochemical changes that are required for cerebellar long-term plasticity. (Otolaryngol Head Neck Surg 1998;119:93-105.)
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Franco, Eloisa Sartori, and Ivone Panhoca. "Avaliação otoneurológica em crianças com queixa de dificuldades escolares: pesquisa da função vestibular." Revista Brasileira de Otorrinolaringologia 73, no. 6 (December 2007): 803–15. http://dx.doi.org/10.1590/s0034-72992007000600012.
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Segundo a literatura, a disfunção vestibular infantil pode afetar consideravelmente a habilidade de comunicação e o desempenho escolar. OBJETIVO: Estudar a função vestibular em crianças com dificuldades escolares e suas queixas vestibulares. ESTUDO DE CASO: Estudo Clínico com coorte transversal. MATERIAL E MÉTODOS: Foram estudadas 50 crianças entre 7 e 12 anos, que freqüentavam escolas públicas de Piracicaba durante os anos de 2004 e 2005. Os procedimentos foram: anamnese; exame otorrinolaringológico; exame audiológico e avaliação vestibular. RESULTADOS: Das crianças avaliadas, 62,0% não relataram dificuldades escolares e 38,0% referiram ter dificuldades. A queixa geral mais comum foi de tontura (36,0%), e o sintoma mais comum no ambiente escolar foi de cefaléia (50,0%). Encontramos 74,2% de exame vestibular normal nas crianças sem dificuldades escolares e 31,6% de normalidade nas crianças com dificuldades. Encontramos alterações vestibulares de origem periférica irritativa tanto unilateral como bilateral, num total de 68,4% para as crianças com dificuldades escolares e um total de 25,8% para crianças sem dificuldades escolares. CONCLUSÃO: A queixa de atordoamento, o sintoma de náuseas e as dificuldades em ler e copiar apresentaram uma relação estatisticamente significante. Todas as alterações vestibulares encontradas foram de origem periférica irritativa. Os dados revelaram uma relação estatisticamente significante.
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Minor, Lloyd B. "Physiological Principles of Vestibular Function on Earth and in Space." Otolaryngology–Head and Neck Surgery 118, no. 3_suppl (March 1998): s5—s15. http://dx.doi.org/10.1016/s0194-59989870002-6.
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Physiological mechanisms underlying vestibular function have important implications for our ability to understand, predict, and modify balance processes during and after spaceflight. The microgravity environment of space provides many unique opportunities for studying the effects of changes in gravitoinertial force on structure and function of the vestibular system. Investigations of basic vestibular physiology and of changes in reflexes occurring as a consequence of exposure to microgravity have important implications for diagnosis and treatment of vestibular disorders in human beings. This report reviews physiological principles underlying control of vestibular processes on earth and in space. Information is presented from a functional perspective with emphasis on signals arising from labyrinthine receptors. Changes induced by microgravity in linear acceleration detected by the vestibulo-ocular reflexes. Alterations of the functional requirements for postural control in space are described. Areas of direct correlation between studies of vestibular reflexes in microgravity and vestibular disorders in human beings are discussed. (Otolaryngol Head Neck Surg 1998;118:S5-S15.)
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Shrestha, Benju, Krishna Prasad Lamichhane, Shaili Pradhan, Ranjita Shrestha Gorkhali, and Pramod Kumar Koirala. "Clark’s Technique of Vestibuloplasty - A Case Report." Journal of Nepalese Society of Periodontology and Oral Implantology 4, no. 2 (December 31, 2020): 93–95. http://dx.doi.org/10.3126/jnspoi.v4i2.34305.
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Shallow vestibule can create a barrier in oral hygiene maintenance and can cause gingival recession due to the muscular traction. Inadequate vestibular depth in combination with inadequate attached gingiva is said to cause more food accumulation during mastication. Hence, shallow vestibule impeding with oral hygiene maintenance requires correction. Vestibuloplasty involves surgical procedure for repositioning of mucosa and muscle attachment thereby increasing the vestibular depth. There are various techniques of vestibuloplasty. This case report highlights upon the Clark’s technique of vestibuloplasty for correction of shallow vestibule.
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Monsell, Edwin M., Derald E. Brackmann, and Fred H. Linthicum. "Why Do Vestibular Destructive Procedures Sometimes Fail?" Otolaryngology–Head and Neck Surgery 99, no. 5 (November 1988): 472–79. http://dx.doi.org/10.1177/019459988809900505.
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Vestibular nerve specimens and one temporal bone, from patients with vestibular symptoms after destructive surgery on the vestibular system, were studied by light microscopy. Surviving nerve axons in three specimens that followed retrolabyrinthine vestibular nerve section (RLVNS) were counted and compared to normative data. Results are consistent with persistence of the central processes of primary vestibular neurons in three specimens from patients who had persistent symptoms and ice-water caloric responses after RLVNS. Incomplete neurectomy probably results from anatomic variations in the plane of separation of the vestibular and cochlear portions of the eighth nerve in the posterior fossa. Regeneration neuromas were found in the vestibule after a complete transmastoid labyrinthectomy and a Fick sacculotomy; this indicates that wide degrees of injury to the labyrinth may provoke this response. Disabling unsteadiness after labyrinthectomy may or may not respond to revision surgery (translabyrinthine vestibular nerve section). The indications for revision surgery are discussed. The excision of Scarpa's ganglion by the translabyrinthine route offers the best chance to ensure complete removal of peripheral vestibular tissue, minimize postoperative unsteadiness, and prevent neuroma formation.
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Guyot, Jean-philippe, and Georges Psillas. "Test-Retest Reliability of Vestibular Autorotation Testing in Healthy Subjects." Otolaryngology–Head and Neck Surgery 117, no. 6 (December 1997): 704–7. http://dx.doi.org/10.1016/s0194-59989770057-3.
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Vestibulo-ocular reflex rotational chair testing in the high-frequency range is seldom performed because it requires specialized and powerful systems. But today a new method of sweep-frequency vestibulo-ocular reflex testing, the Vestibular Autorotation Test system (Western Systems Research, Inc., Pasadena, Calif.), based on active head movements increasing from 2 to 6 Hz, is available on the market. The goal of this study was to evaluate the test-retest variability of this test in healthy subjects. Twelve young adults (22 to 42 years old) without any history of auditory or vestibular dysfunction were included in the study. Subjects underwent five tests under standardized conditions with a 1 -week interval. Each test consisted of three measurements of the gain and phase of the vestibulo-ocular reflex in the horizontal and vertical planes. Statistical analysis shows that the test-retest reliability of the Vestibular Autorotation Test is poor. Therefore this method cannot be used routinely to evaluate precise vestibulo-ocular reflex anomalies.
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Blakley, Brian W., Hugh O. Barber, R. David Tomlinson, Susan Stoyanoff, and Mabel Mai. "On the Search for Markers of Poor Vestibular Compensation." Otolaryngology–Head and Neck Surgery 101, no. 5 (November 1989): 572–77. http://dx.doi.org/10.1177/019459988910100511.
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The effectiveness of pursuit gain, cancellation of the vestibulo-ocular reflex, and a clinical oscillopsia test were assessed as vestibular function tests and tests that may allow prediction of which patients would compensate poorly after vestibular surgery. Cancellation of the vestibulo-ocular reflex in 17 patients and 17 control subjects was compared. Pursuit gain for 17 patients was determined for three frequencies at peak velocities of 25 and 50 degrees/sec. The oscillopsia test was administered to seven patients during at least the first 6 postoperative months. We are unable to state that any of these parameters were effective “markers” of impaired compensation, but the oscillopsia test appears to be a useful clinical tool for vestibular examination.
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Gagliuso, Amelia H., Emily K. Chapman, Giorgio P. Martinelli, and Gay R. Holstein. "Vestibular neurons with direct projections to the solitary nucleus in the rat." Journal of Neurophysiology 122, no. 2 (August 1, 2019): 512–24. http://dx.doi.org/10.1152/jn.00082.2019.
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Anterograde and retrograde tract tracing were combined with neurotransmitter and modulator immunolabeling to identify the chemical anatomy of vestibular nuclear neurons with direct projections to the solitary nucleus in rats. Direct, sparsely branched but highly varicose axonal projections from neurons in the caudal vestibular nuclei to the solitary nucleus were observed. The vestibular neurons giving rise to these projections were predominantly located in ipsilateral medial vestibular nucleus. The cell bodies were intensely glutamate immunofluorescent, and their axonal processes contained vesicular glutamate transporter 2, supporting the interpretation that the cells utilize glutamate for neurotransmission. The glutamate-immunofluorescent, retrogradely filled vestibular cells also contained the neuromodulator imidazoleacetic acid ribotide, which is an endogenous CNS ligand that participates in blood pressure regulation. The vestibulo-solitary neurons were encapsulated by axo-somatic GABAergic terminals, suggesting that they are under tight inhibitory control. The results establish a chemoanatomical basis for transient vestibular activation of the output pathways from the caudal and intermediate regions of the solitary nucleus. In this way, changes in static head position and movement of the head in space may directly influence heart rate, blood pressure, respiration, as well as gastrointestinal motility. This would provide one anatomical explanation for the synchronous heart rate and blood pressure responses observed after peripheral vestibular activation, as well as disorders ranging from neurogenic orthostatic hypotension, postural orthostatic tachycardia syndrome, and vasovagal syncope to the nausea and vomiting associated with motion sickness. NEW & NOTEWORTHY Vestibular neurons with direct projections to the solitary nucleus utilize glutamate for neurotransmission, modulated by imidazoleacetic acid ribotide. This is the first direct demonstration of the chemical neuroanatomy of the vestibulo-solitary pathway.
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Böhmer, Andreas, Dominik Straumann, and Michael Fetter. "Three-Dimensional Analysis of Spontaneous Nystagmus in Peripheral Vestibular Lesions." Annals of Otology, Rhinology & Laryngology 106, no. 1 (January 1997): 61–68. http://dx.doi.org/10.1177/000348949710600111.
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The direction of spontaneous nystagmus was recorded in three dimensions with scleral dual search coils in three patients after vestibular neurectomy and in seven patients with vestibular neuritis. The rotation vectors of the spontaneous nystagmus clustered along the sensitivity vector of the lateral semicircular canal (SCC). The direction of the spontaneous nystagmus after resection of the whole eighth nerve was not different from that after resection of only the superior branch of the vestibular nerve. Deviations from this direction were observed only after resection of the inferior vestibular nerve and in one patient with vestibular neuritis. The absence of nystagmus components in direction of the vertical SCC reflects an anisotropy of oculomotor efferents of the vestibulo—ocular reflex arc rather than alesion limited to the lateral SCC afferents. Therefore, the three-dimensional analysis of spontaneous nystagmus does not permit accurate localization of a peripheral vestibular lesion.
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Zeigelboim, Bianca Simone, Marine Raquel Diniz da Rosa, Karlin Fabianne Klagenberg, and Ari Leon Jurkiewicz. "Reabilitação vestibular no tratamento da tontura e do zumbido." Revista da Sociedade Brasileira de Fonoaudiologia 13, no. 3 (2008): 226–32. http://dx.doi.org/10.1590/s1516-80342008000300005.
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OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) e Tinnitus Handicap Inventory (THI), ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino), na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia e aplicação dos questionários pré e pós-reabilitação vestibular, utilizando-se o protocolo de Cawthorne e Cooksey. RESULTADOS: a) com relação às queixas mais referidas, observou-se desequilíbrio à marcha (83,3%), dor de cabeça (66,6%) e depressão (66,6%); b) no exame vestibular todos os pacientes apresentaram alteração na prova calórica, sendo a maior freqüência das síndromes vestibulares periféricas irritativas (83,3%); c) constataram-se no exame vestibular dois casos de síndrome vestibular periférica irritativa, dois casos de síndrome vestibular periférica irritativa unilateral; um caso de síndrome vestibular periférica irritativa bilateral e um caso de síndrome vestibular periférica deficitária unilateral; d) na aplicação do DHI, observou-se melhora nos aspectos: funcional e emocional, mantendo-se inalterado o aspecto físico; e) na aplicação do THI, observou-se melhora em todos os aspectos avaliados. CONCLUSÃO: O protocolo utilizado de reabilitação vestibular promoveu diminuição do zumbido e da tontura, melhorando a qualidade de vida dos pacientes.
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Yates, Bill J. "Autonomic reaction to vestibular damage." Otolaryngology–Head and Neck Surgery 119, no. 1 (July 1998): 106–12. http://dx.doi.org/10.1016/s0194-5998(98)70179-2.
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The vestibular system provides inputs to many neurons in the brain stem that participate in autonomic control. This multiplicity of vestibular-autonomic connections plays a variety of roles. Whereas it has been known for decades that unilateral vestibular lesions can result in motion sickness, recent data suggest that the vestibular system participates in making adjustments in blood pressure and respiration that are necessary to maintain homeostasis during movement and changes in posture. Animals with bilateral vestibular lesions are more susceptible to posturally related hypotension than vestibularly intact animals, and it is also possible that orthostatic hypotension after space flight is caused in part by microgravity-related changes in otolith function. Patients with vestibular lesions could also be more vulnerable to respiratory disturbances related to posture, such as obstructive apnea. Vestibular dysfunction has additionally been linked with anxiety disorders, such as agoraphobia, which may result from alteration of vestibular inputs to brain stem monoaminergic neurons (which are known to process these signals). Even sleep disturbances might be connected with vestibular disorders because neurons in the pontine reticular formation that are critical in switching between sleep states may be influenced by labyrinthine inputs. Thus it is likely that vestibular damage will result in a number of parallel disturbances in autonomic function. (Otolaryngol Head Neck Surg 1998;119:106-12.)
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Appiah-Kubi, Kwadwo Osei, Anne Galgon, Ryan Tierney, Richard Lauer, and W. Geoffrey Wright. "Effects of Vestibular Training on Postural Control of Healthy Adults." CommonHealth 1, no. 1 (April 2, 2020): 31–36. http://dx.doi.org/10.15367/ch.v1i1.299.
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Background: Postural stability depends on the integration of multisensory inputs to drive motor outputs. When visual and somatosensory input is available and reliable, this reduces the postural control system’s reliance on the vestibular system. Despite this, vestibular loss can still cause severe postural dysfunction (1,2). Training one or more of the three sensory systems can alter sensory weighting and change postural behavior. Vestibular activation exercises, including horizontal and vertical headshaking, influence vestibular-ocular and -motor responses and have been showed to be effective in vestibular rehabilitation (3–8).
Purpose/Hypothesis: To assess sensory reweighting of postural control processing and vestibular-ocular and -motor responses after concurrent vestibular activation with postural training. It was hypothesized that the effect of this training would significantly alter the pattern of sensory weighting by changing the ratio of visual, somatosensory and vestibular dependence needed to maintain postural stability, and significantly decrease vestibular responses.
Methods: Forty-two young healthy individuals (22 females; 23.0+3.9 years; 1.6+0.1 meters) were randomly assigned into four groups: 1) visual feedback weight shift training (WST) coupled with an active horizontal headshake (HHS), 2) same WST with vertical headshake (VHS), 3) WST with no headshake (NHS) and 4) no training/headshake control (CTL) groups. The headshake groups performed an intensive body WST together with horizontal or vertical rhythmic headshake at 80 to 120 beats/minute. The NHS group performed the WST with no headshake while the controls did not perform any training. Five 15-minute training sessions were performed on consecutive days for one week with the weight shift exercises involving upright limits of stability activities on a flat surface, foam or rocker board (Fig. 1). All groups performed baseline- and post-assessments including sensory organization test (SOT) and force platform ramp perturbations, coupled with electromyographic (EMG) recordings. A video head impulse test was also used to record horizontal vestibulo-ocular reflex (VOR) gain. A between- and within-group repeated measures ANOVA was used to analyze five COP sway variables, the equilibrium and composite scores and sensory ratios of the SOT as well as EMG signals and horizontal VOR gain. Similarly, COP variables, EMG, as well as vestibular reflex data (vertical VOR, vestibulo-collic reflex [VCR] and vestibulo-spinal [VSR] gains) during ramp perturbations were analyzed. Alpha level was set at p<.05.
Results: The training showed a significant somatosensory downweighting (p=.050) in the headshake groups compared to the other groups. Training also showed significant decreased horizontal VOR gain (p=.040), faster automatic postural response (p=.003) (Figs. 2-4) with improved flexibility (p=.010) in the headshake groups. Muscle activation pattern in medial gastrocnemius (p=.033) was significantly decreased in the headshake.
Conclusion: The concurrent vestibular activation and weight shift training modifies vestibular-dependent responses after the training intervention as evidenced in somatosensory downweighting, decreased VOR gain, better postural flexibility and faster automatic postural response. Findings suggest this is predominantly due to vestibular adaptation and habituation of VOR, VCR and VSR which induced sensory reweighting.
Clinical relevance: Findings may be used to guide the development of a vestibular-postural rehabilitation intervention in impaired neurological populations, such as with vestibular disorders or sensory integration problems.
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Mitre, Edson Ibrahim, Alessandra Sousa Figueira, Aparecida Barbosa Rocha, and Simone Maria Cordeiro Alves. "Avaliações audiométrica e vestibular em mulheres que utilizam o método contraceptivo hormonal oral." Revista Brasileira de Otorrinolaringologia 72, no. 3 (June 2006): 350–54. http://dx.doi.org/10.1590/s0034-72992006000300009.
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OBJETIVO: Correlacionar o uso de contraceptivo hormonal oral com possíveis alterações auditivas e vestibulares. MÉTODOS: Aplicou-se anamnese, teste audiométrico e teste vestibular em 60 mulheres entre 14 e 35 anos, sendo que 30 mulheres faziam uso do método contraceptivo hormonal oral composto por estrógeno e progesterona (grupo de risco), por um período igual ou superior a 6 meses, sem queixas auditivas e vestibulares anteriores ao uso do mesmo; e 30 mulheres que nunca fizeram uso desses hormônios (grupo controle), sem queixas auditivas e vestibulares. A anamnese foi utilizada como critério de seleção da amostra. RESULTADOS: Com base nos achados otoneurológicos através de uma pesquisa quantitativa, pode-se verificar uma prevalência da Síndrome Vestibular Periférica Irritativa e de zumbidos no grupo de risco, sem alterações audiométricas. CONCLUSÃO: O uso do método contraceptivo hormonal oral pode ocasionar alterações funcionais na orelha interna, principalmente zumbido e Síndrome Vestibular Periférica Irritativa no grupo de risco, mas não evidenciou alterações de limiares auditivos.
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Miller, A. D., T. Yamaguchi, M. S. Siniaia, and B. J. Yates. "Ventral respiratory group bulbospinal inspiratory neurons participate in vestibular-respiratory reflexes." Journal of Neurophysiology 73, no. 3 (March 1, 1995): 1303–7. http://dx.doi.org/10.1152/jn.1995.73.3.1303.
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1. The vestibular system responds to accelerations of the head and produces reflex responses that serve a variety of compensatory functions. The neuronal circuitry that mediates vestibulo-respiratory reflexes is largely unknown. The purpose of the present study was to investigate the possible role of bulbospinal inspiratory neurons located in the para-ambigual region of the ventral respiratory group (VRG) in mediating these reflexes. Experiments were carried out in cats that were decerebrated, paralyzed, and artificially ventilated. 2. Activation of the vestibular nerve by electrical stimulation produced prominent bilateral reflex responses recorded from the phrenic nerve, which supplies the diaphragm. The responses could be complex and consisted of a decrease and/or increase in nerve discharge. 3. Extracellular recordings were made from 35 VRG inspiratory neurons that were antidromically activated from the upper cervical spinal cord. Almost one-half of these neurons (15/35, 43%) responded to vestibular stimulation. The neuronal response patterns were consistent with VRG inspiratory neurons contributing to the vestibular reflex response simultaneously recorded from the phrenic nerve. 4. The present results indicate that approximately one-half of VRG bulbospinal inspiratory neurons contribute to vestibulo-respiratory reflexes. These findings are in contrast to our recent neuroanatomic and electrophysiological studies which revealed a paucity of vestibular inputs to the dorsal respiratory group (DRG) located in the ventrolateral nucleus of the solitary tract. Thus there appears to be a difference between inspiratory neurons in the DRG and VRG in regard to participating in vestibulo-respiratory reflexes.
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Byl, Nancy N., Frederick M. Byl, and Joseph H. Rosenthal. "Interaction of Spatial Perception, Vestibular Function, and Exercise in Young School Age Boys with Learning Disabilities." Perceptual and Motor Skills 68, no. 3 (June 1989): 727–38. http://dx.doi.org/10.2466/pms.1989.68.3.727.
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Form rotation, figure directionality, and figure-ground discrimination were evaluated before and after 10 days of vestibular or aerobic exercises for 30 boys (7 to 12 yr.) who showed problems in learning, reading, and inattention. Eight subjects had normal vestibulo-ocular reflex (VOR) responses as determined by caloric and rotational testing. They were assigned to a vestibular program (Control Group I). The 22 subjects with abnormal VOR test responses were randomly assigned to either aerobic exercises (Experimental Group II) or a vestibular program (Experimental Group III). Spatial perceptual test scores varied widely, with the majority performing below age-expected norms but no significant differences on vestibular status appeared. Postexercise, only subjects completing the vestibular program made significant gains: Experimental Group III (abnormal VOR) made significant gains in accuracy and normal test responses compared to the other groups, and Control Group I made significantly greater gains in speed of spatial perceptual processing. For boys with problems in learning, reading, inattention, and vestibular function, a vestibular exercise program complementing a traditional or special educational program may enhance the spatial perceptual skills needed for reading.
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Roceanu, Adina, Jean Schoenen, Victor De Pasqua, and Ovidiu Bajenaru. "The vestibollo-collic reflex (VCR) - short presentation of the technique." Romanian Journal of Neurology 9, no. 1 (March 31, 2010): 18–20. http://dx.doi.org/10.37897/rjn.2010.1.3.
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The vestibullo-collic reflex (VCR) or Vestibular Evoked Myogenic Potential (VEMP) is a new non-invasive method for assessment of vestibular function. VEMP are recorded over ipsilateral sternocleidomastoidian muscle tonically contracted during monoaural intense clicks deliver via headphones (Colebatch method). VEMPs are useful diagnostic test in a variety of peripheral and central vestibulopathies.
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Bramer, Solange, Yvette Jaffe, and Aravinth Sivagnanaratnam. "Vestibular neuronitis after COVID-19 vaccination." BMJ Case Reports 15, no. 6 (June 2022): e247234. http://dx.doi.org/10.1136/bcr-2021-247234.
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A woman in her 50s presented with acute vertigo and vomiting within 72 hours of receiving the Pfizer-BioNTech COVID-19 vaccine. The only neurological deficit was an impaired vestibulo-ocular reflex with horizontal nystagmus. The patient was subsequently diagnosed with vestibular neuronitis. She was managed symptomatically with prochlorperazine and betahistine, and underwent vestibular rehabilitation for 6 weeks. She made a full recovery and experienced no further symptoms. She received the second dose of the vaccine without complications.This case demonstrates a temporal association between COVID-19 vaccination and vestibular neuronitis. Neurological adverse events are rare but recognised side effects of COVID-19 vaccines and healthcare professionals should be aware of them. This ensures timely management of patients with such presentations. Treatment should be the same as for non-vaccine-associated vestibular neuronitis. The nature of the relationship between COVID-19 vaccination and vestibular neuronitis remains unclear and patients therefore require investigations to exclude other recognised causes of vestibular neuronitis.
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Bramer, Solange, Yvette Jaffe, and Aravinth Sivagnanaratnam. "Vestibular neuronitis after COVID-19 vaccination." BMJ Case Reports 15, no. 6 (June 2022): e247234. http://dx.doi.org/10.1136/bcr-2021-247234.
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A woman in her 50s presented with acute vertigo and vomiting within 72 hours of receiving the Pfizer-BioNTech COVID-19 vaccine. The only neurological deficit was an impaired vestibulo-ocular reflex with horizontal nystagmus. The patient was subsequently diagnosed with vestibular neuronitis. She was managed symptomatically with prochlorperazine and betahistine, and underwent vestibular rehabilitation for 6 weeks. She made a full recovery and experienced no further symptoms. She received the second dose of the vaccine without complications.This case demonstrates a temporal association between COVID-19 vaccination and vestibular neuronitis. Neurological adverse events are rare but recognised side effects of COVID-19 vaccines and healthcare professionals should be aware of them. This ensures timely management of patients with such presentations. Treatment should be the same as for non-vaccine-associated vestibular neuronitis. The nature of the relationship between COVID-19 vaccination and vestibular neuronitis remains unclear and patients therefore require investigations to exclude other recognised causes of vestibular neuronitis.
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Maheu, Maxime, François Champoux, and Adrian Fuente. "Acute Vertigo in a Patient with Long-Term Organic Solvent Exposure: Importance of a Comprehensive Audio-Vestibular Test Battery." Journal of the American Academy of Audiology 31, no. 05 (May 2020): 363–68. http://dx.doi.org/10.3766/jaaa.19034.
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Abstract Background Ototoxicity induced by organic solvents has been identified in several groups of workers. Little is known, however, about the effects of organic solvents on the vestibular system. Purpose The aim of the study was to comprehensively assess the vestibular system and auditory functions in a worker exposed to organic solvents. Research Design Both behavioral and physiological auditory and vestibular evaluations were performed. Results No auditory-related findings associated with solvent exposure were found. The vestibulo-ocular reflex gain was abnormal for all semicircular canals with significant catch-up saccades, as measured by the video head impulse test. The cervical vestibular evoked myogenic potentials was absent in the right ear and small but replicable in the left ear. Ocular vestibular evoked myogenic potential were bilaterally absent. Conclusions The results suggest a case of vestibulotoxicity induced by a long history of organic solvent exposure. We suggest that solvent-exposed individuals should be evaluated with a comprehensive battery of auditory and vestibular tests.
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Dvoryanchikov, V. V., A. E. Golovanov, and F. A. Syroezhkin. "Effect of nonexercise vestibular training on changes in sensitivity of certain areas of peripheral part of vestibular analyzer of persons prone to motion sickness." Russian Otorhinolaryngology 21, no. 2 (2022): 24–28. http://dx.doi.org/10.18692/1810-4800-2022-2-24-28.
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Increased vestibulo-vegetative sensitivity can occur when the vestibular analyzer is damaged (in particular, its peripheral part), it can also be congenital and manifest itself in the form of a condition such as motion sickness. In the first case, a person actively goes to the doctor with certain complaints, some pathology is identified, and appropriate treatment is prescribed. In the second case, problems arise only under certain external conditions – increased vestibular load, usually with the presence of Coriolis accelerations. When examining such persons, it is often only about the asymmetry of excitability between the right and left labyrinths. However, the issues of intralabyrinthine interaction both in pathology and in vestibular rehabilitation measures may be of interest to researchers as a direction for improving diagnostic methods and compensating for the pathology of the peripheral part of the vestibular analyzer. It was suggested that during regular vestibular loads in the form of vestibular training there is a change in the relationship between intralabyrinthine and interlabyrinthine excitability. Objective of the study. To determine whether the relationship between intralabyrinthine and interlabyrinthine excitability changes under the influence of nonexercise vestibular training in persons prone to motion sickness. Materials and methods. Preselected individuals with increased vestibulo-vegetative sensitivity underwent a course of vestibular training on a stabilometric platform according to the Rectis with optical stimulation program. Also, before and after the training course, each of them underwent video oculometry according to the algorithm we developed, when the rotation is performed alternately in the plane of each of the six semicircular canals. The analysis of changes in the indicators of video oculometry, which arose as a result of training, was carried out. Results. A relative change in both interlabyrinthine and intralabyrinthine excitability was revealed.
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Brandt, Thomas, and Marianne Dieterich. "Perceived Vertical and Lateropulsion: Clinical Syndromes, Localization, and Prognosis." Neurorehabilitation and Neural Repair 14, no. 1 (March 2000): 1–12. http://dx.doi.org/10.1177/154596830001400101.
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We present a clinical classification of central vestibular syndromes according to the three major planes of action of the vestibulo-ocular reflex: yaw, roll, and pitch. The plane-specific syndromes are determined by ocular motor, postural, and percep tual signs. Yaw plane signs are horizontal nystagmus, past pointing, rotational and lat eral body falls, deviation of perceived straight-ahead to the left or right. Roll plane signs are torsional nystagmus, skew deviation, ocular torsion, tilts of head, body, and perceived vertical in a clockwise or counterclockwise direction. Pitch plane signs are upbeat/downbeat nystagmus, forward/backward tilts and falls, deviations of the per ceived horizon. The thus defined vestibular syndromes allow a precise topographic analysis of brainstem lesions according to their level and side. Special emphasis is placed on the vestibular roll plane syndromes of ocular tilt reaction, lateropulsion in Wallenberg's syndrome, thalamic and cortical astasia and their association with roll plane tilt of perceived vertical. Recovery is based on a functionally significant central compensation of a vestibular tone imbalance, the mechanism of which is largely un known. Physical therapy may facilitate this central compensation, but this has not yet been proven in prospective studies. Key Words: Visual vertical—Lateropulsion— Vestibulo-ocular reflex—Central vestibular syndromes.
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Lisberger, Stephen G. "Physiologic basis for motor learning in the vestibulo-ocular reflex." Otolaryngology–Head and Neck Surgery 119, no. 1 (July 1998): 43–48. http://dx.doi.org/10.1016/s0194-5998(98)70172-x.
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The vestibulo-ocular reflex has been used extensively for study of the neural mechanisms of learning that is dependent on an intact cerebellum. Anatomic, physiologic, behavioral, and computational approaches have revealed the neural circuits that are used to generate the vestibulo-ocular reflex and have identified two likely sites of plasticity within those circuits. One site of plasticity is in the vestibular inputs to floccular target neurons, which are located in the vestibular nuclei and receive monosynaptic inhibition from Purkinje cells in the floccular complex of the cerebellar cortex. The other site of plasticity is in the vestibular inputs to Purkinje cells in the floccular complex, possibly in the cerebellar cortex. After reviewing the evidence that supports these conclusions, I consider a number of observations showing that the dynamics of neural circuits or cellular mechanisms play important roles in learning in the vestibulo-ocular reflex. (Otolaryngol Head Neck Surg 1998;119:43–8.)
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Enticott, Joanne C., Stephen J. O'Leary, and Robert J. S. Briggs. "Effects of Vestibulo-ocular Reflex Exercises on Vestibular Compensation after Vestibular Schwannoma Surgery." Otology & Neurotology 26, no. 2 (March 2005): 265–69. http://dx.doi.org/10.1097/00129492-200503000-00024.
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