The nature and severity of the traumas causing t-BPPV are diverse, ranging from minor head injuries to more severe head and neck trauma with brief loss of consciousness. It appears that t-BPPV is more difficult to treat than i-BPPV, and also has a greater tendency to recur.
The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI). Truncal ataxia was measured by independent observers as grade 1, mild to moderate imbalance with walking independently; grade 2, severe imbalance with standing, but cannot walk without support; and grade 3, falling at upright posture. When we applied the HINTS protocol to our sample, we obtained 100% sensitivity and 94.4% specificity, similar to previously published findings. Only those patients with stroke presented with grade 3 ataxia. Of those with grade 2 ataxia (n = 38), 11 had cerebellar stroke and 28 had vestibular neuritis, not related to the patient’s age. Grade 2–3 ataxia was 92.9% sensitive and 61.1% specific to detect AICA/PICA stroke in patients with AVS, with 100% sensitivity to detect AICA stroke. In turn, two signs (nystagmus of central origin and grade 2–3 Ataxia) had 100% sensitivity and 61.1% specificity. Ataxia is less sensitive than HINTS but much easier to evaluate.
The purpose of this study was t o determine the extent to which gcndcr and prior computer exposure (has a computer at home; participated in a computer course; knows how to work with computers) affect students' attitudes toward computers prior to computer instruction in school. An attitude questionnaire including cognitive and affective attitude scales was administered to 222 Israeli pupils in grades 8 through 10 who study in schools where computers have not yet been introduced. The results showed that prior computer exposure (in particular, having a computer at home), had a stronger effect on attitudes toward computers than sex. Pupils owning computers were more motivated to become familiar with computers; felt a stronger need for computers in their lives and had more positive affective attitudes toward computers than pupils who don't have computers at home. Sex differences in affective and cognitive attitudes were also observed where boys had significantly more positive affective attitudes toward computers than girls. They perceived computers as being more "enjoyable," "special," "important," "friendly," and "cheaper" than girls. Furthermore, boys tended to hold more stereotyped attitudes about who is capable of using computers and had more positive attitudes toward the computer as a medium of instruction than girls.
The present study characterizes a previously reported adaptive phenomenon in a somatosensory-motor system involved in directional control of locomotor trajectory through foot contact with the floor. We call this the "podokinetic" (PK) system. Podokinetic adaptation was induced in six subjects by stepping in-place over the axis of a horizontally rotating disc over a range of disc angular velocities (11.25-90 degrees/s) and durations (7.5-60 min). After adaptation, subjects were blindfolded and attempted to step in-place on the floor without turning. Instead they all rotated relative to space. The rate of the "podokinetic afterrotation" (PKAR) was linearly related to stimulus amplitude up to 45 degrees/s, and the ratio of initial PKAR velocity to that of the adaptive stimulus was approximately 1:3. PKAR exhibited exponential decay, which was composed of "short-" and "long-term" components with "discharging" time constants on the order of 6-12 min and 1-2 h, respectively. The effect of stimulus duration on PKAR revealed a "charging" time constant that approximated that of the short-term component. A significant suppression of PKAR occurred during the 1 st min of the postadaptive response, suggesting functional interaction between the PK and vestibular systems during the period of vestibular stimulation. During PKAR subjects perceived no self-rotation, indicating that perception as well as locomotor control of spatial orientation were remodeled by adaptation of the PK system.
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