Our results showed higher VOR gains and poorer fixation abilities in children with cADHD compared with typically developing children. Cerebellar dysfunction in patients with ADHD has been well documented in the literature, and our findings of cVEMP and rotary chair tests for these children showed impaired vestibular function in these children, based on increased VOR gain values and decreased fixation capabilities. Because VOR gain is mediated through the inferior olive and controlled by the cerebellum, our results suggest that central inhibition of vestibular function may be deficient in children with cADHD, resulting in higher VOR gains. Also, there is general agreement that failure of fixation suppression indicates a central lesion. The lesion can originate from the parietal-occipital cortex, the pons, or the cerebellum. However, failure of fixation suppression is most prominent in lesions involving the midline cerebellum that could be counted for children with cADHD. We believe that this contribution is theoretically and practically relevant as high VOR gains and decreased suppression capabilities may result in symptoms of reading and writing difficulties, learning disabilities, vertigo, and motion sickness in these children. Therefore, assessment of vestibular function in children with cADHD at a young age must be considered when developing rehabilitation protocols for these children.
Of the 8 patients (16 ears), normal response was detected in 3 ears (1 in right and 2 in left ears). There were unrepeatable waves in four ears and absent VEMPs in nine ears.
Our investigation was designed to assess the saccular function of the vestibular system upon postural control dysfunction amongst children with spastic cerebral palsy (CP) using recording of cervical vestibular evoked myogenic potentials (cVEMPs), as well as to compare such findings with those in healthy subjects. Sixty two children (aged 7-12 years) were enrolled and assigned into two groups. There were 31 cases of spastic CP with the functional levels of I or II according to the Gross Motor Function Classification System in the patient group and 31 aged-matched healthy children as controls. The examined parameters were the latencies of the P 13 and N 23 waves, P 13 -N 23 peak-to-peak amplitude, amplitude asymmetry ratio (AAR) and the cVEMP threshold. The cVEMP responses were recorded in 93.5 % of cases in the CP group and in all healthy subjects. Only 51.6% of the CP-group cases were within the normal AAR spectrum range. There were significant differences between the two groups with regard to the N 23 wave latency (P < 0.001), P 13 -N 23 wave amplitude (P < 0.001) and cVEMP threshold (P<0.05). The significant difference in the cVEMP measured values between the CP cases and healthy controls may be attributed to a motor development delay and deficits in the vestibulo-collic reflex pathway. Our findings suggest that cVEMP recording may be considered an auxiliary tool for the assessment of the vestibular system in children with spastic CP. Such a test is expected to help more adequate planning for interventions.
The vestibular system is important for the development of normal movement reactions, motion tolerance, and motor control for postural alignment, balance, and vision. A vestibular system that is damaged by disease or injury in childhood can have a major impact on a child's development. In addition, the emergence of vestibular lesions may also lead to cognitive deficits, including attention deficit. Despite the advances in testing and documentation of vestibular deficits in children, the vestibular problems continue to be an overlooked entity. Many children do not receive treatment that could significantly improve function and address the developmental delays caused by vestibular disorders. Vestibular rehabilitation therapy (VRT) has been defined as an effective modality for most individuals with disorders of the vestibular or central balance system disorders. The basis for the success of VRT is the use of existing neural mechanisms in the human brain for adaptation, plasticity, and compensation. The vestibular system cannot be considered as a separate entity ignoring other balance subsystems. Hence, a modified VRT program, named pediatric balance therapy with special modifications in exercises, was developed for children with vestibular disorders, in accordance to the whole balance system.
Background and Aim: Auditory-verbal memory and reading problems are frequently observed in patients with vestibular disorders, but rarely considered as a cognitive consequence of vestibular disease. Many clinicians do not recognize or ignore the psychological symptoms of vestibular disease. This approach could underestimate the cognitive problems of the patients, or even led to misdiagnosis of a combined vestibular-cognitive condition. The current study aimed to assess the cognitive impact of acute vestibular disorders.
Methods: A total of 71 patients with unilateral vestibular neuritis, Meniere’s disease, and benign paroxysmal positional vertigo underwent a through audiologic evaluation, including otoscopy, pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, videonystagmography plus caloric testing, and video head impulse testing in the plane of horizontal semicircular canals. After determination of the disease, the Persian version of the dizziness handicap inventory, the Persian reading test, and Rey auditory-verbal learning test were administered.
Results: There were no significant difference between the patient groups with regard to their inabilities like reading and learning problems according to their auditory verbal memory score induced by acute vertigo. However, acute vertigo can reduce the reading ability and capacity of auditory-verbal memory of the patients compared with normal subjects.
Conclusion: Unilateral vestibular disorders in which patients suffer from acute rotatory vertigo could lead to reading difficulties and learning because of auditory-verbal memory impairment. The exact mechanism of vestibular impairment is not a determinant factor for these cognitive problems.
Background and Objective: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo with peripheral origin, and its psychologic consequences frequently ignored by clinicians. In this regard, the present study aimed to investigate the effects of BPPV on patient auditory-verbal memory. Materials and Methods: In this cross-sectional study, a total of 40 volunteer patients with acute vertigo underwent auditory and vestibular function tests. In addition, after the confirmation of BPPV, the Persian version of Dizziness Handicap Inventory was completed by all the subjects. Then, the Persian version of the Rey Auditory-Verbal Learning Test was conducted on the participants. Results: The obtained results showed that the level of disability caused by BPPV could lead to a decrease in the capacity of auditory-verbal memory in comparison to that in normal individuals.
Conclusion:Patients with BPPV who suffer from severe rotator vertigo have higher number of problems in learning through auditory-verbal memory in comparison to normal individuals. Moreover, suffering from acute vertigo as an unpleasant physical condition can lead to considerable cognitive consequences in these patients.
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