A video-oculographic study of acute vestibular syndromes

Roberts, Hayley; McGuigan, Sean; Infeld, Bernard; Sultana, Ron; Gerraty, Richard

doi:10.1111/ane.12536

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…Overt saccades, as secondary catch-up saccades, are generated when the covert saccades fail to drive eye-movements reaching the target during head rotation. In line with previous study, our study found a certain number of patients presenting with covert saccades at early stage of VN ( 39 ). Therefore, the incidence and parameters of saccades, covert or overt, are a promising indicator for evaluation of vestibular deficit and central compensation other than VOR ( 49 ).…”

Section: Discussionsupporting

confidence: 93%

“…However, we did not track their vHITs in the early stages in this study. By sequentially measuring the VOR gains of patients with acute VN, previous studies have found the ipsilesional VOR gains vary after the initial measurement during the week from onset ( 38 , 39 ). Meanwhile, patients with lower initial VOR gains were less likely to improve on subsequent 3–5 days, and would generate more covert catch-up saccades over time ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although the quantitative lesion indicators are commonly irrelevant to the intensity of symptoms in clinical practice, negative results without correlations are rarely seen in literature. Limited cases reported that some patients had physical signs of VN, but their ipsilesional VOR gains were in the normal range ( 39 ). By sequential head impulse measurements, Palla et al found that VOR gains toward the ipsilesional side appeared to descend initially and then increased with the course, which was not parallel to the disease progression ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

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New onset episodic vertigo as a presentation of vestibular neuritis

2022

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ObjectiveVestibular neuritis (VN) is a common peripheral cause of acute vestibular syndrome, characterized by sustained vertigo and gait instability, persisting from 1 day to several weeks. With the widespread use of comprehensive vestibular function tests, patients with VN and non-sustained vertigo have drawn attention. In this study, we retrospectively analyzed the clinical presentation of patients with VN and episodic vertigo, aiming to expand the atypical clinical features of VN.MethodsThis retrospective study enrolled 58 patients with VN. Among them, 11 patients with more than 3 remissions per day, each lasting over 1 h were assigned to the episodic vertigo (EV) group, and 47 subjects without significant relief into the sustained vertigo (SV) group. Demographic information, clinical manifestations and data of supplementary examinations were collected and statistically analyzed. These patients were followed up 1 year after discharge to gather prognostic information.ResultsThe incidence of spontaneous nystagmus (SN) and proportion of severe vertigo (Dizziness Handicap Inventory questionnaire score >60) in the SV group were significantly higher than those in the EV group. Spearman correlation showed that with a longer disease course, the velocity of overt saccade was smaller (p < 0.05, Rs = −0.263) in all patients with VN.ConclusionThe non-sustained manifestations in VN overlap with a wider spectrum of other vestibular disorders and stroke-related vertigo, which add an additional layer of complexity to the differential diagnosis of new onset episodic vertigo. By retrospectively analyzing the clinical characteristics and vHIT parameters, our study has expounded on the atypical features and potential pathophysiological mechanism of episodic syndromes in VN. VOR gain and saccades measured by vHIT could be reliable indicators for vestibular rehabilitation process.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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New onset episodic vertigo as a presentation of vestibular neuritis

2022

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“…В таких случаях необходимо проведение видеоимпульсного теста, более известного как vHIT,более чувствительного и объективного метода, позволяющего оценить функцию каждого из полукружных каналов и количественно определить дефицит ВОР с пораженной стороны. Принцип проведения исследования остается таким же, как и при пробе Хальмаги, однако оценка скорости поворота головы и глаз проводится встроенным в прибор гироскопом и высокочастотной камерой соответственно [30].…”

Section: оценка и характеристики нистагма при внunclassified

Dizziness and vertigo associated with vestibular neuronitis: the approaches to the diagnostics and treatment

Pal'chun

Makoeva

2018

Vestn. otorinolaringol.

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This article is focused on the peculiar features of diagnostics and treatment of dizziness and vertigo in the patients presenting with vestibular neuronitis. The authors present the detailed overview of various theories concerning etiology and pathogenesis of this condition, describe the methods for its clinical and instrumental diagnostics (including its differential diagnostics from other diseases associated with acute dizziness and vertigo). Special attention is given to the methods of pharmacological and physical rehabilitation of the patients suffering from vestibular neuronitis.

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“…Recently it has been argued that SHIMP gives more precise information on the VOR slow phase velocity value compared to HIMP because the evaluation of the gain is not affected by covert saccades [ 9 , 10 ]. Several studies [ 11 , 12 ] have already suggested the use of vHIT with HIMP to diagnose a VN in the acute phase and as a valid tool to diagnose peripheral vestibulopathy in the different stages of the disease [ 3 ]. A recent systematic review [ 13 ] highlighted the usefulness of the SHIMP in diagnosing a VOR alteration in patients with vestibulopathy suggesting to evaluate with new studies if this new paradigm could replace the HIMP in both the acute and chronic phases of vestibulopathy.…”

Section: Introductionmentioning

confidence: 99%

Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study

Manzari¹,

Bustos

Princi

et al. 2022

Healthcare

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Background: This study aims to explore the clinical relevance of the Suppression Head Impulse Paradigm (SHIMP) to better understand if it represents an additional clinical value compared to the Head Impulse Paradigm (HIMP) in patients with vestibular neuritis (VN) in different stages of the disease. Methods: From January 2020 to June 2022, patients with unilateral VN were found in a database of an ENT vestibular clinic. Clinical presentation, vestibular test outcomes, therapy, and recovery were examined in medical records. Results: A total of 42 patients (16 Females, mean age 51.06 ± 12.96; 26 Male, mean age 62.50 ± 9.82) met the inclusion criteria and were enrolled in the study. The means of the VOR gain for both paradigms were respectively 0.38 ± 0.12 (SHIMP) and 0.46 ± 0.13 (HIMP) at T0 and 0.55 ± 0.20 (SHIMP) and 0.64 ± 0.19 (HIMP) at T1 for the lesional side. For the HIMP, the gain value <0.76 identified the affected side of VN with 100% sensitivity (92–100) and 100% specificity (91–100). For the SHIMP, the gain value <0.66 identified the affected side of VN with 100% sensitivity (92–100) and 100% specificity (91–100) and an AUC of 1.0 (0.96–1.0, p < 0.0001). Conclusion: The SHIMP paradigm has a diagnostic accuracy equal to the classic HIMP paradigm in patients with VN. The assessment of VOR slow phase velocity and vestibulo-saccadic interaction in patients with VN could be easier with the use of the SHIMPs paradigm. SHIMPs paradigm provides helpful information about the evaluation of VOR slow phase velocity and vestibulo-saccadic interaction as new recovery strategies in patients with VN.

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A video-oculographic study of acute vestibular syndromes

Cited by 11 publications

References 17 publications

New onset episodic vertigo as a presentation of vestibular neuritis

New onset episodic vertigo as a presentation of vestibular neuritis

Dizziness and vertigo associated with vestibular neuronitis: the approaches to the diagnostics and treatment

Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study

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