Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic

Nishikawa, Daisuke; Wada, Yoshiro; Shiozaki, Tomoyuki; Shugyo, Masayuki; Ito, Taeko; Ota, Ichiro; Kitahara, Tadashi

doi:10.1016/j.anl.2020.09.012

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…SVV alterations have also been mentioned in MD. 29 , 37 , 38 , 42 , 43 SVV deviation to the side of the lesion and to the opposite side in unilateral MD and without lateralization in bilateral MD has also been found. 30 Abnormal inter-crisis SVV in vestibulopathies suggests insufficient vestibular compensation.…”

Section: Discussionmentioning

confidence: 79%

See 1 more Smart Citation

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease

Ferreira¹,

Lopes²,

Grigol³

et al. 2023

Brazilian Journal of Otorhinolaryngology

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Section: Discussionmentioning

confidence: 79%

“…The SVV assessed through the bucket method was identified in only five studies in MD. 37 , 38 , 39 , 40 , 41…”

Section: Discussionmentioning

confidence: 99%

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease

Ferreira¹,

Lopes²,

Grigol³

et al. 2023

Brazilian Journal of Otorhinolaryngology

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“…Next, the vHIT was conducted in each nGVS condition: sham, 0.2, 0.6, and 1.2 mA. In one vHIT, passive head rotation to the right and left was performed until 20 successes were achieved in each direction ( 28 ) under all of the nGVS conditions. The nGVS was delivered at 70 s, and the vHIT was completed within 40 s during nGVS.…”

Section: Methodsmentioning

confidence: 99%

Vestibulo-Ocular Reflex Is Modulated by Noisy Galvanic Vestibular Stimulation

2022

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We investigated whether noisy galvanic vestibular stimulation (nGVS) modulates the vestibulo-ocular reflex (VOR) and whether this effect is correlated with the effect of nGVS on body sway. Thirty healthy young adults participated. The video head impulse test (vHIT) was used to estimate the ratio of eye motion velocity/head motion velocity to VOR-gain. The gain 60 ms after the start of head motion (VOR-gain-60 ms) and regression slope (RS) (i.e., gain in eye and head motion; VOR-gain-RS) were calculated. The total path length of the foot center of pressure (COP-TL) during upright standing was calculated to estimate body sway. Noisy Galvanic Vestibular Stimulation at 0.2, 0.6, 1.2 mA, or sham stimulation (direct current: 0 mA) was delivered to the bilateral mastoid process in random order during vHIT and COP measurements. Application of nGVS at 0.2 mA significantly reduced VOR-gain-RS, while application of nGVS at 0.6 mA significantly increased COP-TL. Vestibulo-ocular reflex-gain-60 ms differed significantly between 0.2 and 1.2 mA. There was no significant correlation between COP-TL and VOR-related parameters. These findings suggest that nGVS at 0.2 mA inhibits the VOR, while nGVS at 0.6 mA increases body sway during upright standing, although there may be no relationship between the respective effects in healthy individuals.

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“…How- ever, the diagnosis of dizziness is not always easy because of the diversity of the etiology [Newman-Toker et al, 2008]. Even though general physical, neurological, and otological examinations were performed, approximately 10-40% of patients were diagnosed unknown [Newman-Toker et al, 2008;Parker et al, 2019;Nishikawa et al, 2021]. Especially in the elder age, presbystasis or presbyvestibulopathy (PVP) is used to describe an age-related disequilibrium that means specific etiology could not be clinically identified [Agrawal et al, 2019].…”

Section: Introductionmentioning

confidence: 99%

Temporal Bone Histopathology of Undiagnosed Dizziness in the Elderly

Okayasu

Kamakura²,

Kitahara³

et al. 2022

Audiol Neurotol

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Introduction: Dizziness is a common disease. However, approximately 10–40% of patients were diagnosed unknown dizziness even though general, neurological, and otological examinations were performed. The aim of this otopathological study was to investigate the histopathology of the peripheral vestibular system of patients who suffered from undiagnosed dizziness. Methods: Eighteen temporal bone specimens from 9 patients with undiagnosed dizziness and 20 temporal bone specimens from age-matched 10 normal controls were selected. Cases with a history of dizziness and vertigo caused by particular peripheral vestibular disease and central etiology were excluded. Specimens of the vestibular system were carefully assessed by light microscopy. The basophilic deposits adhered to cupulae of the semicircular canals and the wall of the labyrinth were investigated. Scarpa’s ganglion cell counts in the vestibular nerves were performed. Results: Fifteen ears of 9 patients had the findings of vestibular pathology such as a basophilic deposit on cupula (8 ears), on canal wall (7 ears), vestibular nerve loss (8 ears), or vestibular atelectasis (2 ears). Unclear pathological findings such as crista neglecta, subepithelial deposits of the crista ampullaris, and adhesion of the cupula to dark cell area were demonstrated. The mean size of basophilic deposits seen in the patients (mean: 191 µm) was larger than that of latent deposits seen in the normal controls (mean: 101 µm; p = 0.01). Conclusions: We demonstrated some peripheral vestibular pathological findings such as deposit within the semicircular canal, vestibular nerve loss, and vestibular atelectasis and suggested the possible diagnosis of dizziness (benign paroxysmal positional vertigo, presbyvestibulopathy, vestibular atelectasis). These findings will provide a better insight into the multiple etiologies of the unknown dizziness in the elderly.

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Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic

Cited by 9 publications

References 26 publications

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease

Vestibulo-Ocular Reflex Is Modulated by Noisy Galvanic Vestibular Stimulation

Temporal Bone Histopathology of Undiagnosed Dizziness in the Elderly

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