Peripheral vestibular disorders

Strupp, Michael; Brandt, Thomas

doi:10.1097/wco.0b013e32835c5fd4

Cited by 86 publications

(52 citation statements)

References 77 publications

(1 reference statement)

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“…In specialty practice, the horizontal HIT (h-HIT) is now widely used to assist in clinical diagnosis of peripheral vestibular disorders [Curthoys, 2012;Strupp and Brandt, 2013] such as vestibular neuritis [Blödow et al, 2013], unilateral vestibular loss [Weber et al, 2008], and bilateral vestibulopathy [Petersen et al, 2013]. Impulsive testing of the vertical semicircular canals is useful for diagnosing inferior vestibular neuritis [Kim and Kim, 2012], postsurgical follow-up of superior canal dehis-cence syndrome repair [Janky et al, 2012], or to assess the success of vestibular neurectomy [Lehnen et al, 2004].…”

Section: Introductionmentioning

confidence: 99%

Quantifying the Vestibulo-Ocular Reflex with Video-Oculography: Nature and Frequency of Artifacts

et al. 2014

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Video-oculography devices are now used to quantify the vestibulo-ocular reflex (VOR) at the bedside using the head impulse test (HIT). Little is known about the impact of disruptive phenomena (e.g. corrective saccades, nystagmus, fixation losses, eye-blink artifacts) on quantitative VOR assessment in acute vertigo. This study systematically characterized the frequency, nature, and impact of artifacts on HIT VOR measures.From a prospective study of 26 patients with acute vestibular syndrome (16 vestibular neuritis, 10 stroke), we classified findings using a structured coding manual. Of 1,358 individual HIT traces, 72% had abnormal disruptive saccades, 44% had at least one artifact, and 42% were uninterpretable. Physicians using quantitative recording devices to measure head impulse VOR responses for clinical diagnosis should be aware of the potential impact of disruptive eye movements and measurement artifacts. i 2014 S. Karger AG, Basel

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Section: Introductionmentioning

confidence: 99%

Quantifying the Vestibulo-Ocular Reflex with Video-Oculography: Nature and Frequency of Artifacts

et al. 2014

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“…20,21 The test is performed by having the patient stare at a central focal point, such as the examiner’s nose, and then the examiner briskly rotates the patient’s head in yaw, either left or right, approximately 20°. The test is positive (abnormal) if the examiner observes a saccade during counter-rotation of the eye.…”

Section: Introductionmentioning

confidence: 99%

Utility of Stepping, Walking, and Head Impulses for Screening Patients for Vestibular Impairments

Cohen

Sangi‐Haghpeykar²,

Ricci

et al. 2014

Otolaryngol.--head neck surg.

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Objective To determine if some common screening tests predict scores on detailed, objective diagnostic tests of the vestibular system. Study design Sixty patients with vestibular disorders were compared to 60 asymptomatic controls. Setting Vestibular diagnostic laboratory, tertiary care center. Subjects and Methods Subjects were screened with head impulse tests (HT), Fukuda Stepping Tests while walking and marching in place, and tandem walking tests (TW) with eyes open and closed. All subjects had bi-thermal caloric tests and Dix-Hallpike maneuvers; patients had low frequency sinusoidal tests of the vestibulo-ocular reflex in darkness, and cervical vestibular evoked myogenic potentials. Results On TW patients differed significantly from controls but Receiver Operating Characteristic (ROC) scores were < 0.8. On Fukuda tests patients turned significantly more than controls for walking but not marching, but ROC values were considerably < 0.80. For HT patients with bi-thermal caloric weakness ≥ 20% and < 60% did not differ from controls but patients with severe bi-thermal caloric weakness, ≥ 60%, differed significantly from controls. ROC values were > 0.80 only for subjects with severe bi-thermal caloric weakness and were highest, 0.88, for subjects with severe weakness and age ≥ 60. Conclusion The Fukuda is a poor screening test because it does not correlate well with objective test findings. TW is best used for screening older patients for vestibular disorders. A positive HT is probably consistent with severe peripheral vestibular impairment and may be most useful in older patients. In younger patients with vertigo a negative HT may not be informative.

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“…According to Jen [11] , in 50% of the cases, the cause of BVH remains unknown. Strupp and Brandt [12] considered that degenerative cere- mitochondrial encephalopathy with lactic acidosis and stroke-like episodes; PTA: puretone average bellar diseases would be responsible for 20% of the cases classified as idiopathic. In only two of our patients (8%), the etiology remained unknown, and they had no signs of cerebellar disease.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Vestibular Hypofunction in Quantitative Head Impulse Test: Clinical Characteristics in 23 Patients

2017

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OBJECTIVE: To explore clinical features of patients with bilateral vestibular hypofunction (BVH) verified in motorized head impulse test (MHIT). MATERIALS and METHODS:We examined clinical records of 23 adult patients (10 males and 13 females), whose gain of the vestibulo-ocular reflex in the MHIT was bilaterally lowered. Fifteen of 62 unilateral cochlear implant (CI) recipients routinely tested both pre-and postoperatively with the MHIT had BVH. Eight of 198 vestibular outpatients selected to the MHIT due to clinical causes had BVH. Clinical characteristics and a questionnaire regarding current sensations were analyzed. RESULTS:The mean gain±SD in the MHIT was 0.26±0.17 on the right and 0.26±0.14 on the left side. The mean gain in the CI recipients did not differ from that of vestibular outpatients (p>0.05). All outpatients with BVH suffered from oscillopsia, whereas only 46% of CI recipients experienced oscillopsia (p=0.048). Instability was more prominent (p=0.004) and quality of life further decreased (p=0.012) among vestibular outpatients compared with CI patients. Most common etiology for the BVH was meningitis. Other causes were either sudden or progressive loss of labyrinthine function, bilateral Meniére's disease, and ototoxicity. CONCLUSION:BVH is rare even in a specialized clinic. Vestibular outpatients were more disabled than CI recipients with the BVH.

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Peripheral vestibular disorders

Cited by 86 publications

References 77 publications

Quantifying the Vestibulo-Ocular Reflex with Video-Oculography: Nature and Frequency of Artifacts

Quantifying the Vestibulo-Ocular Reflex with Video-Oculography: Nature and Frequency of Artifacts

Utility of Stepping, Walking, and Head Impulses for Screening Patients for Vestibular Impairments

Bilateral Vestibular Hypofunction in Quantitative Head Impulse Test: Clinical Characteristics in 23 Patients

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