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Biomedical subjects

J Bergenius

Publications and source records attributed to J Bergenius.

At least 37 records · Page 2Linked to original sources
PubMed1994

Oculomotor and nystagmus tests in subjects with strabismus.

Smooth pursuit (SP) and saccades (SC) as well as nystagmus were recorded with electro-oculography in 21 healthy subjects with manifest non-paralytic strabismus. A normal SP function under binocular conditions could be recorded in 67% of the subjects and complementary monocular recordings increased the figure to 81%. The corresponding figure for the SC test was 38 and 67%, respectively. However, a minority of the subjects presented a normal test result under both binocular and monocular conditions. Spontaneous nystagmus and/or nystagmus after headshaking was present in 67%. These findings may indicate that subjects with strabismus have a combination of a 'subclinical' vestibular and oculomotor dysfunction.

Ear Diseases↗
PubMed1993

Audiovestibular findings in patients with vestibular neuritis: a long-term follow-up study.

During the years 1980-1981, 19 patients with a mean age of 39 years, given the diagnosis vestibular neuritis were subjected to a caloric bithermal test, a pure tone audiogram and stapedius reflex measurements within 1 week, 3 weeks, 9 weeks and 1 year after the onset of symptoms, respectively. In a majority of the patients the feeling of dysequilibrium and vertigo diminished within the first 3 weeks and the difference in caloric reaction between the two sides also diminished during this period. In 9 of the patients, a uni- or bilaterally elevated stapedius reflex threshold was found. The return of the caloric response was somewhat slower in this group of patients.

Adult↗
PubMed1990

Inner ear effects of topical gentamicin treatment in patients with Menière's disease.

Several efforts have been made to treat patients with Menière's disease with ototoxic drugs. Lately the aminoglycoside antibiotic, gentamicin, has been favored. Several reports have proved its efficacy. In a series of 12 patients treated at the Karolinska Hospital in Stockholm, two patients failed to show improvement regarding their vertigo in spite of repeated courses of treatment. These patients both underwent labyrinthectomy where their vestibular sensory epithelia as well as portions of the cochlea were removed. The findings in these two cases were quite unanimous in that the vestibular sensory epithelia were retained showing advanced signs of degeneration. The organ of Corti in the cochlea was totally absent in all specimens examined. These findings indicate that gentamicin seems to affect the cochlea more than the vestibular sensory epithelia that also was clinically proven since both patients totally lost their hearing in the affected ear. Possible routes and actions of the drug in the inner ear are discussed.

Administration, Topical↗
PubMed1988

Some considerations on caloric test results.

The caloric test procedure as suggested by Fitzgerald & Hallpike is still widely used. With a carefully standardized procedure it is well suited to identify the affected side in patients with unilateral vestibular impairments. By repeated testing it is also possible to follow the course of a vestibular affection.

Caloric Tests↗
PubMed1988

Drop attacks in Menière's disease.

An inner ear etiology for drop attacks is easily overlooked and seldom mentioned in the literature. Cardiovascular pathology is what generally is looked for, e.g. transitory ischemic attacks. Twenty-nine patients with frequent and severe Meniere attacks were treated with gentamicin intratympanally, when they had reached a stage of incapacitation due to vertigo and dread of further attacks and all medical treatments had failed. All but one patient were suffering from more or less frequent drop attacks. The attacks of vertigo were successfully cured in all patients except 2, who had recurrence of the inner ear problem. The drop attacks disappeared in all patients, which indicates that they had an inner ear origin.

Adult↗
PubMed1983

Stapedius reflex test, brainstem audiometry and opto-vestibular tests in diagnosis of acoustic neurinomas. A comparison of test sensitivity in patients with moderate hearing loss.

The stapedius reflex test, brainstem audiometry and the opto-vestibular tests for identifying acoustic neurinomas (AN) were evaluated and compared in a study of 21 patients with radiologically or surgically verified AN and a pure tone average not exceeding 60 dB HL. The stapedius reflex test results were interpreted according to the criteria developed at this clinic. The stimuli for the auditory brainstem response (ABR) were 2 kHz haversine waves and 4 kHz square waves. The vestibular examination consisted of a caloric test and the recording of eye-tracking and gaze nystagmus. In the cases studied the stapedius reflex test gave 1 false-negative result and ABR none. The ENG gave 3 false-negatives whereas the results of speech discrimination tests were misleading in no fewer than 1/3 of the cases. The results of the different tests were directly correlated but correlation coefficients did not exceed 0.65. Tumours larger than 15-20 mm showed a different test pattern than those below that size: stapedius reflex response, ABR and caloric response were eliminated and all of these patients had abnormal optomotor function. It is suggested that an optimal routine test procedure should consist of a pure tone audiogram, supplemented by ABR or the stapedius reflex test. Opto-vestibular tests may be of value in a preliminary estimation of tumour size.

Audiometry↗
PubMed1983

[Head trauma with resultant irreversible deafness on one side and reversible hearing impairment on the other side. A case report].

Following a severe head trauma, a 27-year-old man immediately suffered from bilateral hearing loss and impaired balance. On examination there was a complete loss of hearing on the right side. On the left side a subtotal hearing loss of sensorineural origin occurred and became total after a few days. The vestibular function was absent on both sides. Following treatment with prednisolone, hearing recovered in the left ear and reached an average tone threshold of 55 dB. The vestibular function remained lost from the onset of the trauma. At follow up two years later the subtotal hearing loss in the left ear was unchanged as was also the vestibular impairment.

Acoustic Impedance Tests↗
PubMed1981

Automatic analysis of electro-oculographic (EOG) recordings. Application to audio-vestibular diagnosis.

An automatic, computerized system for analysis of the ocular movements in nystagmus, slow pursuit and saccades is presented. The performance of the system has been tested in healthy subjects, as well as in patients with peripheral or brainstem audio-vestibular disorders. The automatized procedure enables an extended application of opto-motor tests in the clinical examination of patients with suspected retrocochlear and brainstem involvement.

Computers↗
PubMedDate not supplied

Nystagmus findings in healthy subjects examined with infrared videonystagmoscopy.

The increased use of video systems for the detection of nystagmus is a new diagnostic tool in the diagnosis of patients with vestibular disorders. Small video cameras mounted in a light sealed mask visualize the eyes which are illuminated with infrared light. Compared to the well-established use of Frenzel glasses the patient has no visual references at all. This new technique requires standards for normal limits. Thirty subjects between 20 and 78 years of age with no history of vestibular disorders were examined with infrared video-oculoscopy with the gaze in primary position, after head-shake and in supine position with head torsion and Dix-Hallpike positions backward and forward according to a standardized procedure at our department. Two subjects had spontaneous nystagmus, but nystagmus after head-shake was not found in any. No subject had torsional nystagmus in the Dix-Hallpike positions. In the elderly subjects horizontal nystagmus in head hanging position was a frequent finding.

Adult↗
PubMedDate not supplied

Gentamicin treatment in peripheral vestibular disorders other than Ménière's disease.

Intratympanic instillation of gentamicin may not exclusively be a treatment for Ménière's disease. We present case reports of successful vertigo control in peripheral vestibular disorders other than Ménère's disease. Cases 1 and 2 illustrate treatment of vertigo attacks caused by vestibular dysfunction in deaf ears. Case 3 illustrates treatment of brief sensations of linear acceleration in a patient who had suffered idiopathic sudden hearing loss a few years earlier. Case 4 illustrates treatment of disabling benign paroxysmal positioning vertigo. Case 5 illustrates treatment of severe and frequent attacks of vertigo in an elderly patient with a medium-sized acoustic neuroma who did not want surgical extirpation of the tumor.

Adolescent↗
PubMedDate not supplied

Audio-vestibular findings in patients with vestibular neuritis.

19 patients with the clinical diagnosis vestibular neuritis, i.e., cases with unilaterally ENG verified abolished or reduced caloric reactions but without symptoms of central nervous involvement or hearing impairment, participated in the study. In addition to ENG examinations and Békésy audiometry all patients were submitted to stapedius reflex tests and auditory brainstem response examinations (ABR) for signs of subclinical auditory nerve engagement. In all but one of the 19 patients the caloric reactions improved; 8 of the 13 patients available for tests after one year recovered completely. The ABR was normal in all cases but the stapedius reflex thresholds were pathologically elevated and remained so in about half of the subjects throughout the observation time; reflex decay was not present in anyone. Cases with pathologically elevated stapedius reflex thresholds showed a tendency to slower recovery of the vestibular function than the group with the normal reflexes. The results were interpreted to indicate lack of eighth nerve or CNS engagement. The possibility that subjects with reflex threshold elevation may constitute a group with constitutional weakness of the audio-vestibular apparatus disposed for vestibular disease is discussed.

Adult↗
PubMedDate not supplied

Computerized analysis of voluntary eye movements. A clinical method for evaluation of smooth pursuit and saccades in oto-neurological diagnosis.

To permit rapid and exact quantification of the oculomotor function in clinical practice, a computerized program has been designed for the recording and analysis of pursuit eye movements and voluntary saccades. In a pursuit sequence the subject tracks a moving target, projected onto a screen at a constant speed of 20 degrees/sec over a horizontal visual angle of 60 degrees. The pursuit sequence is followed by a refixation saccade when the subject rapidly shifts his gaze back to the starting point of the target. A complete test procedure consists of ten consecutive pursuit sequences and refixation saccades in each direction. The EOG signal is fed to a PDP11/23 computer for storage and analysis. The pursuit eye movements are quantified and arranged in five velocity intervals: less than 8, 8-16, 16-24, 24-32 and greater than 32 degrees/sec. The relative distribution of the velocity content is calculated for these intervals and presented in histogram form. Saccades superimposing on the smooth pursuit are identified and grouped according to amplitude and direction. The refixation saccades are quantified as mean peak velocities and also the highest and lowest velocities of the refixation saccades are determined. In a material of 70 healthy subjects, normative data and limits for pathological function were established. In the smooth pursuit, 69% of the velocity values were located within the 16-24 degrees/sec interval. Pathological limits were set for each velocity interval and impaired pursuit tracking ability was considered to be present when those limits were reached in at least three of the five intervals. Normal mean peak eye velocity of the refixation saccade was found to be 460 degrees/sec with a range of 354-575 degrees/sec. Application of the test procedure and method of analysis is described in two patients with impairment of the oculomotor function due to a disturbance in the cerebellar brain stem area.

Adolescent↗
PubMedDate not supplied

Vestibular findings in sensorineural hearing disorders. Results of caloric, oculomotor and hearing tests in 205 patients with unilateral hearing dysfunction.

In 205 patients with unilateral hearing loss, 117 of cochlear and 88 of retrocochlear origin, thorough audiovestibular examinations were performed to establish the occurrence and severity of vestibular dysfunction. The results were also analysed with the aim of determining the relationships between the severity of the hearing loss, the etiology and the topical location of the hearing disorder, on the one hand, and vestibular dysfunction, recorded as reduced caloric sensitivity and occurrence of oculomotor disturbances, on the other. No correlation was found between severity of hearing loss and recordable vestibular dysfunction, in either the cochlear or retrocochlear group of patients, or in the etiological subgroups of these main groups. With respect to the relations between the topic locations of the lesions and the results of vestibular tests, distinct characteristics were observed. In the affected ears, totally extinguished caloric reactions were more than six times as frequent in the retrocochlear group as in the cochlear group and appeared as a specific but rather insensitive sign of acoustic neurinoma. Oculomotor disturbances were only exceptionally observed in patients with cochlear lesions, but were noted in nearly half of the retrocochlear group; when only those patients with lesions of the brain stem or cerebellum were considered, all were found to exhibit such disturbances. The relations between audiometric hearing test pattern, caloric sensitivity and oculomotor disturbances seem to form interesting diagnostic paradigms of great value for the topical localization of audiovestibular disorders.

Auditory Pathways↗
PubMedDate not supplied

Saccade abnormalities in patients with ocular flutter.

In a group of 8 patients with opsoclonus or ocular flutter, the eye movements were recorded by electro-oculography (EOG). The spontaneous eye movement pattern and the amplitude and peak velocity of the refixation saccade were analysed. The EOG recording demonstrated frequent bursts of horizontally and vertically directed saccades elicited without any intersaccadic interval. Three patients also demonstrated an increased frequency of square waves. In 6 of the 8 patients the peak velocity of the voluntary saccades was increased; in 5 patients this condition was found for saccades in both directions. Over-shooting oscillations or slightly hypermetric voluntary saccades occurred in 5 patients. It is proposed that the ocular flutter and the increased saccadic velocities found in the present series of patients is caused by a disorder of the burst cells in the brain stem saccadic control system.

Adolescent↗
PubMedDate not supplied

The relationship between caloric response, oculomotor dysfunction and size of cerebello-pontine angle tumours.

Seventy-nine consecutive patients, 70 patients with acoustic neurinomas (ACN) and 9 patients with cerebello-pontine angle tumours of other etiology (o-CPA) were analysed with respect to tumour size and the result of the caloric and oculomotor tests. The size of the tumour was judged by the largest diameter calculated from the computerized tomography. A highly significant linear relationship between tumour size and caloric side difference was found for the group of ACN patients who had normal oculomotor function. A unilateral loss of caloric response on the tumour side was found in 75% of the ACN patients with tumours larger than 20 mm, but not in any of the ACN patients with tumours smaller than 10 mm. Oculomotor dysfunction (OMD), defined as disturbed pursuit eye movements and/or gaze nystagmus was frequently found in the patients with ACN larger than 20 mm (77%), and was present in all but one of the o-CPA patients. However, the caloric response on the tumour side was significantly more impaired in the group of ACN patients with OMD than in the o-CPA group. A combined view of the oculomotor and caloric test results offers a possibility to obtain a rough estimate of tumour size as well as to distinguish ACNs from other types of tumours in the cerebello-pontine angle.

Adult↗