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Biomedical subjects

John Waterston

Publications and source records attributed to John Waterston.

3 recordsLinked to original sources

The influence of otolith dysfunction on the clinical presentation of people with a peripheral vestibular disorder.

BACKGROUND AND PURPOSE: Traditional vestibular function testing has measured horizontal semicircular canal function only. Otolith function tests have recently been developed, but their clinical significance has not been determined. The purpose of this study was to investigate the influence of otolith dysfunction on the clinical presentation of individuals with a peripheral vestibular disorder. SUBJECTS AND METHODS: Twenty-one subjects with loss of horizontal semicircular canal function only and 37 subjects with combined loss of horizontal semicircular canal and otolith organ function were recruited. All subjects received a comprehensive clinical assessment, including self-report questionnaires and measures of balance performance. RESULTS: No significant differences were identified between subjects with or without otolith dysfunction with respect to symptom severity, self-perceived handicap, functional limitations, or balance performance. DISCUSSION AND CONCLUSION: Otolith dysfunction does not significantly influence the clinical presentation of individuals with a peripheral vestibular disorder. Other factors, including symptom severity, may be more influential.

Activities of Daily Living↗

A pilot study of falls risk and vestibular dysfunction in older fallers presenting to hospital emergency departments.

PURPOSE: To compare falls risk in older fallers and non-fallers, with an emphasis on dizziness and signs of vestibular dysfunction. METHOD: The fallers had presented to the Emergency Department of the Royal Melbourne Hospital, Australia following a fall and were discharged directly home (n = 20) (75% female, mean age 78 years). The non-fallers were an age and gender matched group, who had not fallen in the past 12 months (n = 20). All clients received a home-based assessment, which involved a comprehensive assessment of falls risk. RESULTS: Over three-quarters of the fallers took four or more medications, had balance impairments, and used a gait aid in the community. The fallers had a significantly higher falls risk score (P < 0.001), demonstrated significantly poorer balance (P < 0.001) and walked significantly more slowly (P < 0.001) than the non-fallers. There was no significant difference between the groups in their reports of dizziness (P = 0.68), although static balance testing (CTSIB condition 5) suggested a greater degree of underlying vestibular dysfunction in the group of fallers (P < 0.001). CONCLUSION: Older people discharged home from the ED following a fall are at high risk of falling in the future and have a greater level of vestibular dysfunction based on simple clinical testing. Additional clinically applicable tests of vestibular function are required to further investigate the relationship between vestibular dysfunction and falling in older people.

Accidental Falls↗

Chronic migrainous vertigo.

A series of 16 subjects is described who presented with chronic vertigo that was thought to be migrainous in nature. The vertigo occurred on a daily basis and had been present for six months or more. Common symptoms included motion-induced dizziness, positional vertigo and motion sensitivity. Investigations were frequently normal apart from the finding of atypical positional nystagmus in four subjects and unilateral vestibular hypofunction in two subjects. It was frequently not possible to make a diagnosis of migraine on the basis of International Headache Society criteria, however the dramatic beneficial response to anti-migraine therapy supported the hypothesis that the vertigo was migrainous in nature.

Adolescent↗