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Biomedical subjects

N S Longridge

Publications and source records attributed to N S Longridge.

At least 19 recordsLinked to original sources
PubMed1996

Superficial siderosis--a cause of audiovestibular failure.

Bilateral vestibular end organ failure in adult life is a rare condition with some specific known causes, such as relapsing polychondritis, autoimmune inner ear disease, Lues venerium, and an acute effect of gentamicin. This case report draws attention to a rare condition that is potentially recognizable early in its development. The patient has superficial siderosis, which is iron deposits over the cerebrum, resulting in progressive neurologic failure involving all of the systems. Early in its course before other symptoms appear, there is development of progressive hearing loss and vestibular failure. This case report and literature review are given, including a potential for attempts at therapy if the disorder is recognized early.

Brain Diseases↗
PubMed1995

Effect of age and training schedules on balance improvement exercises using visual biofeedback.

There has been a growing popularity and success rate of balance rehabilitation programs, and this success is paralleled by the growth of technology, making available instruments that provide objective, quantitative, and immediate results. The Balance Master is such a commercially available instrument, consisting of a dual-force platform connected to a micro-computer that provides visual feedback of the centre of gravity (COG) in relation to the theoretical limits of stability. Spontaneous body sway can be measured in a static central position, or in peripheral positions around the limits of stability (peripheral sway area). The trajectory between targets can also be analyzed in terms of time (transition time) and accuracy (path error) of transition, which gives a quantitative measure of dynamic movement of the COG. This study examined the practice effect that occurs while using this instrument over repeated sessions for two schedules of training (daily and weekly) and over two age groups (20-35 years, and 60-75 years). Each group completed a series of postural exercises, with an assessment of static and dynamic postural variables before and after training, and at approximately 3 and 6 weeks post-training. Spontaneous body sway was measured with eyes open, eyes closed, and with visual feedback of the COG. No significant changes were observed in these variables as measured over the four standard assessment occasions. Peripheral sway area and path error decreased significantly for both the daily and weekly training groups from pre- to post-training, and these skills were retained over both retention tests, whereas the tendency toward decreasing transition time was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Topical gentamicin vestibular toxicity.

Two patients with large tympanic membrane perforations received Garasone eardrops. They developed severe acute vestibular deafferentation. In one patient, the middle ear mucosa was healthy and uninfected, and in the other ear, it was inflamed. It is recommended that caution be used in administration of Garasone to the middle ear. If damage can occur with gentamicin, it likely occurs with other ototoxic agents. It is recommended that ototoxic agents not be used in uninflamed middle ears during surgery. The patient should be instructed to treat the discharge through a perforation or tube for only 2 days after the discharge from the external canal ceases.

Administration, Topical↗
PubMed1994

Computerised dynamic posturography: its place in the evaluation of patients with dizziness and imbalance.

As well as vestibular information, computerised dynamic posturography (CDP) measures visual and proprioceptive contributions to the balance system. Three hundred and seventy-five patients were evaluated by computerised dynamic posturography and the results were compared to electronystagmography (ENG) results. CDP demonstrated abnormalities in the balance system in many of the patients who had normal ENGs. It can hone the physician's skill in recognising subtle balance disease; it does not provide localization to one side; it does not offer disease-specific information; however, taken in conjunction with history, physical examination, and other tests, CDP will prove to be a helpful addition to the battery of tests available, and it may provide an objective measure of abnormal balance function in contentious cases.

Adult↗
PubMed1992

Training effects during repeated therapy sessions of balance training using visual feedback.

Visual biofeedback of postural sway is currently being investigated as a therapeutic technique to reduce postural instability in selected patient populations. Before the efficacy of this type of therapy can be determined in a clinical setting, the performance curves of a normal population doing the static and dynamic balance training exercises have to be delineated. Two groups of normal subjects were evaluated during a daily and weekly protocol of dynamic balance exercises using visual feedback of their center of gravity (COG) and theoretical limits of stability. Static stability in a central position was measured with eyes open, eyes closed, and with visual feedback of the COG in a pre-therapy to post-therapy assessment. No significant change was observed in any of these variables from the pre-therapy to the post-therapy evaluation; as well there was no difference between the scores of both groups. Dynamic variables were evaluated in both a pre-therapy to post-therapy assessment, and over the course of therapy. Each of these protocols required the subjects to track targets representing 75% of their limits of stability on a computer screen with their COG. The time taken and the accuracy to move the COG cursor from target to target, as well as the body sway upon reaching the target were evaluated. Transition time and sway area both decreased significantly (p less than 0.01) from the pre-therapy to the post-therapy assessment for both groups, with path error decreasing significantly for the daily therapy group only. No significant difference was demonstrated between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The dynamic illegible E (DIE) test: a simple technique for assessing the ability of the vestibulo-ocular reflex to overcome vestibular pathology.

Vestibulo-ocular reflex (VOR) compensation, shown by the Dynamic Illegible E test (DIE test), for vestibular damage (as shown by caloric reduction) did not coincide consistently with time from initial onset of vestibular disease. We theorize that the reason for this is the variable efficiency of different compensatory mechanisms used by individuals in overcoming vestibular pathology. Methods of compensation are discussed in detail. The DIE test measures the efficiency of the VOR by comparing visual acuity with head still and head moving. While many patients compensated satisfactorily for vestibular injury to the point where they were able to function adequately, other patients appeared not to compensate. There was no obvious prior indication of which patients would compensate well. There was a suggestion that younger patients did better, but neither duration of symptoms nor severity of pathology appeared to be factors in the ability to compensate. Although younger patients may fare better as a group, there are no predictive criteria for the amount or rate of recovery which an individual patient with vestibular pathology will make.

Adult↗
PubMed1987

Bilateral vocal cord paralysis in Shy-Drager syndrome.

A patient with a permanent tracheostomy was seen and noted to have bilateral abductor vocal cord paralysis. He was being investigated neurologically and was found to have several types of autonomic failure, specifically including postural hypotension. It was felt that he had Shy-Drager syndrome. A review of the literature showed that bilateral vocal cord paralysis is a recognized abnormality in this condition for which permanent speaking tracheostomy is the treatment of choice. Reflux esophagitis due to lax cardiac sphincter may be a factor in the laryngeal symptomatology.

Autonomic Nervous System Diseases↗
PubMed1986

Machado-Joseph disease: the vestibular presentation.

Three patients presented with Machado-Joseph disease. We documented the vestibular abnormalities characteristic of Machado-Joseph disease during clinical examination. Electronystagmographic (ENG) abnormalities included bilateral gaze nystagmus, saccadic pursuit and failure of fixation suppression suggestive of cerebellar-brainstem pathology. Machado-Joseph disease is a degenerative neurological condition, inherited in an autosomal dominant fashion. It occurs in patients of Portuguese Azorean extraction. We suggest that otolaryngologists with a referral base including a Portuguese community be familiar with this disease as it may present in its early stages with symptoms of non-specific imbalance.

Azores↗
PubMed1986

Computerized ENG acquisition system.

A computerized transportable ENG acquisition system has been designed, at far less cost than a conventional ENG system, using easily obtainable and standard microcomputer components from our local computer store. Its advantages of reduced cost and greater flexibility as well as its applications to other fields such as word processing and office management would make it a useful addition to any ENG laboratory and otolaryngologist's office as well.

Computers↗
PubMed1985

Arnold-Chiari malformation and the otolaryngologist: place of magnetic resonance imaging and electronystagmography.

The Arnold-Chiari malformation (ACM) is a rare congenital condition in which there is a downward displacement of the cerebellum through the foramen magnum. Patients with this condition frequently develop symptoms of ataxia, imbalance, or vertigo. As a result the patient is often referred to an otolaryngologist. Such a case is reported. A patient presented with imbalance, had downbeating nystagmus on down gaze, and had other eye movement abnormalities recorded on electronystagmography (ENG) which were strongly suggestive of central pathology. Although her computerized tomography (CT) scan was normal, the eye findings and neurological evaluation were strongly suggestive of an ACM. A repeat CT scan with intrathecal metrizamide was abnormal. A definite diagnosis of ACM was confirmed using the new investigative technique of magnetic resonance imaging (MRI).

Adult↗
PubMed1984

A discussion of the dynamic illegible "E" test: a new method of screening for aminoglycoside vestibulotoxicity.

Although aminoglycoside antibiotics have been successful in controlling infections, the side effects of these drugs include vestibulotoxicity that can be irreversible. In a patient with intact visual and proprioceptive systems, the effects can be compensated for, but in a patient with impairment of one of these systems, loss of vestibular function can be devastating. There is little if any agreement in the literature about how to monitor patients undergoing therapy with these drugs. A reading test is described. It uses the ability of the vestibulo-ocular reflex to stabilize an image during head movement. The test is quantified using change in visual acuity with head movement to monitor damage to the vestibular system. Patients with loss of vestibular function are incapable of performing the test. Some evidence points to the test being more sensitive than standard caloric irrigations. We propose that it be used to monitor patients receiving aminoglycoside antibiotics.

Adult↗
PubMed1984

Coincident facial paralysis and serous otitis media in metastatic breast disease.

Carcinoma of the breast is a common disorder. Metastatic breast carcinoma was found to be the underlying cause in two women who presented with serous otitis and facial palsy. Bone scan was abnormal in both patients, one of whom had normal plain films and CT scan. Literature search reveals nine similar cases, in two of which the degree of facial paralysis fluctuated as it did also in the two cases reported here.

Aged↗
PubMed1984

Clinical manifestations of otological syphilis.

One patient with early otological syphilis and five patients with late otological syphilis are described including audiological and serological findings. In patients with late syphilis poorer than expected speech discrimination scores relative to the pure tone audiograms were noted. Profound hypo-activity of vestibular responses to caloric stimulation was present in the cases of late otological syphilis. Routine non-treponemal serological tests were not sensitive enough to establish the diagnosis. It is recommended that more sensitive treponemal serological tests such as the FTA-ABS should be employed.

Adult↗
PubMed1984

Effect of reduced atmospheric pressure on patients with fluctuating hearing loss due to Ménière's disease.

Subjective symptomatic and objective audiologic effects of reduced atmospheric pressure on patients with confirmed fluctuating hearing loss due to Ménière's disease were statistically assessed on a prospective basis. The effect of hypobaric environments on absolute hearing thresholds was investigated in 10 normal subjects at 6,500 ft. Absolute hearing threshold levels obtained at altitude, after one hour altitude exposure, and on descent to normobaric conditions were compared with levels obtained prior to the hypobaric exposure. The results indicated slightly increasing sensitivity of the audiometer headphones with altitude and an insignificant difference in hearing threshold when comparing the differing experimental conditions. The Ménière's disease study group of 16 patients was followed symptomatically and audiologically for one year prehypobaric exposure and for one month post-treatment. The results in this group utilizing the same experimental protocol as with normal subjects indicated a mild deterioration of hearing in the lower frequencies (1,000, 2,000 Hz and calculating the Ménière's pure tone average) despite significant improvements in the vertigo and disability components of their disease.

Adolescent↗
PubMed1983

Vestibular studies in Pelizaeus-Merzbacher disease.

Pelizaeus-Merzbacher disease is a rare sex-linked recessive neurological disorder. It presents with a slowly progressive neurological deterioration. It is liable to be misdiagnosed as cerebral palsy. A family history of similar disease is a clue to the diagnosis. A patient with this condition has been followed over many years. Nystagmus was noted to be present shortly after birth. Audiovestibular investigations were performed. All tests of peripheral hearing were normal. ABR indicated abnormal brainstem conduction. Several electronystagmographic abnormalities were present. These were of a central type. They included failure of fixation suppression, poor smooth pursuit, and impaired performance of optokinetic nystagmus at high stripe speeds. During caloric-induced nystagmus an excessively prolonged slow phase of nystagmus with wide eye excursions was seen. We have not seen this feature in any other diseases and we suggest it may be specific for this syndrome.

Adult↗