PubMed HealthSearch

Biomedical subjects

N Torok

Publications and source records attributed to N Torok.

At least 19 recordsLinked to original sources

Pitfalls in detecting vestibular decruitment with air calorics.

Vestibular decruitment is a pathological finding which indicates retrolabyrinthine disease. In the overwhelming majority of cases, it is consistent with posterior fossa pathology. Weak and strong caloric stimulations must be applied with precision for detecting decruitment. Air-caloric stimulation has inherent limitation in regards to reproducing the strength of the stimulus. Thus, it is inadequate for decruitment detection. It is, therefore, advisable to use water-caloric testing to assess vestibular decruitment or recruitment as one of the most revealing diagnostic clues in our neurotologic armamentarium.

Air

Old and new in Ménière disease.

The clinical experience is increasing, but still there is no uniform understanding in the substrate of Ménière's disease. The criteria of the diagnosis is loose and great controversy exists in the therapeutic efforts. A bewildering number of concepts and methods have been suggested and praised as the best answers in solving the problem until the next claim of success shatters the popularity of earlier allegations. The array of articles in the world literature for the past 25 years treats the entity of Ménière's disease in general and from the viewpoint of etiology, pathology, histology, clinical diagnosis and treatment. This review is concerned primarily with the treatment aspect of the literature. All the published ideas, regimens and techniques have one significant feature in common. They all claim success but not in 100% of the cases. Recovery varies from about 60% to 80%. Those cases considered "improved" are 20% to 30% and the rate of failure is between 10% and 25%. The diagnostic tools and capabilities have improved considerably. For treatment, except for reasonable medical or surgical palliation, nothing more can be offered than was offered a half century ago.

Diuretics

Diffential diagnosis of the caloric nystagmus.

Diagnostic considerations based upon the nystagmogram are limited. Quantitative assessment of horizontal canal sensitivity is available through the use of culmination frequency or culmination slow phase velocity. Qualitative characteristics of nystagmometry have been sought but with no satisfactory results. Three distinctive features of the caloric nystagmus were evaluated and were found to be suggestive or outrightly pathognomonic for retrolabyrinthine or central nervous system abnormalities. These are: (1) Vestibular decruitment. The disproportionate caloric responsiveness when a weak stimulus elicits a more intense nystagmic reaction than a strong stimulus is capable of creating. (2) Hyperactive vestibular responsiveness (3) Ocular fixation reversal phenomenon. Contrary to the normal behaviour, the elimination of fixation decreases the nystagmus intensity instead of facilitating the evoked nystagmus. The assessment of these qualitative features of the caloric nystagmus in addition to the quantitative measurements widens the scope of our diagnostic capabilities.

Adult