PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Vestibular Function Tests”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources

Vestibular neuropathy accompanying auditory and peripheral neuropathies.

OBJECTIVE: To define the incidence of measurable vestibular disorders in patients with auditory and peripheral neuropathies. DESIGN: Descriptive study of the case features of auditory neuropathy in 14 patients, 8 of whom had concomitant peripheral neuropathies. SETTING: University referral center. PATIENTS: Fourteen patients aged from 10 to 75 years and diagnosed as having auditory neuropathy, 8 of whom had concomitant peripheral neuropathies. MAIN OUTCOME MEASURES: Incidence of abnormal vestibular caloric test results and the relationship of such incidence to clinical variables including the ages of the subjects, the presence of a concomitant peripheral neuropathy, vestibular symptoms, and audiological findings. RESULTS: Abnormal vestibular caloric test results occurred in 9 of the 14 patients. These 9 patients were on average older (35.6 years) than patients with normal caloric responses (17.8 years). Seven of the 9 patients with abnormal caloric responses had concomitant peripheral neuropathies compared with only 1 of the 5 patients with normal caloric responses. None of the 14 patients experienced symptoms of vestibular disorder. CONCLUSIONS: Asymptomatic vestibular disorders are common in patients with auditory neuropathy when a peripheral neuropathy is also present. The reason for the abnormal vestibular test results is likely a neuropathy of the vestibular nerves. Arch Otolaryngol Head Neck Surg. 2000;126:1453-1456

Adolescent↗

Vestibulospinal component of postural control (vestibular function) in very preterm infants (25 to 27 weeks) at 3, 6, and 12 months corrected age.

Postural control, which is important for the development of all movement, balance, and locomotion, depends a great deal on the vestibulospinal component of vestibular function in early childhood. Vestibulospinal input is important for muscle power regulation, which, in turn, influences postural control. The aim of this study was to focus particularly on this component of vestibular function during the first year of life in 67 infants with a very short gestational age (25-27 weeks), to search for possible neonatal confounders, and to see whether it influences the course of muscle power development in preterm infants. Outcome was described as being optimal, suspect, or abnormal. The infants were categorized into the Neonatal Medical Index according to the severity of neonatal illness and separately into three groups for neonatal brain ultrasonography findings (normal to severe abnormalities). At the age of 3 months, 20 infants performed optimally on all items testing vestibular function, increasing to 40 at 6 months and 48 at 12 months. This significant improvement (also seen in muscle power regulation) was primarily caused by better head control (during the traction response and prone position), whereas less shoulder retraction and hyperextension were found in the sitting position. Vestibular function was significantly related to brain ultrasonography classification but not to gestational age, birthweight, the Neonatal Medical Index, or gender.

Age Factors↗

Audiovestibular evolution in a patient with multiple sclerosis.

Multiple sclerosis is characterized by the presence of multiple plaques within the central nervous system, manifesting as remission and exacerbation of neurologic dysfunction over variable time courses. We present the case of a 20-year-old woman. Before treatment, her auditory brain stem response (ABR) test revealed bilateral prolongation. A caloric test showed canal paresis of the right ear and a normal response on the left. A vestibular evoked myogenic potential (VEMP) test displayed an absent response in the right ear and a delayed response in the left. A magnetic resonance imaging (MRI) scan demonstrated multiple diffuse high signal lesions in the hemispheres, brain stem, and cerebellum. Six months after treatment, the demyelinating plaques were shown to have resolved spontaneously on MRI. Recovery of caloric responses was anticipated. Bilateral prolongation of ABRs remained, but the VEMP test disclosed a normal response in the right ear and a delayed response in the left. Accordingly, in addition to MRI, caloric tests and ABR and VEMP tests are useful in monitoring the evolution of audiovestibular function in patients with multiple sclerosis.

Adult↗

Walk-rotate-walk test identifies patients responding to Lempert's maneuver, with benign paroxysmal positional vertigo of the horizontal canal.

Two hundred and fifteen patients were diagnosed and treated for benign paroxysmal positional vertigo of the horizontal canal (BPPV-HC). All patients were tested with conventional positional nystagmus tests lying supine and rotating head for geotropic nystagmus, registered with Frenzels glasses, and in 109 cases with ENG. The walk-rotate-walk (WRW) test, developed by one of us (T.R.) and described in the text, was applied to all patients. The immediate good treatment results with Lempert's maneuver verify the correct diagnosis of BPPV-HC. The WRW test is a more sensitive test for BPPV-HC than earlier positional tests. The unhabituated acute phase of vestibular neuritis shows positive test results and must be eliminated with caloric tests. The WRW test identifies as a dynamic test patients with symptoms of even lesser magnitude, where the compensatory capacity of the equilibrium system suppresses the diagnostic findings with earlier positional horizontal canal tests.

Adolescent↗

A head autorotation test for patients with Menière's disease.

OBJECTIVE: We compared the vestibulo-ocular reflex (VOR) of healthy volunteers and of two groups (group A, conservatively treated; and group B, with gentamicin or surgically treated) of Menière's disease (MD) patients to determine whether the head autorotation test (HART) can reveal abnormality of the VOR and whether the HART can be applied in evaluation of MD. METHODS: The gain, phase, asymmetry, and the highest frequency band reached was evaluated with the HART in the frequency range of 1-5 Hz. The caloric responses and posturography results were also determined. RESULTS: The mean gain was lower for the both groups of MD patients than for the controls. In the MD patients the phase difference was shorter and the asymmetry was greater than in the controls. Only 58% (group A) and 36% (group B) of the MD patients reached the frequency band of 4 Hz, and 33% (group A) and 19% (group B) reached 5 Hz. The respective percentages for the controls were 97 and 77%. Of the 25 MD patients (group B) 72% had abnormal HART results. Among the group A of MD patients the HART (50%) was more sensitive to VOR abnormality than the caloric test (10%) was. For aggressively treated MD patients a decrease in gain at 2 and 3 Hz in the HART correlated with abnormal caloric test results. Increased body sway in posturography correlated with the pathological results in the HART. CONCLUSION: The HART is a complementary method for evaluating the natural frequency range of the VOR, and evaluation of MD patients may benefit from combined results of the caloric test and HART.

Adult↗

Superior vestibular nerve sectioning. Experimental studies in squirrel monkeys.

Spontaneous, positional, and paroxysmal positional nystagmus were studied before and after sectioning the superior division of the vestibular nerve and the anterior vestibular artery in squirrel monkeys. Histopathologic study of the temporal bones confirmed the degeneration of the macula utriculi with release of statoconia, but failed to identify the released utricular statoconia within the vestibular endolymphatic space in any animal. Postoperatively the animals consistently demonstrated direction-fixed spontaneous nystagmus until the end of the experiment (five months). Positional tests and Dix-Hallpike maneuver occasionally changed the intensity of the spontaneous nystagmus, but never elicited paroxysmal positional nystagmus. Possible reasons for not demonstrating paroxysmal positional nystagmus in the squirrel monkey are as follows: a resorption of statoconia; slight morphological alteration of the sensory epithelia of the posterior cristae; interference of the posterior crista function due to partial collapse of the membranous ampulla; the existence of interspecies difference; or possibly a faulty hypothesis regarding the etiologic mechanism of benign paroxysmal positional vertigo.

Animals↗

Clinical investigation of the vestibular cortex.

This study attempted to identify the vestibular cortex that is involved in the perception of vestibular vertigo in the human brain. We used single-photon emission computed tomography (SPECT) to measure regional cerebral blood flow (rCBF) in two cerebrovascular patients with nystagmus-sensation dissociation, which is known as brisk caloric nystagmus without simultaneous sensation of vertigo. Both patients had ischemic lesions involving mainly the parieto-temporal lobe in the nondominant hemisphere. It is suggested that the parieto-temporal lobe in the nondominant hemisphere contains the vestibular cortex which is a center for the perception of vertigo due to vestibular stimulation.

Aged↗

Clinically relevant physiology of the vestibulo-ocular reflex.

This review attempts to explain those aspects of the physiology of the vestibulo-ocular reflex (VOR) which could be of future clinical value. The literature cited has been selected for its didactic worth to readers with limited time, preferring concise reviews to detailed reports wherever possible. Physiological data provide the background for the following possible improvements in clinical diagnosis: 1) In gaze analysis, coordination of the VOR with other motor patterns can be analyzed. 2) Precision of vestibular tests can be improved by selecting stimuli within the range of natural movements.3) Resolution of the caloric test can be imporved when the change of temperature at the semicircular canal mimics endolymph pressure changes during natural movements. 4) A direct test of the three neuron VOR pathways is possible, but not practicable. 5) Integration of the input signal (transformation from head acceleration to eye position information) can be directly tested. 6) Plasticity (the adaptation to visual requirements) of the VOR can be examined. 7) It is possible to quantify vestibular damage and detect the side of lesion in one test analyzing gain and binocular symmetry of the vertical VOR.

Cerebellum↗

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↗

[Study on the nature of tonic ocular movement produced during pendular vestibular stimulation (author's transl)].

During vestibular function tests using the pendulum chair, electronystagmography has repeatedly shown that a tonic ocular deviation precedes the change in nystagmus. This tonic movement may be anticipated in respect to the change in the sinusoidal movement of the chair. Greiner, Conraux, Collard and more recently J.B. Causse, have proposed a hypothesis based on the own periodicity of the vestibular system. J. Max explained this phenomenon in terms of a difference in phase with the electronic system. Our investigation suggests another explanation of this phenomenon. Each half-period consists of a acceleration phase and a decelaration phase. Thus within half-period alone there are two successive forms of nystagmus induced. The succession of half-periods gives the usual systagmus response. We consider that the tonic response of the eyes is not an anticipated one in respect to the change in sinusoidal movement of the chair, but rather a delayed one in respect to the reversal in the direction of acceleration.

Acceleration↗

Progressive auditory neuropathy in patients with Leber's hereditary optic neuropathy.

OBJECTIVE: To investigate auditory neural involvement in patients with Leber's hereditary optic neuropathy (LHON). METHODS: Auditory assessment was undertaken in two patients with LHON. One was a 45 year old woman with Harding disease (multiple-sclerosis-like illness and positive 11778mtDNA mutation) and mild auditory symptoms, whose auditory function was monitored over five years. The other was a 59 year old man with positive 11778mtDNA mutation, who presented with a long standing progressive bilateral hearing loss, moderate on one side and severe to profound on the other. Standard pure tone audiometry, tympanometry, stapedial reflex threshold measurements, stapedial reflex decay, otoacoustic emissions with olivo-cochlear suppression, auditory brain stem responses, and vestibular function tests were undertaken. RESULTS: Both patients had good cochlear function, as judged by otoacoustic emissions (intact outer hair cells) and normal stapedial reflexes (intact inner hair cells). A brain stem lesion was excluded by negative findings on imaging, recordable stapedial reflex thresholds, and, in one of the patients, olivocochlear suppression of otoacoustic emissions. The deterioration of auditory function implied a progressive course in both cases. Vestibular function was unaffected. CONCLUSIONS: The findings are consistent with auditory neuropathy-a lesion of the cochlear nerve presenting with abnormal auditory brain stem responses and with normal inner hair cells and the cochlear nucleus (lower brain stem). The association of auditory neuropathy, or any other auditory dysfunction, with LHON has not been recognised previously. Further studies are necessary to establish whether this is a consistent finding.

Audiometry, Evoked Response↗

Assessment of auditory and vestibular functions after vestibular neurectomy for Menière's disease.

Fourteen patients (12 Meniere's disease, one delayed endolymphatic hydrops and one labyrinthitis) suffering from intractable vertigo were treated with retrosigmoid vestibular neurectomy (RSVN) in our institute. Dizziness was controlled completely in all patients. Hearing was preserved in 91.7% of the cases with pure tone threshold deteriorating by more than 10 dB in one case, remained unchanged in 10 cases and improved in one case during long term observation. Substantial decrease of tinnitus was observed in 78.6%. Vestibular compensation was chronologically analyzed with a stabilometer, ENG and vestibular rotation test (0.01-0.64 Hz). Vestibular compensation under static conditions was accomplished within 2 weeks, except for spontaneous nystagmus measured in the dark. Asymmetry of vestibulo-ocular reflex was noted 2 weeks after the operation but had disappeared after 4 weeks. However, for over 2 years the VOR time constant remained lower (4.3-5.2 s) than the pre-operative value (8.2 s). Electro-cochleogram (ECoG) was recorded before and after RSVN. The -SP/AP ratio tended to increase after RSVN in the operated ear, though there was no change in the contralateral ear. The efferent olivo-cochlear bundle was thought to play a potential role in this increase of the -SP/AP ratio.

Adult↗

Clinical experience with the vestibular evoked myogenic potential.

The vestibular evoked myogenic potential (VEMP) is a promising test of the descending vestibulocollic system. Our aim was to determine whether the VEMP can be applied to an older patient population and can detect lesions in descending vestibulospinal pathways. We also compared VEMP clinical performance with that of the standard caloric test. VEMP test performance was retrospectively analyzed in relation to clinical diagnosis and other vestibular test performance in 62 patients (age, 30-85 years) referred for vestibular testing to Mayo Clinic, Jacksonville, Florida. The VEMP was evoked using a 250 Hz tone burst. Results suggest age-related changes in VEMP amplitude and latency in this patient population. VEMP tests were sensitive to lesions not detected by electronystagmography. VEMP and caloric sensitivity and specificity were essentially equal (d' = 1). Combining both tests improved sensitivity. However, VEMP false-positive rates hampered specificity. VEMP testing may be refined to improve false-positive rates and clinical utility.

Adult↗

[Spatial orientation and postural regulation in patients with idiopathic scoliosis].

QUESTION: Etiology of idiopathic scoliosis is unknown. In literature a primarily neurogenic disturbance of postural regulation is discussed with subsequent changes of the spine. In the present paper, individual functions of postural regulation in patients with idiopathic scoliosis were examined by neurophysiologic investigations and compared to a normal population. METHOD: The body sway of 28 patients was investigated in upright position under various testing conditions by means of a force measuring platform, allowing examination of the efferent part of postural regulation as well as the sensory systems involved. Registration of the eye movements (ENG) made it possible to investigate the function of the vestibulo-cerebellar system. Furthermore the optokinetic capability of scoliotic patients was tested by determination of the subjective visual vertical (SVV). RESULTS: It turned out that none of the neurophysiologic test procedures showed clearly pathological findings in scoliotic patients as compared to a normal population. CONCLUSION: It has not to be considered as probable that idiopathic scoliosis is caused by a disturbance of postural regulation.

Adolescent↗

Impairment of visuo-vestibular interaction in humans exposed to toluene.

15 healthy volunteers were investigated in a vestibulo-oculomotor test battery during toluene exposure. The concentration was comparable to the threshold limit value. The results were compared to an identical air experiment. The intoxication caused an impaired visual suppression during a pseudo-random oscillatory swing test and also an increased saccade speed. Other vestibular-oculomotor parameters were normal. The findings are in accordance with our earlier study on styrene in humans, showing that the visual suppression test and the saccade test are sensitive parameters assessing neurotoxic influences by organic solvents.

Adult↗

Drop attacks and vertigo secondary to a non-meniere otologic cause.

BACKGROUND: Tumarkin falls are sudden drop-attack falls that occur in a subset of patients with Meniere syndrome (endolymphatic hydrops), an inner ear disorder characterized by vertigo spells and hearing loss. OBJECTIVE: To describe the clinical features and quantitative audiovestibular testing results in a case series of patients with Tumarkin falls, episodic vertigo, and normal hearing. SETTING: University referral center for disorders of balance and hearing. METHODS: Case series (unselected) of all patients with Tumarkin falls and a normal audiogram at least 1 year after onset of vestibular symptoms (n = 6) from a retrospective analysis of the records of all patients with Tumarkin falls presenting to Neurotology Clinic at UCLA Medical Center, Los Angeles, Calif, from October 1, 1975, to February 1, 2001 (N = 55). Quantitative audiologic and vestibular function testing, neurologic history, and examination were performed. RESULTS: Five of 6 patients had unilateral caloric paresis, and 1 had bilateral vestibulopathy. Five of 6 had a personal and/or family history of migraine headaches meeting International Headache Society criteria. All patients had a subjective sensation of feeling pushed by an external force, and half of the patients had a subjective tilt of the environment concurrent with the fall. CONCLUSIONS: The incidence of migraine is high in this subgroup of patients with Tumarkin falls and normal hearing. The clinical description of the falls is similar to those associated with Meniere syndrome. Further studies are needed to understand the etiology of Tumarkin falls in these patients with normal hearing.

Adult↗