[Report of some unusual vestibular findings and attempted analysis of them].
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Clinical aspects of sudden deafness and sudden vestibular loss. The cases of sudden deafness and/or sudden vestibular loss are 90% idiopathic. Initially they can be overlooked but they can be responsible for an important sensorial impairment. In 65% of cases, and within the first two weeks, there may be a relevant or complete recovery or functional compensation. Etiology and pathogenesis are considered to be pluri-factorial; multiple virus infection including the Herpesvirus family, is the most relevant and better documented cause. Such an infection is responsible for a derangement of inner ear microcirculation, ions imbalance at labyrinthine fluids level, reduction of receptors and nervous supply function. Therapy is essentially symptomatic and therefore the most widely used drugs are cortisonics and heparin. In the Author's opinion also dextran 40, by slow endovenous drip, and carbogen (O2 95% + CO2 5%), by inhalations, are very effective with only rare contraindications. The occurrence of an important number of spontaneous improvements or even recoveries does not authorize therapeutic abstension especially in severe or delayed cases.
An ependymoma was diagnosed in a 4.5-year-old spayed Siamese cat with clinical signs of vestibular disease. Diagnosis was based on history, results of neurologic examination, and the finding of neoplastic cells in CSF. Necropsy revealed an ependymoma arising from the fourth ventricle of the ventricular CNS and involving the left medullary and cerebellar areas.
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Normal values of the caloric test are reported in 202 healthy subjects; besides the absolute values, these comprise the degree of side-difference of excitability and of directional preponderence in percent of the total reaction. In addition to mean values with standard deviations, the median values and the interquantile areas 80, 90, 94 and 100% have been reproduced in tabular form, because, according to statistical calculations, there is no normal distribution of the values in the strict sense. The problematic nature of borderline values for the separation of physiological from pathological responses is discussed in detail. In vieu of the considerable scattering, a knowledge of normal distribution areas appears to be absolutely necessary for an accurate evaluation of the caloric test in patients.
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