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The effects of intense click sounds on velocity storage in optokinetic after-nystagmus.

Vestibular evoked myogenic potentials (VEMP) occurring after click stimulation in cervical muscles are thought to be a polysynaptic response of otolith-vestibular nerve origin. In optokinetic after-nystagmus (OKAN) the direction of after-nystagmus changes and slow-phase velocity decreases with head tilt. This phenomenon may be an otolith response to the direction of gravity. We assumed that intense clicks might have some influence on OKAN via the otolith-vestibular nerve. Twelve normal subjects who showed VEMP at 75 dB normal hearing level (nHL) clicks were examined. The OKAN was recorded under four conditions: right monaural, left monaural and binaural stimulation by 75 dB nHL clicks, and absence of click stimulation. Horizontal optokinetic stimulation was applied using stepwise increasing speeds from 30 deg/s to 90 deg/s. Two seconds before the stimulus ended, clicks were sounded. The slow-phase velocity of the recorded electro-nystagmography was manually measured. There was no effect on OKAN with unilateral stimulation but binaural stimulation suppressed it. These results suggest that a velocity storage integrator is influenced by intense clicks via the otolithic area.

Acoustic Stimulation↗

Bilateral loss of vestibular function: clinical findings in 53 patients.

The clinical presentations and aetiologies of a series of 53 cases of bilateral vestibular failure (BVF) seen by the authors over a decade were evaluated by retrospective review of the medical records. Thirty-nine per cent of patients had associated neurological disease; 13% had a progressive cerebellar syndrome with disabling gait ataxia, abnormal eye movements and cerebellar atrophy on neuro-imaging. BVF was usually unsuspected. Nine per cent had cranial or peripheral neuropathies and in this group there was no abnormality of brain stem/cerebellar oculomotor function, but hearing loss was common. Eleven per cent revealed BVF and hearing loss secondary to meningitis, and 6% had other neurological disorders. Idiopathic BVF was found in 21% of cases, characterised by paroxysmal vertigo and/or oscillopsia, but no abnormal clinical signs. Gentamicin ototoxicity accounted for a further 17%, while autoimmune disease was present in 9% of patients. Otological or neoplastic disease was diagnosed in the remaining 13% of patients. It was concluded that neurological, audiological and ocular motor assessments allow the probable cause of BVF to be defined in approximately 80% of cases. A group of BVF related to autoimmune pathologies is reported for the first time, indicating the need for immunological screening. Idiopathic BVF may present with only minor visual or vestibular symptoms, while in patients with cerebellar degeneration, BVF may be unsuspected and, thus, underdiagnosed.

Adult↗

Evidence that L-type calcium channels do not contribute to static vestibular function in the guinea pig vestibular nucleus.

Labyrinthine-intact guinea pigs received unilateral, brainstem cannula injections of (1) 2.5 micrograms of the selective dihydropyridine L-type Ca2+ channel agonist, Bay K 8644 (n = 4 animals); (2) 10 micrograms Bay K 8644 (n = 4); 12.5 micrograms of the selective dihydropyridine L-type Ca2+ channel antagonist, nifedipine (n = 4); or 40 micrograms nifedipine (n = 4). In 11/16 cases, the lesion associated with the cannula tip was located within or near the border of the right vestibular nucleus (VN) complex. All cannula injections were delivered in a 1 microliter volume of artificial cerebrospinal fluid (ACSF) and dimethylsulphoxide (DMSO) (70% DMSO, 30% ACSF for Bay K 8644; 80% DMSO, 20% ACSF for nifedipine), adjusted to a pH of approx. 7.0. The effects of these injections were compared with control injections of ACSF/DMSO in our previous studies. Animals were observed for signs of a labyrinthine syndrome (i.e. spontaneous ocular nystagmus, yaw and roll head tilt) directed to the contralateral or ipsilateral side. In no case did Bay K 8644 or nifedipine cause ocular motor or postural symptoms similar to those produced by a unilateral labyrinthectomy. These results suggest that L-type Ca2+ channels do not contribute significantly to the resting activity of VN neurons and therefore do not contribute to static vestibular function at the level of the VN.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗

A new application of LBNP to measure orthostatic tolerance before and after 0-g simulation (water immersion).

Lower body negative pressure (LBNP) remains an important device for the generation of orthostatic stress in the space flight environment as well as a tool to measure inflight and postflight changes in orthostatic response. These applied levels of LBNP have typically not exceeded 50-60 mm Hg negative pressure. Information is incomplete as to the levels of absolute LBNP orthostatic tolerance, and the factors responsible for their variance. A better definition of the tolerance limits for males and females could be expected to aid the evaluation of lower levels of LBNP. An LBNP device was built to study absolute orthostatic tolerance; additionally, another LBNP device was constructed to permit orthostatic tolerance testing directly after a controlled water immersion period. Absolute LBNP orthostatic tolerance patterns are analyzed for a group of males and females (series I). A preliminary statement on the variations of LBNP orthostatic tolerance after limited periods of water immersion and bed rest is also provided (series II).

Adolescent↗

Vestibular experiences of humans during brief periods of partial sensory deprivation are enhanced when daily geomagnetic activity exceeds 15-20 nT.

The intensity of reported vestibular experiences by normal volunteers (n = 127, over a 4-year period) increased significantly in a step-like manner during partial sensory deprivation when the daily geomagnetic activity exceeded about 15 nT; the effect size was equivalent to a correlation of about 0.33. Post hoc analyses indicated that the geomagnetic activity during the 3-h period at the beginning of the previous sleep cycle was the single greatest contributor. The enhanced occurrences of experiences that are similar to those associated with complex partial epileptic seizures suggests that specific stimuli associated with geomagnetic activity above about 15 nT affects specific regions of the human brain; the vulnerability occurs during the subsequent 24 h. However, in non-epileptic individuals these experiences must be amplified neurocognitively by removing input from auditory and visual modalities.

Adolescent↗

Vestibular neuritis in a child with otitis media with effusion; clinical application of vestibular evoked myogenic potential by bone-conducted sound.

Vestibular evoked myogenic potential (VEMP) has been applied for patients with vestibulo-cochlear disorders. The impairment of the sound transmission due to middle ear pathology affects VEMP results. In children, otitis media with effusion (OME) is well documented and it is difficult to apply conventional VEMP in such cases. To overcome the attenuation of stimulation due to middle ear pathology, VEMP by bone-conducted sound has been developed. We report a 3-year-old girl with vestibular neuritis and OME as a representative case of clinical application of VEMP by bone-conducted sound. VEMP by bone-conducted sound can be an alternative method to elicit vestibular-dependent potential.

Bone Conduction↗

Vestibular evoked myogenic potentials in children.

OBJECTIVE: The aim of this work is to establish if the vestibular evoked myogenic potentials (VEMPs) could be used as a clinical test of vestibular function in children. MATERIALS AND METHODS: Forty normal hearing children, aged between 3 and 15 years, and classified in preschool and scholar group, have been investigated in order to study normal development of vestibular potentials and to define fundamental parameters of VEMPs, establishing normal data of latencies and amplitude ratio. Electromyographic activity of sternocleidomastoid muscle was recorded while children were laid supine on a bed and asked to raise their head off of the bed in order to activate their neck flexors bilaterally. The saccular receptors were acoustically stimulated with a logon of 500Hz at an intensity of 130dB peSPL presented monaurally through earphones. In each recording, we analysed latencies and amplitudes of the p13 and n23 waves and the amplitude ratio between the two ears. RESULTS: VEMPs were normally detected in all subjects. In preschool group mean p13 and mean n23 latencies were, respectively, 16.13 (+/-2.12)ms and 21.17 (+/-2.77)ms; mean amplitude ratio was 28.49 (+/-18.10). In scholar group mean p13 and n23 were respectively 16.14 (+/-3.48)ms and 21.78 (+/-3.39)ms, while mean amplitude ratio 20.44 (+/-13.24). Comparison of latencies and amplitude ratio between the children groups and control adult group did not showed any significant differences. CONCLUSION: In conclusion, VEMPs could represent a valid and non-invasive technique able to investigate vestibular function in children and, in particular, vestibulo collic reflex.

Acoustic Stimulation↗