Articles: vertigo.
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Vestibular paroxysmia is a syndrome of cross-compression of the VIII cranial nerve and was first described by Jannetta who used the term "disabling positional vertigo". This syndrome is characterized by brief attacks of vertigo, tinnitus, vestibular and auditory deficits. MRI may show the VIII nerve compression from vessels in the posterior fossa, such as the basilar, vertebral, anterior-inferior cerebellar or the posterior-inferior cerebellar arteries. ⋯ This study describes eight patients with vestibular paroxysmia. Four of them showed also clinical signs suggesting cross-compression of the V and/or VII nerve. Seven patients treated with carbamazepine had significant improvement of vertigo and tinnitus.
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Comparative Study
Approach to benign paroxysmal positional vertigo in old age.
Benign paroxysmal positional vertigo is a common and treatable vestibular disorder characterized by attacks of positional vertigo. Although elderly patients often complain about unsteadiness, the symptom of positional vertigo is seldom reported. Several studies on BPPV in the elderly reveal a low success rate in the treatment of this entity. ⋯ Our study shows that BPPV characteristics and treatment effectiveness, as measured by negative Dix-Hallpike maneuver, are not age-dependent and there is no need for a special approach or cautiousness in prognosis prediction. It is important to search actively for this condition since treatment leads to amelioration of unsteadiness and improved well-being in these patients.
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The study explored the hypothesis that spontaneous nystagmus (Ny) in migraine patients can be triggered or modulated by painful trigeminal stimulation, providing evidence of a functional connection between vestibular and trigeminal systems. ⋯ The main result of our study is that in migraine patients painful trigeminal stimulation elicits de novo, or modifies pre-existing spontaneous Ny, generally increasing it. The finding was obtained after trigeminal stimulation, but not after median nerve stimulation. We suggest that painful trigeminal stimulation can induce an imbalance of the vestibular system in migraine patients and possibly explain their predisposition to vertigo. Our data require confirmation by other studies.
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Auris, nasus, larynx · Mar 2005
Validity and limitation of manual rotational test to detect impaired visual-vestibular interaction due to cerebellar disorders.
The aim of this study was to investigate validity and limitation of the novel infrared system to record and analyze horizontal visual-vestibular interaction using whole-body rotation rapidly and conveniently in the routine vestibular clinic. We examined 11 patients with cerebellar dysequilibrium and 25 patients with peripheral dysequilibrium for vestibulo-ocular reflex in darkness (DVOR), visually-enhanced vestibulo-ocular reflex (VEVOR), and fixation suppression of vestibulo-ocular reflex (FSVOR), and compared the results with those of examination for head-fixed smooth pursuit and fixation suppression during caloric stimulation. The manual rotation stimuli were 0.5-0.75 Hz in frequency and 60-90 degrees /s in maximal angular velocity. ⋯ On the other hand, there was no significant difference among the two disease groups and the normal control group in gain of visually-enhanced vestibulo-ocular reflex. In about a half of patients with cerebellar dysequilibrium, measured smooth pursuit gain was lower than estimated smooth pursuit gain calculated based on a simple superposition theory of vestibulo-ocular reflex and smooth pursuit. Testing fixation suppression using the present system is an unusually convenient tool for detection of cerebellar dysequilibrium.