Computerized analysis of established craniocorpography (original) (raw)
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European Archives of Oto-Rhino-Laryngology, 2001
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.
Acta Otorrinolaringologica (English Edition), 2008
There are many different vertigo classifications and different denominations are frequently used for the same clinical processes. The Otoneurology Committee of the Spanish Society for Otorhinolaryngology and Head and Neck Pathology proposes an eminently practical classification of peripheral vertigo to facilitate a common terminology that can be easily used by general ENT practitioners. The methodology used has been by consensus within our society and especially among the most outstanding work groups in the area of otoneurology in Spain. Initially vertigo is divided into single-episode vertigo and recurring attacks of vertigo, and these are then sub-divided into 2 groups, depending on whether or not hearing loss is present. Acute vertigo without hearing loss corresponds to vestibular neuritis and if it is associated with hearing loss, it is due to labyrinthitis of different aetiologies and cochleovestibular neuritis. Recurrent vertigos without hearing loss are classified as induced, either by posture (BPPV) or pressure (perilymphatic fistula), or as spontaneous, including migraine-associated vertigo, metabolic vertigo, childhood paroxysmal vertigo, and vertigo of vascular causes (TIAs, vertebrobasilar insufficiency). Finally, recurrent vertigo with hearing loss includes Ménière's disease and others such as vertigomigraine (with hearing loss), autoimmune pathology of the inner ear, syphilitic infection, and perilymphatic fistula (with hearing loss).
Practical diagnosis and management of peripheral vertigo
Praxis of Otorhinolaryngology, 2017
Bu çalışmada baş dönmesi olan hastaların tanısında kullandığımız klinik tanı yöntemlerinin güvenilirliği ve vestibüler rehabilitasyon tedavisinin etkinliği araştırıldı. Hastalar ve Yöntemler: Şubat 2013-Haziran 2014 tarihleri arasında hastanemize baş dönmesi nedeniyle başvuran ve odiyo-vestibüler laboratuvarda periferik vertigo tanısıyla tedavi edilen hastalar incelendi. Odiyo-vestibüler laboratuvarında hastalar şu muayenelerden geçti: spontan nistagmus ve bakışta (gaze) nistagmus, bakış yönünde kayma testi (skew deviation), baş itme testi, baş sallama nistagmus testi, dinamik görme keskinliği testi, Dix-Hallpike manevrası, sırt üstü yuvarlanma testi, Tandem Romberg testi ve modifiye denge duyusal etkileşimi klinik testi. Merkezi sinir sistemi patoloji semptomları olan hastalar çalışma dışı bırakıldı. Hastaların klinik tanısına göre vestibüler rehabilitasyon tedavisi yapıldı. Hastalar bir yıl sonra vestibüler rehabilitasyon tedavisinin sonuçlarını incelemek üzere değerlendirildi. Bulgular: Yüz dört hasta (35 erkek, 69 kadın) bu çalışma için uygun bulundu. Yüz dört hastanın 92'sine (%88.4) nihai klinik tanı konulabildi. En sık konulan tanılar sırasıyla tek taraflı vestibüler disfonksiyon ve posteriyor kanal benign pozisyonel paroksizmal vertigo idi. Her ne kadar on iki hastaya (%11.6) kesin tanı konulamamış olsa da tüm hastalarda akut santral patoloji hariç tutuldu. Yüz dört hastanın %75.96'sının tedavisi 15 gün, %94.23'ünün 30 gün, %98.08'inin 45 gün, %99.04'ünün 60 gün sürdü ve kalan hastaların tedavisinin sonlanması ise 75 günü buldu. Bir yıl sonra telefon görüşmesiyle yapılan değerlendirmede hastaların %83.2'sinin vestibüler rehabilitasyon tedavisinden fayda gördüğü ve hiçbir hastada serebral inme gelişmediği öğrenildi. Sonuç: Odiyo-vestibüler laboratuvarında kullanılan klinik testler serisi birlikte değerlendirildiğinde güvenilir ve yeterlidir. Vestibüler rehabilitasyon, periferik vestibüler disfonksiyon semptomlarının hafifletilmesinde ve baş dönmesi olan hastaların yaşam kalitesinin artırılmasında çok etkilidir.
Brain Research Bulletin, 1996
Asymmetries in the settings of the subjective visual vertical after unilateral vestibular neurectomy during eccentric centrifugation [3] might provide a clinical test for unilateral otolithic function. This study investigates whether these asymmetries can also be revealed by a technically much easier practicable roll tilt of the subject relative to gravity instead of a roll tilt of the gravitational force on a human centrifuge. Twenty-seven normal subjects and 13 patients before surgery indicated vetiicality very accurately in the upright position. In 28" roll positions (subjects seated on a slanted chair), they were only slightly more variable with no asymmetries larger than 5.3 and 7.8" in normals and preoperative patients, respectively, between the roll positions toward the healthy and toward the affected ear. One week after surgical unilateral vestibular deafferentation, there was a consistent shii (mean 11.9") of the subjective vertical toward the affected ear in all patients and in all body positions. When the settings in the two roll tilt positions were referred to the setting in upright position, the group means of the patients were symmetrical although single subjects revealed asymmetries up to 22.4". Only one of four patients who were tested also during eccentric rotation revealed an important asymmetry with decreased sensitivity for tilts of the gravitational vector toward the affected ear. Measuring the subjective visual vertical assesses only asymmetrical tonic otolithic input, while a simple clinical test for unilateral otolithic sensitivity still has to be found.
DIFFERENTIAL DIAGNOSIS OF VERTIGO
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Rad za medicinske znanosti, Zagreb, 2007., str. 25-36 V. Demarin, Z. Trkanjec, A. Aleksiae-Shibabi, M. Uremoviae: Differential diagnosis of vertigo 02.p65 16. 10. 07, 22:56 24 Rad za medicinske znanosti, Zagreb, 2007., str. 25-36 V. Demarin, Z. Trkanjec, A. Aleksiae-Shibabi, M. Uremoviae: Differential diagnosis of vertigo
Visual vertigo: symptom assessment, spatial orientation and postural control
Brain, 2001
facing the tilted frame and during disc rotation. In vertigo' in which their symptoms are provoked or psychophysical and postural tests, both LDS and VV aggravated by specific visual contexts (e.g. supermarkets, patients showed: (i) a significant increase in the tilt of the driving or movement of objects). In order to determine visual vertical both with the static tilted frame and with the causes of visual vertigo (VV), we assessed symptoms, the rotating disc; and (ii) an increased postural deviation anxiety and the influence of disorienting visual stimuli in whilst facing the tilted frame and the rotating disc. The 21 such patients. In 17 out of 21 patients, a peripheral ratio between sway path with eyes closed and eyes open vestibular disorder was diagnosed. Sixteen bilateral (i.e. the stabilizing effect of vision) was increased in the labyrinthine-defective subjects (LDS) and 25 normal LDS, but not in VV patients, compared with normal subjects served as controls. Questionnaire assessment subjects. In contrast, the ratio between sway path during showed that the levels of trait anxiety and childhood disc rotation and sway path during eyes open (i.e. the motion sickness in the three subject groups were not destabilizing effect of a moving visual stimulus) was significantly different. Reporting of autonomic symptoms increased in the VV patients but not in LDS. Taken and somatic anxiety was higher than normal in both together, these data show that VV patients have patient groups but not significantly different between abnormally large perceptual and postural responses to LDS and VV patients. Handicap levels were not different disorienting visual environments. VV is not related to in the two patient groups, but the reporting of vestibular trait anxiety or a past history of motion sickness. The symptoms was higher in the VV than in the LDS group. results indicate that VV emerges in vestibular patients if The experimental stimuli required subjects to set the they have increased visual dependence and difficulty in subjective visual vertical in three visual conditions: total resolving conflict between visual and vestibulodarkness, in front of a tilted luminous frame (rod and proprioceptive inputs. It is argued that treating these frame test) and in front of a large disc rotating in the patients with visual motion desensitization, e.g. repeated optokinetic stimulation, should be beneficial. frontal plane (rod and disc test). Body sway was also
Vestibular autorotation testing in patients with benign paroxysmal positional vertigo☆☆☆
Otolaryngology - Head and Neck Surgery, 2000
The current gold standard for diagnosis of benign paroxysmal positional vertigo (BPPV) is the Dix-Hallpike maneuver. However, because of fatigability, the Dix-Hallpike is often falsely normal. The objective of this study was to evaluate the utility of vestibular autorotation testing in the diagnosis of BPPV.