Vestibular dysfunction in Gulf War syndrome

2000 ◽  
Vol 122 (3) ◽  
pp. 319-329 ◽  
Author(s):  
Peter S. Roland ◽  
Robert W. Haley ◽  
Wendy Yellin ◽  
Kris Owens ◽  
Angela G. Shoup ◽  
...  
Keyword(s):  
Gulf War ◽  
Gulf War Syndrome ◽  
Auditory Brain Stem Response ◽  
Gulf War Veterans ◽  
Group Identities ◽  
Saccadic Velocity ◽  
Interpeak Latency ◽  
Caloric Response ◽  
Pathologic Nystagmus ◽  
Sinusoidal Harmonic Acceleration

METHODS Vestibular complaints of Gulf War veterans were characterized by a nested case-control study of 23 veterans with 3 different Gulf War syndromes and 20 matched control subjects. All subjects completed a standardized symptom questionnaire and underwent standard audiovestibular tests administered by audiologists blinded to group identities. RESULTS The prevalence of reported dizzy spells was higher in veterans with Gulf War syndromes 1 (100%), 2 (85%), and 3 (100%) than in controls (25%, P < 0.0001). Dizzy spells were more frequent, lasted longer, and involved a wider variety of accompanying symptoms in veterans with syndrome 2 than in those with syndromes 1 and 3. Audiovestibular testing showed greater interocular asymmetry of nystagmic velocity on sinusoidal harmonic acceleration in syndromes 1 ( P = 0.015) and 2 ( P = 0.002), greater asymmetry of saccadic velocity in syndrome 2 ( P = 0.4), diminished nystagmic velocity after caloric stimulation bilaterally in syndrome 3 ( P = 0.02 to 0.04), more subjects with pathologic nystagmus ( P = 0.09), and greater interside asymmetry of wave I to III interpeak latency on auditory brain stem response in syndromes 1 ( P = 0.005) and 2 ( P = 0.07). Asymmetry of gain on sinusoidal harmonic acceleration and pathologic nystagmus were most strongly associated with symptoms of paroxysmal vertigo ( P = 0.002 and 0.07, respectively); asymmetry of saccadic velocity, with the severity of vertigo ( P = 0.004); and abnormal caloric response, with chronic dysequilibrium ( P = 0.006). CONCLUSIONS The findings are compatible with a subtle neurologic injury from organophosphate-induced delayed neurotoxicity.

Vestibular Dysfunction in Gulf War Syndrome

2000 ◽  
Vol 122 (3) ◽  
pp. 319-330 ◽  
Author(s):  
Peter S. Roland ◽  
Robert W. Haley ◽  
Wendy Yellin ◽  
Kris Owens ◽  
Angela G. Shoup ◽  
...  
Keyword(s):  
Gulf War ◽  
Gulf War Syndrome ◽  
Auditory Brain Stem Response ◽  
Gulf War Veterans ◽  
Group Identities ◽  
Saccadic Velocity ◽  
Interpeak Latency ◽  
Caloric Response ◽  
Pathologic Nystagmus ◽  
Sinusoidal Harmonic Acceleration

METHODS: Vestibular complaints of Gulf War veterans were characterized by a nested case-control study of 23 veterans with 3 different Gulf War syndromes and 20 matched control subjects. All subjects completed a standardized symptom questionnaire and underwent standard audiovestibular tests administered by audiologists blinded to group identities. RESULTS: The prevalence of reported dizzy spells was higher in veterans with Gulf War syndromes 1 (100%), 2 (85%), and 3 (100%) than in controls (25%, P < 0.0001). Dizzy spells were more frequent, lasted longer, and involved a wider variety of accompanying symptoms in veterans with syndrome 2 than in those with syndromes 1 and 3. Audiovestibular testing showed greater interocular asymmetry of nystagmic velocity on sinusoidal harmonic acceleration in syndromes 1 ( P = 0.015) and 2 ( P = 0.002), greater asymmetry of saccadic velocity in syndrome 2 ( P = 0.4), diminished nystagmic velocity after caloric stimulation bilaterally in syndrome 3 (P = 0.02 to 0.04), more subjects with pathologic nystagmus ( P = 0.09), and greater interside asymmetry of wave I to III interpeak latency on auditory brain stem response in syndromes 1 ( P = 0.005) and 2 ( P = 0.07). Asymmetry of gain on sinusoidal harmonic acceleration and pathologic nystagmus were most strongly associated with symptoms of paroxysmal vertigo (P = 0.002 and 0.07, respectively); asymmetry of saccadic velocity, with the severity of vertigo (P = 0.004); and abnormal caloric response, with chronic dysequilibrium ( P = 0.006). CONCLUSIONS: The findings are compatible with a subtle neurologic injury from organophosphate-induced delayed neurotoxicity.

Gulf War illness: an overview of events, most prevalent health outcomes, exposures, and clues as to pathogenesis

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Kathleen J. Kerr
Keyword(s):  
Oxidant Stress ◽  
Gastrointestinal Symptoms ◽  
Epidemiologic Studies ◽  
Gulf War ◽  
Institute Of Medicine ◽  
Gulf War Illness ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
The Usa

AbstractIntroduction:During or very soon after the 1990–1991 Persian Gulf War, veterans of the conflict began to report symptoms of illness. Common complaints included combinations of cognitive difficulties, fatigue, myalgia, rashes, dyspnea, insomnia, gastrointestinal symptoms and sensitivity to odors. Gradually in the USA, and later in the UK, France, Canada, Denmark and Australia, governments implemented medical assessment programs and epidemiologic studies to determine the scope of what was popularly referred to as “the Gulf War syndrome”. Attention was drawn to numerous potentially toxic deployment-related exposures that appeared to vary by country of deployment, by location within the theater, by unit, and by personal job types. Identifying a single toxicant cause was considered unlikely and it was recognized that outcomes were influenced by genetic variability in xenobiotic metabolism.Methods:Derived from primary papers and key reports by the Research Advisory Committee on Gulf War Veterans’ Illnesses and the Institute of Medicine, a brief overview is presented of war related events, symptoms and diagnostic criteria for Gulf War illness (GWV), some international differences, the various war-related exposures and key epidemiologic studies. Possible exposure interactions and pathophysiologic mechanisms are discussed.Results:Exposures to pyridostigmine bromide, pesticides, sarin and mustard gas or combinations thereof were most associated with GWI, especially in some genotype subgroups. The resultant oxidant stress and background exposome must be assumed to have played a role.Conclusion:Gulf War (GW) exposures and their potential toxic effects should be considered in the context of the human genome, the human exposome and resultant oxidant stress to better characterize this unique environmentally-linked illness and, ultimately, provide a rationale for more effective interventions and future prevention efforts.

scholarly journals Health Status and Clinical Diagnoses of 3000 UK Gulf War Veterans

2002 ◽  
Vol 95 (10) ◽  
pp. 491-497 ◽  
Author(s):  
Harry A Lee ◽  
Roger Gabriel ◽  
J Philip G Bolton ◽  
Amanda J Bale ◽  
Mark Jackson
Keyword(s):  
Traumatic Stress ◽  
Gulf War ◽  
Post Traumatic Stress ◽  
Medical Assessment ◽  
Gulf War Syndrome ◽  
Health Service Provision ◽  
Medical Diagnoses ◽  
Gulf War Veterans ◽  
Clinical Diagnoses ◽  
Post Traumatic

Up to June 2001, 3000 British veterans of the Gulf War had sought advice from a special medical assessment programme established because of an alleged Gulf War syndrome. After assessment those attending were classified as completely well, well with symptoms, well with incidental diagnoses treated or controlled, or unwell (physically or mentally). Mental illness was confirmed by a psychiatrist. The first 2000 attenders have been reported previously. The present paper summarizes findings in all 3000. 2252 (75%) of those attending were judged ‘well’, of whom 303 were symptom-free. Medical diagnoses were those to be expected in such an age-group (mean age 34 years, range 21–63). No novel or unusual condition was found. In 604 of the 748 unwell veterans, a substantial element of the illness was psychiatric, the most common condition being post-traumatic stress disorder. The healthcare requirements of the Gulf veterans seen in this programme can therefore be met by standard National Health Service provision.

Gulf War Syndrome: a review of current knowledge and understanding

2014 ◽  
Vol 100 (3) ◽  
pp. 252-258 ◽  
Author(s):  
D Minshall
Keyword(s):  
Persian Gulf ◽  
Matched Control ◽  
Current Knowledge ◽  
Gulf War ◽  
Persian Gulf War ◽  
Gulf War Syndrome ◽  
Anthropological Perspective ◽  
Gulf War Veterans ◽  
Military Life ◽  
Combat Disorders

AbstractThe 1991 Persian Gulf War was a resounding military success for coalition forces, who liberated Kuwait following the Iraqi invasion. The medical legacy we have from the conflict is the poorly understood, yet remarkable, phenomenon of Gulf War Syndrome, which surfaced soon after.Epidemiological research has proven beyond doubt that Gulf War veterans report a wide variety of symptoms, in excess of appropriately matched control subjects, and experience worse general health. Numerous toxic environmental hazards have been suggested as causes of Gulf War Syndrome, yet exhaustive scientific study has failed to provide conclusive proof of any link. No novel or recognised disease has been found to account for the symptomatic burden of veterans, and the optimal treatment remains uncertain.This understanding can be added to from an anthropological perspective, where the narratives of those afflicted provide further insight. The nature of military life was changing at the time of the Gulf War, challenging the identity and beliefs of some veterans and causing socio-cultural distress. The symptomatic presentation of Gulf War Syndrome can be considered an articulation of this disharmony. Gulf War Syndrome can also be considered within the group of post-combat disorders such as shellshock, the like of which have occurred after major wars in the last century. With the current withdrawal from Afghanistan, the Defence Medical Services (DMS) should heed the lessons of history.

Risk factors for continued illness among Gulf War veterans: a cohort study

2004 ◽  
Vol 34 (4) ◽  
pp. 747-754 ◽  
Author(s):  
M. HOTOPF ◽  
A. DAVID ◽  
L. HULL ◽  
V. NIKALAOU ◽  
C. UNWIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Psychological Distress ◽  
Physical Functioning ◽  
Gulf War ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Initial Symptoms

Background. There are no prospective cohort studies of prognostic factors on the outcome of Gulf War veterans. We aimed to test the hypotheses that Gulf War veterans who were older; had more severe symptoms; had more exposures during deployment; had increased psychological distress and believed they had ‘Gulf War syndrome’ would experience greater fatigue and poorer physical functioning at follow-up.Method. Gulf War veterans who responded to an earlier retrospective cohort study were followed with a postal survey. More symptomatic individuals were oversampled. Outcome was measured on the Chalder fatigue questionnaire, the General Health Questionnaire and the Medical Outcome Study Short-Form 36.Results. Of those surveyed, 73·8% responded. We found some evidence for four of the five hypotheses. More self-reported exposures at baseline were not associated with poorer outcome, but older people, those with more severe symptoms at baseline, those with psychological distress and who believed they were suffering from ‘Gulf War syndrome’ had more fatigue at follow-up. Officer status was associated with a better outcome. A similar lack of association was found for exposures and physical functioning and GHQ-12 score. ‘Gulf War syndrome’ attribution was associated with a worse outcome for GHQ-12 and physical functioning even after controlling for severity of symptoms at baseline.Conclusions. This study suggests that while multiple vaccination and military exposures are important risk factors for the onset of symptoms in Gulf War veterans, these are not important risk factors for persistence of such symptoms. Instead the severity of the initial symptoms; psychological distress and attributions may be more important determinants of outcome.

scholarly journals Prevalence of Gulf war veterans who believe they have Gulf war syndrome: questionnaire study

BMJ ◽  
2001 ◽  
Vol 323 (7311) ◽  
pp. 473-476 ◽  
Author(s):  
T Chalder ◽  
M Hotopf ◽  
C Unwin ◽  
L Hull ◽  
K Ismail ◽  
...  
Keyword(s):  
Gulf War ◽  
Questionnaire Study ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans

scholarly journals RNAs in the Sera of Persian Gulf War Veterans Have Segments Homologous to Chromosome 22q11.2

1999 ◽  
Vol 6 (3) ◽  
pp. 330-335 ◽  
Author(s):  
Howard B. Urnovitz ◽  
James J. Tuite ◽  
Jean M. Higashida ◽  
William H. Murphy
Keyword(s):  
Persian Gulf ◽  
Genetic Alterations ◽  
Gulf War ◽  
Persian Gulf War ◽  
Rt Pcr ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Chromosome 22Q11.2 ◽  
Persian Gulf War Veterans

ABSTRACT Reverse transcriptase PCR (RT-PCR) was used for polyribonucleotide assays with sera from deployed Persian Gulf War veterans with the Gulf War Syndrome and a cohort of nonmilitary controls. Sera from veterans contained polyribonucleotides (amplicons) that were obtained by RT-PCR and that ranged in size from 200 to ca. 2,000 bp. Sera from controls did not contain amplicons larger than 450 bp. DNA sequences were derived from two amplicons unique to veterans. These amplicons, which were 414 and 759 nucleotides, were unrelated to each other or to any sequence in gene bank databases. The amplicons contained short segments that were homologous to regions of chromosome 22q11.2, an antigen-responsive hot spot for genetic rearrangements. Many of these short amplicon segments occurred near, between, or in chromosome 22q11.2 Alu sequences. These results suggest that genetic alterations in the 22q11.2 region, possibly induced by exposures to environmental genotoxins during the Persian Gulf War, may have played a role in the pathogenesis of the Gulf War Syndrome. However, the data did not exclude the possibility that other chromosomes also may have been involved. Nonetheless, the detection of polyribonucleotides such as those reported here may have application to the laboratory diagnosis of chronic diseases that have a multifactorial etiology.

scholarly journals Highlights in this issue

2002 ◽  
Vol 32 (8) ◽  
pp. 1333-1333
Keyword(s):  
Cluster Analysis ◽  
Statistical Technique ◽  
Gulf War ◽  
Gulf War Syndrome ◽  
Research Papers ◽  
War Veterans ◽  
Public Controversy ◽  
Gulf War Veterans ◽  
The Usa ◽  
The Subject

This issue features groups of papers on Gulf War syndrome, health service outcome assessment, somatization, personality disorders and depression.Gulf War syndrome has been the subject of much scientific research and public controversy. Two research papers, both from the group at the Institute of Psychiatry in London report studies. David et al. (pp. 1357–1370) find cognitive abnormalities in Gulf War veterans compared with military controls, most attributable to mood disturbances, except for impairment of constructional ability. Everitt et al. (pp. 1371–1378) employ the statistical technique of cluster analysis to search for a unique syndrome in Gulf War veterans but fail to find it. In an accompanying editorial two authorities, from the USA and Canada, examine the issues.

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