Pulse-synchronous torsional nystagmus

2021 ◽  
pp. practneurol-2021-003027
Author(s):  
Ivan Milenkovic ◽  
Thomas Sycha ◽  
Evelyn Berger-Sieczkowski ◽  
Paulus Rommer ◽  
Christian Czerny ◽  
...  
Keyword(s):  
Pulse Oximeter ◽  
Spontaneous Nystagmus ◽  
Superior Canal Dehiscence ◽  
Torsional Nystagmus ◽  
Canal Dehiscence

Purely torsional spontaneous nystagmus almost always has a central vestibular cause. We describe a man with spontaneous pulse-synchronous torsional nystagmus in which the clockwise component corresponded to his pulse upswing, in keeping with a peripheral vestibular cause; following imaging we diagnosed left-sided superior canal dehiscence syndrome. Identifying pulse synchronicity of spontaneous nystagmus may help to distinguish central from peripheral vestibular torsional nystagmus, and is readily confirmed at the bedside using Frenzel’s glasses and a pulse oximeter.

scholarly journals Second-Side Surgery in Superior Canal Dehiscence Syndrome

2012 ◽  
Vol 33 (1) ◽  
pp. 72-77 ◽  
Author(s):  
Yuri Agrawal ◽  
Lloyd B. Minor ◽  
Michael C. Schubert ◽  
Kristen L. Janky ◽  
Marcela Davalos-Bichara ◽  
...  
Keyword(s):  
Superior Canal Dehiscence ◽  
Canal Dehiscence

scholarly journals A Case of Superior Canal Dehiscence Syndrome

2013 ◽  
Vol 137 (0) ◽  
pp. 10-11
Author(s):  
Kiyoko Fujimori ◽  
Naoki Saka ◽  
Toru Seo ◽  
Shigeto Ota ◽  
Masafumi Sakagami
Keyword(s):  
Superior Canal Dehiscence ◽  
Canal Dehiscence

Acoustic Responses of Vestibular Afferents in a Model of Superior Canal Dehiscence

2004 ◽  
Vol 25 (3) ◽  
pp. 345-352 ◽  
Author(s):  
John P. Carey ◽  
Timo P. Hirvonen ◽  
Timothy E. Hullar ◽  
Lloyd B. Minor
Keyword(s):  
Superior Canal Dehiscence ◽  
Vestibular Afferents ◽  
Acoustic Responses ◽  
Canal Dehiscence

scholarly journals Patients’ experiences of living with superior canal dehiscence syndrome

2018 ◽  
Vol 57 (11) ◽  
pp. 825-830
Author(s):  
Jenny Öhman ◽  
Annika Forssén ◽  
Anette Sörlin ◽  
Krister Tano
Keyword(s):  
Superior Canal Dehiscence ◽  
Canal Dehiscence

scholarly journals Perilymph Fistula: Fifty Years of Controversy

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Jeremy Hornibrook
Keyword(s):  
Head Trauma ◽  
Local Anaesthetic ◽  
Diagnostic Tests ◽  
Round Window ◽  
Trauma History ◽  
Superior Canal Dehiscence ◽  
Natural Tissue ◽  
Balance Problems ◽  
Emotional Issue ◽  
Canal Dehiscence

Perilymph fistula (PLF) is defined as a leak of perilymph at the oval or round window. It excludes other conditions with “fistula” tests due to a dehiscent semi circular canal from cholesteatoma and the superior canal dehiscence syndrome. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural tissue became routine. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF. Descriptions of “spontaneous” PLF with no trauma history followed. A large literature on PLF from all causes accumulated. It became an almost emotional issue in Otolaryngology with “believers” and “nonbelievers.” The main criticisms are a lack of reliable symptoms and diagnostic tests and operative traps in reliably distinguishing a perilymph leak from local anaesthetic. There are extensive reviews on the whole topic, invariably conveying the authors' own experiences and their confirmed views on various aspects. However, a close examination reveals a disparity of definitions and assumptions on symptoms, particularly, vestibular. This is an intentionally provocative paper with suggestions on where some progress might be made.

MRI contribution for the detection of endolymphatic hydrops in patients with superior canal dehiscence syndrome

2020 ◽  
Author(s):  
Albane Ray ◽  
Charlotte Hautefort ◽  
Jean-Pierre Guichard ◽  
Julien Horion ◽  
Philippe Herman ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Superior Canal Dehiscence ◽  
Canal Dehiscence

scholarly journals Toward Optimizing cVEMP: 2,000-Hz Tone Bursts Improve the Detection of Superior Canal Dehiscence

2018 ◽  
Vol 23 (6) ◽  
pp. 335-344 ◽  
Author(s):  
Kimberley S. Noij ◽  
Barbara S. Herrmann ◽  
John J. Guinan Jr. ◽  
Steven D. Rauch
Keyword(s):  
Roc Analysis ◽  
Matched Control ◽  
Tone Burst ◽  
Sound Level ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Inferior Vestibular Nerve ◽  
Canal Dehiscence

Background: The cervical vestibular evoked myogenic potential (cVEMP) test measures saccular and inferior vestibular nerve function. The cVEMP can be elicited with different frequency stimuli and interpreted using a variety of metrics. Patients with superior semicircular canal dehiscence (SCD) syndrome generally have lower cVEMP thresholds and larger amplitudes, although there is overlap with healthy subjects. The aim of this study was to evaluate which metric and frequency best differentiate healthy ears from SCD ears using cVEMP. Methods: Twenty-one patients with SCD and 23 age-matched controls were prospectively included and underwent cVEMP testing at 500, 750, 1,000 and 2,000 Hz. Sound level functions were obtained at all frequencies to acquire threshold and to calculate normalized peak-to-peak amplitude (VEMPn) and VEMP inhibition depth (VEMPid). Third window indicator (TWI) metrics were calculated by subtracting the 250-Hz air-bone gap from the ipsilateral cVEMP threshold at each frequency. Ears of SCD patients were divided into three groups based on CT imaging: dehiscent, thin or unaffected. The ears of healthy age-matched control subjects constituted a fourth group. Results: Comparing metrics at all frequencies revealed that 2,000-Hz stimuli were most effective in differentiating SCD from normal ears. ROC analysis indicated that for both 2,000-Hz cVEMP threshold and for 2,000-Hz TWI, 100% specificity could be achieved with a sensitivity of 92.0%. With 2,000-Hz VEMPn and VEMPid at the highest sound level, 100% specificity could be achieved with a sensitivity of 96.0%. Conclusion: The best diagnostic accuracy of cVEMP in SCD patients can be achieved with 2,000-Hz tone burst stimuli, regardless of which metric is used.

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