Peripheral Vestibulopathy Presenting as Acute Vertigo and Spontaneous Nystagmus with Negative Video Head Impulse Test

2019 ◽  
Vol 160 (5) ◽  
pp. 894-901
Author(s):  
Jung-Yup Lee ◽  
Chang-Hee Kim ◽  
Jin Su Park ◽  
Min-Beom Kim

Objective To analyze acute vertigo showing spontaneous nystagmus with negative video head impulse test (vHIT). Study Design Retrospective chart analysis. Setting Tertiary referral hospital. Subjects and Methods Over 16 months, 155 patients were identified with acute vertigo with spontaneous nystagmus. Of these 155, 30 (19.4%) were enrolled in this study because they did not show gain loss or catch-up saccades in both sides of the horizontal vHIT. Results of vestibular function tests (videonystagmography, horizontal vHIT, caloric test, and cervical vestibular-evoked myogenic potential [cVEMP]) and pure tone audiometry were analyzed. For all cases, magnetic resonance imaging with diffusion-weighted imaging was checked. Results Patients consisted of 17 with Ménière’s disease and 7 with sudden sensorineural hearing loss with vertigo (SSNHL_V), and only 3 patients were finally diagnosed as having acute vascular stroke. Except for the loss of hearing on the lesion side, the direction of nystagmus or cVEMP asymmetry showed very different results. All 7 patients with SSNHL_V did not have canal paresis in the caloric test, but cVEMP amplitude was smaller on the lesion side for 6 patients. Conclusions For patients with acute vertigo presenting spontaneous nystagmus with negative horizontal vHIT, it is important not only to focus on the diagnosis of acute vascular stroke but also to evaluate hearing because of the high possibility of Ménière’s disease or SSNHL_V.

2020 ◽  
Vol 47 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Koichi Kitano ◽  
Tadashi Kitahara ◽  
Taeko Ito ◽  
Tomoyuki Shiozaki ◽  
Yoshiro Wada ◽  
...  

2019 ◽  
Vol 277 (3) ◽  
pp. 679-686 ◽  
Author(s):  
Siriporn Limviriyakul ◽  
Chadarthan Luangsawang ◽  
Kanokrat Suvansit ◽  
Sarun Prakairungthong ◽  
Kanthong Thongyai ◽  
...  

2019 ◽  
Vol 4 (6) ◽  
pp. 1364-1374
Author(s):  
Dennell E. Benson ◽  
James H. McPherson ◽  
Neil T. Shepard ◽  
Devin L. McCaslin

Purpose Ménière's disease (MD) is a constellation of otologic symptoms that includes aural fullness, tinnitus, hearing loss, and episodic vertigo. Even though the criteria for diagnosing the disorder was set forth in 1972, the causes are still not well understood. The purpose of this study was to describe the relationships between tests of hearing and vestibular function and length of time patients diagnosed with unilateral MD have experienced symptoms. Method The charts of 254 patients with definite unilateral MD from the Mayo Clinic database were retrospectively reviewed. In order to be included, patients must have reported active MD diagnosis within the previous 5 years. Main outcome measures were results for audiometry, cervical vestibular evoked myogenic potentials, ocular vestibular evoked myogenic potentials, caloric test findings, video head impulse test, and sinusoidal harmonic acceleration. Results Results indicate there is a significant effect of the duration of MD symptoms reported by the patient and findings on some tests of hearing and vestibular function. Specifically, pure-tone average, caloric paresis, and rotational chair phase were all positively correlated with duration of symptoms. Rotational chair gain was found to have an inverse relationship with time. We did not find that video head impulse test gain or certain vestibular evoked myogenic potential measures were significantly correlated with the reported duration of patient symptoms. Conclusions Our results suggest that, although the duration of symptoms reported by the patient does correlate with a number of vestibular and hearing tests, the relationships are relatively weak. The number of attacks and severity of symptoms should be investigated to determine if they are better predictors of laboratory testing results in the patient with MD.


2020 ◽  
Vol 140 (7) ◽  
pp. 537-543
Author(s):  
Shreyas Bharadwaj ◽  
Michelle R. Petrak ◽  
Cammy M. Bahner ◽  
Laurin E. Sharp ◽  
Sara F. Mosey-Claycomb ◽  
...  

2019 ◽  
Vol 28 (5-6) ◽  
pp. 401-407 ◽  
Author(s):  
B.F. van Esch ◽  
K. Abolhosseini ◽  
S. Masius-Olthof ◽  
H.J. van der Zaag-Loonen ◽  
P.P.G. van Benthem ◽  
...  

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