Prevalence of Post-Headshake Nystagmus in Patients with Caloric Deficits and Vertigo

1992 ◽  
Vol 106 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Joel A. Goebel ◽  
Philip Garcia
Keyword(s):  
Retrospective Review ◽  
Clinical Observation ◽  
Physical Sign ◽  
Sudden Stop ◽  
Eyes Closed ◽  
Peripheral Vestibulopathy ◽  
Eyes Open ◽  
History Of ◽  
Caloric Deficit

Post-headshake nystagmus (PHN) has recently been described as a clinically useful physical sign implying uncompensated asymmetric input from the vestibular end organs. A rapid 20-second headshake and sudden stop produces a jerk nystagmus of 5- to 20-second duration in certain individuals with symptoms suggestive of a peripheral vestibulopathy. This retrospective review of 214 patient evaluations was undertaken to study the associations between post-headshake nystagmus, caloric deficits after bi-thermal binaural irrigation, and the presence of vertigo. Both clinical observation of the nystagmus with eyes open (PHN-OBS) and routine EOG recording with eyes closed (PHN-EOG) were used. In patients with unilateral caloric deficits, 42% (18 of 43) had PHN-EOG, compared with 18% (3 of 17) in patients with bilateral dysfunction and 15% (23 of 154) in patients with normal calorics (p < 0.001H). In similar fashion, 26% (32 of 124) of patients with vertigo (recent or past) had PHN-EOG compared to 13% (12 of 90) of patients without vertigo (p < 0.03). Finally, of 110 cases with both PHN-EOG and PHN-OBS performed, 45% (9 of 20) with PHN-EOG also had PHN-OBS, as opposed to only 4% (4 of 90) without PHN-EOG displaying PHN-OBS (p < 0.0001). We conclude that the prevalence of post-headshake nystagmus is increased in patients with either a unilateral caloric deficit or a history of true vertigo, and is best detected in the absence of vision.

Progressive Visual Occlusion and Postural Control Responses in Individuals With and Without Chronic Ankle Instability

2021 ◽  
pp. 1-6
Author(s):  
Lilly H. VanDeMark ◽  
Christina B. Vander Vegt ◽  
Cassie B. Ford ◽  
Jason P. Mihalik ◽  
Erik A. Wikstrom
Keyword(s):  
Postural Control ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Heterogeneous Sample ◽  
Eyes Closed ◽  
Visual Occlusion ◽  
Sensory Organization ◽  
Eyes Open ◽  
History Of ◽  
Partially Occluded

Context: Prophylactic and rehabilitative balance training is needed to maximize postural control and develop appropriate sensory organization strategies. Partially occluding vision during functional exercise may promote appropriate sensory organization strategies, but little is known about the influence of partially occluded vision on postural control in those with and without a history of musculoskeletal injury. Objective: To determine the effect of increasing levels of visual occlusion on postural control in a heterogeneous sample of those with and without chronic ankle instability (CAI). The secondary objective was to explore postural control responses to increasing levels of visual occlusion among those with unilateral and bilateral CAI relative to uninjured controls. Design: Cross-sectional. Setting: Sports medicine research laboratory. Patients or Other Participants: Twenty-five participants with unilateral CAI, 10 with bilateral CAI, and 16 participants with no history of lower extremity injury. Main Outcome Measures: All participants completed four 3-minute postural control assessments in double-limb stance under the following 4 visual conditions: (1) eyes open, (2) low occlusion, (3) high occlusion, and (4) eyes closed. Low- and high-occlusion conditions were produced using stroboscopic eyewear. Postural control outcomes included time-to-boundary minima means in the anteroposterior (TTB-AP) and mediolateral directions (TTB-ML). Repeated-measures analysis of variances tested the effects of visual condition on TTB-AP and TTB-ML. Results: Postural control under the eyes-open condition was significantly better (ie, higher) than the limited visual occlusion and eyes-closed conditions (P < .001) for TTB-AP and TTB-ML. For TTB-AP only, partially occluded vision resulted in better postural control than the eyes-closed condition (P ≤ .003). Conclusions: Partial and complete visual occlusion impaired postural control during dual-limb stance in a heterogeneous sample of those with and without CAI. Stroboscopic eyewear appears to induce postural control impairments to the same extent as complete visual occlusion in the mediolateral direction.

scholarly journals Baseline Postural Control and Lower Extremity Injury Incidence Among Those With a History of Concussion

2020 ◽  
Vol 55 (2) ◽  
pp. 109-115
Author(s):  
Nicholas Murray ◽  
Emily Belson ◽  
Brian Szekely ◽  
Arthur Islas ◽  
Daniel Cipriani ◽  
...  
Keyword(s):  
Postural Control ◽  
Root Mean Square ◽  
National Collegiate Athletic Association ◽  
Injury Incidence ◽  
Mean Square ◽  
Logistic Regression Models ◽  
Eyes Closed ◽  
Complexity Index ◽  
Eyes Open ◽  
History Of

Context Lower extremity musculoskeletal (LEMSK) injury may be more prevalent among those with a history of sport-related concussion (SRC). Objective To investigate the relationship between baseline postural control metrics and the LEMSK injury incidence in National Collegiate Athletic Association Division I student-athletes with a history of SRC. Setting National Collegiate Athletic Association Division I athletes. Design Cohort study. Patients or Other Participants Of 84 total athletes (62 males), 42 had been previously diagnosed with an SRC, and 42 were matched controls based on age, sex, height, weight, and sport. Main Outcome Measure(s) During the preseason baseline evaluation, all participants performed 3 trials of eyes-open and eyes-closed upright quiet stance on a force platform. Medical charts were assessed for all the LEMSK injuries that occurred from preseason baseline to 1 year later. Center-of-pressure data in the anteroposterior and mediolateral directions were filtered before we calculated root mean square and mean excursion velocity; the complexity index was calculated from the unfiltered data. Factorial analysis-of-variance models were used to examine differences between groups and across conditions for root mean square; mean excursion velocity, complexity index, and tests of association to examine between-groups LEMSK differences; and logistic regression models to predict LEMSK. Results Concussion history and injury incidence were related in the SRC group (P = .043). The complexity index of the SRC group was lower with eyes closed (14.08 ± 0.63 versus 15.93 ± 0.52) and eyes open (10.25 ± 0.52 vs 11.80 ± 0.57) in the mediolateral direction than for the control participants (P &lt; .05). Eyes-open root mean square in the mediolateral direction was greater for the SRC group (5.00 ± 0.28 mm) than the control group (4.10 ± 0.22 mm). Logistic regression models significantly predicted LEMSK only in control participants. Conclusions These findings may suggest that LEMSK after SRC cannot be predicted from postural-control metrics at baseline.

scholarly journals Balance Regularity Among Former High School Football Players With or Without a History of Concussion

2018 ◽  
Vol 53 (2) ◽  
pp. 109-114 ◽  
Author(s):  
Julianne D. Schmidt ◽  
Douglas P. Terry ◽  
Jihyun Ko ◽  
Karl M. Newell ◽  
L. Stephen Miller
Keyword(s):  
High School ◽  
Postural Control ◽  
Sample Entropy ◽  
Mean Difference ◽  
Multiscale Entropy ◽  
Football Players ◽  
High School Football ◽  
Eyes Closed ◽  
Eyes Open ◽  
History Of

Context:  Subclinical postural-control changes may persist beyond the point when athletes are considered clinically recovered postconcussion. Objective:  To compare postural-control performance between former high school football players with or without a history of concussion using linear and nonlinear metrics. Design:  Case-control study. Setting:  Clinical research laboratory. Patients or Other Participants:  A total of 11 former high school football players (age range, 45–60 years) with 2 or more concussions and 11 age- and height-matched former high school football players without a history of concussion. No participant had college or professional football experience. Main Outcome Measure(s):  Participants completed the Sensory Organization Test. We compared postural control (linear: equilibrium scores; nonlinear: sample and multiscale entropy) between groups using a 2 × 3 analysis of variance across conditions 4 to 6 (4: eyes open, sway-referenced platform; 5: eyes closed, sway-referenced platform; 6: eyes open, sway-referenced surround and platform). Results:  We observed a group-by-condition interaction effect for medial-lateral sample entropy (F2,40 = 3.26, P = .049, ηp2 = 0.140). Participants with a history of concussion presented with more regular medial-lateral sample entropy values (0.90 ± 0.41) for condition 5 than participants without a history of concussion (1.30 ± 0.35; mean difference = −0.40; 95% confidence interval [CI] = −0.74, −0.06; t20 = −2.48, P = .02), but conditions 4 (mean difference = −0.11; 95% CI: −0.37, 0.15; t20 = −0.86, P = .40) and 6 (mean difference = −0.25; 95% CI: −0.55, 0.06; t20 = −1.66, P = .11) did not differ between groups. Conclusions:  Postconcussion deficits, detected using nonlinear metrics, may persist long after injury resolution. Subclinical concussion deficits may persist for years beyond clinical concussion recovery.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Detergent properties as the basis of the dimexide therapeutic effect in AA-amyloidosis infectious nature (clinical case analysis)

2020 ◽  
Vol 24 (2) ◽  
pp. 60-71
Author(s):  
V. Rameev ◽  
L. Kozlovskaya ◽  
A. Rameeva ◽  
P. Tao
Keyword(s):  
Therapeutic Effect ◽  
Medical Practice ◽  
Clinical Case ◽  
Clinical Observation ◽  
Case Analysis ◽  
Systemic Amyloidosis ◽  
Aa Amyloidosis ◽  
Functional Amyloid ◽  
History Of

The article discusses the current possibilities of postinfectious AA-amyloidosis treatment with dimexide on the example of clinical observation, discribes in detail the problem of functional amyloid and debates the prospects of the principle of amyloid resorption in the treatment of systemic amyloidosis. The history of the use of dimexide in medical practice is given, thenecessary dataon the pharmacology of dimexide are presented.

A systematic review and meta-analysis on efficacy of exercise on posture and balance in patients suffering from Diabetic Neuropathy

2020 ◽  
Vol 16 ◽  
Author(s):  
Neerja Thukral ◽  
Jaspreet Kaur ◽  
Manoj Malik
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Neuropathy ◽  
Meta Analysis ◽  
Berg Balance Scale ◽  
Risk Of Bias ◽  
Core Stability ◽  
Balance Scale ◽  
Eyes Closed ◽  
Significant Difference ◽  
Eyes Open

Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% of patients suffering from diabetes. There is involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability. Objective: To assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus. Method: Mean changes in Timed Up and Go test(TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. Included studies had low risk of bias. Sixteen RCT’s were included for the meta-analysis. Result: Results of meta-analysis showed that there was statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I 2 = 84%, p < 0.00001) in experimental group as compared to control group. There was statistically significant difference in Berg Balance Scale scores and heterogeneity of I 2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I 2 = 100%, p =0.01 and eyes closed, heteogeneity I 2 = 0%, p =0.01). Sensitivity analysis causes change in heterogeneity. Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training etc. have a significant effect in improving balance and posture in diabetic neuropathy.

scholarly journals Gender Differences in Postural Stability among 13-Year-Old Alpine Skiers

2020 ◽  
Vol 17 (11) ◽  
pp. 3859 ◽  
Author(s):  
Agnieszka D. Jastrzębska
Keyword(s):  
Gender Differences ◽  
Postural Balance ◽  
Lactate Concentration ◽  
Blood Lactate Concentration ◽  
Body Sway ◽  
Foot Pressure ◽  
Eyes Closed ◽  
Before And After ◽  
Eyes Open ◽  
Alpine Skiers

This experiment examined changes in body sway after Wingate test (WAnT) in 19 adolescents practicing alpine skiing, subjected to the same type of training load for 4–5 years (10 girls and nine boys). The postural examinations were performed with eyes open (EO), eyes closed (EC), and sway reverenced vision (SRV) in the medial-lateral (ML) and anterior-posterior (AP) planes. The displacement of center of foot pressure (CoP), range of sway (RS), mean sway velocity (MV), way length, and surface area were measured in bipedal upright stance before and after the WAnT to assess the influence of fatigue on postural balance. There were no significant differences in WAnT parameters between girls and boys. Relative peak power (RPP), relative total work (RWtot) were (girls vs. boys) 8.89 ± 0.70 vs. 9.57 ± 1.22 W/kg, p < 0.05 and 227.91 ± 14.98 vs. 243.22 ± 30.24 W/kg, p < 0.05 respectively. The fatigue index (FI) was also on similar level in both genders; however, blood lactate concentration (BLa) was significantly higher in boys (10.35 ± 1.16 mM) than in girls (8.67 ± 1.35 mM) p = 0.007. In the EO examination, statistically significant differences between resting and fatigue conditions in the whole group and after the division into girls and boys were found. In fatigue conditions, significant gender differences were noted for measurements in the ML plane (sway path and RS) and RS in the AP plane. Comparison of the three conditions shows differences between EO vs. EC and SRV in AP plane measured parameters, and for RS in ML plane in rest condition in girls. The strong correlations between FI and CoP parameters mainly in ML plane in the whole group for all examination conditions were noted. By genders, mainly RS in ML plane strongly correlates with FI (r > 0.7). No correlation was found between BLa and CoP parameters (p > 0.06). The presented results indicate that subjecting adolescents of both genders to the same training may reduce gender differences in the postural balance ability at rest but not in fatigue conditions and that girls are significantly superior in postural balance in the ML plane than boys. It was also shown that too little or too much information may be destructive to postural balance in young adolescents.

scholarly journals Minimal shoes improve stability and mobility in persons with a history of falls

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomasz Cudejko ◽  
James Gardiner ◽  
Asangaedem Akpan ◽  
Kristiaan D’Août
Keyword(s):  
Fall Prevention ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Stability Margin ◽  
Timed Up And Go ◽  
Balance Test ◽  
Margin Of Stability ◽  
Eyes Open ◽  
History Of ◽  
Falls In Older Adults

AbstractPostural and walking instabilities contribute to falls in older adults. Given that shoes affect human locomotor stability and that visual, cognitive and somatosensory systems deteriorate during aging, we aimed to: (1) compare the effects of footwear type on stability and mobility in persons with a history of falls, and (2) determine whether the effect of footwear type on stability is altered by the absence of visual input or by an additional cognitive load. Thirty participants performed standing and walking trials in three footwear conditions, i.e. conventional shoes, minimal shoes, and barefoot. The outcomes were: (1) postural stability (movement of the center of pressure during eyes open/closed), (2) walking stability (Margin of Stability during normal/dual-task walking), (3) mobility (the Timed Up and Go test and the Star Excursion Balance test), and (4) perceptions of the shoes (Monitor Orthopaedic Shoes questionnaire). Participants were more stable during standing and walking in minimal shoes than in conventional shoes, independent of visual or walking condition. Minimal shoes were more beneficial for mobility than conventional shoes and barefoot. This study supports the need for longitudinal studies investigating whether minimal footwear is more beneficial for fall prevention in older people than conventional footwear.

scholarly journals The effect of congenital blindness on resting-state functional connectivity revisited

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria J. S. Guerreiro ◽  
Madita Linke ◽  
Sunitha Lingareddy ◽  
Ramesh Kekunnaya ◽  
Brigitte Röder
Keyword(s):  
Functional Connectivity ◽  
Resting State ◽  
Visual Experience ◽  
Brain Regions ◽  
State Condition ◽  
Resting State Functional Connectivity ◽  
Congenital Blindness ◽  
Eyes Closed ◽  
Congenitally Blind ◽  
Eyes Open

AbstractLower resting-state functional connectivity (RSFC) between ‘visual’ and non-‘visual’ neural circuits has been reported as a hallmark of congenital blindness. In sighted individuals, RSFC between visual and non-visual brain regions has been shown to increase during rest with eyes closed relative to rest with eyes open. To determine the role of visual experience on the modulation of RSFC by resting state condition—as well as to evaluate the effect of resting state condition on group differences in RSFC—, we compared RSFC between visual and somatosensory/auditory regions in congenitally blind individuals (n = 9) and sighted participants (n = 9) during eyes open and eyes closed conditions. In the sighted group, we replicated the increase of RSFC between visual and non-visual areas during rest with eyes closed relative to rest with eyes open. This was not the case in the congenitally blind group, resulting in a lower RSFC between ‘visual’ and non-‘visual’ circuits relative to sighted controls only in the eyes closed condition. These results indicate that visual experience is necessary for the modulation of RSFC by resting state condition and highlight the importance of considering whether sighted controls should be tested with eyes open or closed in studies of functional brain reorganization as a consequence of blindness.

scholarly journals Gait Stability Measurement by Using Average Entropy

Entropy ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 412
Author(s):  
Han-Ping Huang ◽  
Chang Francis Hsu ◽  
Yi-Chih Mao ◽  
Long Hsu ◽  
Sien Chi
Keyword(s):  
Postural Stability ◽  
Multiscale Entropy ◽  
Gait Stability ◽  
Eyes Closed ◽  
Stride Interval ◽  
Step Interval ◽  
Stability Measurement ◽  
Eyes Open ◽  
Two Measures ◽  
Better Than

Gait stability has been measured by using many entropy-based methods. However, the relation between the entropy values and gait stability is worth further investigation. A research reported that average entropy (AE), a measure of disorder, could measure the static standing postural stability better than multiscale entropy and entropy of entropy (EoE), two measures of complexity. This study tested the validity of AE in gait stability measurement from the viewpoint of the disorder. For comparison, another five disorders, the EoE, and two traditional metrics methods were, respectively, used to measure the degrees of disorder and complexity of 10 step interval (SPI) and 79 stride interval (SI) time series, individually. As a result, every one of the 10 participants exhibited a relatively high AE value of the SPI when walking with eyes closed and a relatively low AE value when walking with eyes open. Most of the AE values of the SI of the 53 diseased subjects were greater than those of the 26 healthy subjects. A maximal overall accuracy of AE in differentiating the healthy from the diseased was 91.1%. Similar features also exists on those 5 disorder measurements but do not exist on the EoE values. Nevertheless, the EoE versus AE plot of the SI also exhibits an inverted U relation, consistent with the hypothesis for physiologic signals.

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