scholarly journals Vibration-induced nystagmus in patients with chronic unilateral Meniere's disease

2021 ◽  
Author(s):  
Elaheh Mosharaf Dehkordi ◽  
Moslem Shaabani ◽  
Ali Kouhi ◽  
Mohsen Vahedi
Keyword(s):  
Vestibular Stimulation ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Spontaneous Nystagmus ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Vibratory Stimulation ◽  
Menière's Disease ◽  
Significant Difference ◽  
Ménière's Disease

Background and Aim: Meniere's disease (MD) is one of the inner ear disorders associated with fluctuating hearing loss, vertigo, ear fullness, and tinnitus. Vestibular stimulation delas with the int­egrity of the peripheral vestibular system and may cause nystagmus due to the functional asy­mmetry between right and lef peripheral vesti­bular system. This study aimed to assess the vibration-induced nystagmus (VIN) in patients with chronic unilateral MD and investigate the effectiveness of this test in detecting the affected ear in these patients. Methods: This study was conducted on 29 pati­ents with chronic unilateral MD. For this pur­pose, spontaneous nystagmus (SN) and VIN at frequencies of 30 Hz and 100 Hz were recorded by videonystagmography test under five recor­ding conditions. The vibratory stimulation was presented to both healthy and affected ears. Coll­ected were analyzed in SPSS v.22 software. Results: Vibratory stimulation compared to the unstimulated condition, revealed a significant difference in eye movements for both healthy and affected ears. Moreover, the difference between VIN and SN in the affected ear was much greater than in the healthy ear. Conclusion: In patients with chronic unilateral MD, 100 Hz vibratory stimulation of the affected ear induces more reliable nystagmus than 30 Hz stimulation and unstimulated condition. The VIN test can be used for the evaluation of the vesti­bular system function and is a promising techni­que to detect the MD ear. Keywords: Meniere's disease; spontaneous nystagmus; vibration-induced nystagmus; chronic; definite; vestibular vibrator

scholarly journals Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Norman A. Orabi ◽  
Brian M. Kellermeyer ◽  
Christopher A. Roberts ◽  
Stephen J. Wetmore ◽  
Adam M. Cassis
Keyword(s):  
Meniere’S Disease ◽  
Adult Patients ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Psychiatric Comorbidities ◽  
Significant Difference ◽  
Ménière's Disease

Purpose. To explore outcomes of endolymphatic sac surgery for patients with Meniere’s disease with and without the comorbid condition of migraine. Materials and Methods. A retrospective chart review of adult patients undergoing endolymphatic sac surgery at a single tertiary care center from 1987 to 2019 was performed. All adult patients who failed medical therapy and underwent primary endolymphatic sac surgery were included. The main outcome measures were vertigo control and functional level scale (FLS) score. Patient characteristics, comorbidities, and audiometric outcomes were tracked as well. Results. Patients with Meniere’s disease and migraine had a stronger association with psychiatric comorbidities (64.29% vs. 25.80%, p = 0.01 ), shorter duration of vertigo episodes (143 vs. 393 min, p = 0.02 ), and younger age (36.6 vs. 50.8 yr, p = 0.005 ) at the time of endolymphatic sac surgery. Postoperative pure tone averages and word recognition scores were nearly identical to preoperative baselines. Class A vertigo control (47.92%) was most common, followed by class B vertigo control (31.25%). The FLS score improved from 4.2 to 2.8 ( p < 0.001 ). Both patients with and without migraine had classes A-B vertigo control (66.67% vs. 80.95%) without any statistically significant difference ( p = 0.59 ). Of the patients who required secondary treatment (10.42%), none had migraine. Conclusions. Endolymphatic sac surgery is an effective surgical intervention for Meniere’s disease with and without migraine. Patients with comorbid migraine tend to be younger and present with psychiatric comorbidities.

scholarly journals A Puzzle of Vestibular Physiology in a Meniere’s Disease Acute Attack

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Marta Martinez-Lopez ◽  
Raquel Manrique-Huarte ◽  
Nicolas Perez-Fernandez
Keyword(s):  
Acute Attack ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Spontaneous Nystagmus ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Functional Evaluation ◽  
Vestibuloocular Reflex ◽  
Menière's Disease ◽  
Ménière's Disease

The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere’s disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere’s disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT) are shown before, during, and after the attack. Nystagmus was initially left beating and a few minutes later an upbeat component was added. No skew deviation was observed. A decrease in the gain of the vestibuloocular reflex (VOR) and the presence of overt saccades were observed when the stimuli were in the plane of the left superior semicircular canal. At the end of the crisis nystagmus decreased and vestibuloocular reflex returned to almost normal. A review of the different possibilities to explain these findings points to a hypothetical utricular damage.

scholarly journals Effectiveness of intratympanic dexamethasone for the treatment of vertigo attacks in patients with Ménière’s disease compared with betahistine pharmacotherapy

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052098564
Author(s):  
András Molnár ◽  
Stefani Maihoub ◽  
László Tamás ◽  
Ágnes Szirmai
Keyword(s):  
Symptomatic Treatment ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Significant Difference ◽  
Group A ◽  
Ménière's Disease ◽  
Group B

Objective This study analyzed the possible effects of intratympanic steroid (ITS) therapy in the symptomatic treatment of vertigo attacks in patients with Ménière’s disease. Methods Thirty-five patients treated with ITS (dexamethasone) plus betahistine (Group A) and 35 patients treated with betahistine alone (Group B) were enrolled in this investigation. Complaints were analyzed using medical records and vertigo diaries. Statistical analysis was conducted using IBM SPSS V24 software. Results Based on the analysis, there were no significant differences in baseline features between the two groups. When the occurrence of vertigo attacks was compared using the Kaplan–Meier method, no significant difference was detected between Groups A and B (odds ratio [OR] = 1.051, 95% confidence interval [CI] = 0.965–1.067; p = 0.972). In addition, no difference in the incidence of vertigo attacks was noted in group A between the periods of treatment with betahistine alone and betahistine plus ITS when the groups were analyzed via logistic regression (OR = 1.07, 95% CI = 0.065–1.467; p = 0.614). Conclusion It can be concluded that the addition of ITS therapy to betahistine did not improve outcomes in patients with Ménière’s disease. Further prospective studies should be conducted to analyze the results in a more detailed manner.

scholarly journals Investigation of Spontaneous Nystagmus in Meniere's Disease

2000 ◽  
Vol 2000 (Supplement104) ◽  
pp. 70-74
Author(s):  
Meiho Nakayama ◽  
Men-dar Wu ◽  
Shigeru Inafuku ◽  
Hiromichi Ishigami
Keyword(s):  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Spontaneous Nystagmus ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Transtympanic Gentamicin and Fibrin Tissue Adhesive for Treatment of Unilateral Menière's Disease: Effects on Vestibular Function

2005 ◽  
Vol 133 (6) ◽  
pp. 929-935 ◽  
Author(s):  
Augusto Casani ◽  
Daniele Nuti ◽  
Stefano Sellari Franceschini ◽  
Elisa Gaudini ◽  
Iacopo Dallan
Keyword(s):  
Vestibular Function ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Tissue Adhesive ◽  
Spontaneous Nystagmus ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Vestibular Hypofunction ◽  
Ménière's Disease

OBJECTIVE: To determine the effects of transtympanic injections, with a mixture composed of gentamicin and fibrin tissue adhesive (FTA), on vestibular function of patients with intractable unilateral Menière's disease. STUDY DESIGN: This was an open, prospective study. SETTING AND PATIENTS: The study was performed at 2 tertiary referral centers. Twenty-six patients affected by “definite” unilateral Menière's disease, unresponsive to medical therapy for at least 6 months, were enrolled. INTERVENTION: A buffered gentamicin solution mixed with FTA was injected in the middle ear until the development of bedside vestibular hypofunction signs and/or caloric weakness in the treated ear. MAIN OUTCOME MEASURE: Vestibular function was evaluated by 3 bedside vestibular tests (observation of spontaneous nystagmus, head shaking test, and head thrust test) and by a caloric test. Tests were performed on days 10 and 30 after completion of treatment. Tests were also performed 3, 6, and 12 months from completion of the gentamicin-FTA protocol. The effects of treatment were also assessed in terms of hearing levels, control of vertigo, and disability status. RESULTS: In 22 of the 26 patients, only 1 gentamicin-FTA injection was necessary to obtain 1 or more signs indicating a reduction of the vestibular function in the treated ear. Four patients needed another treatment because of the persistence of their incapacitating symptoms during the follow-up. Four patients needed more than 1 injection to obtain a vestibular hypofunction. None of the patients who received 1 or 2 injections presented hearing loss in direct temporal relationship to the treatment. CONCLUSIONS: A mixture of gentamicin and fibrin glue makes it possible to considerably reduce the number of administrations in patients with intractable unilateral Menière's disease. Spontaneous nystagmus, post head shaking nystagmus, and a head thrust sign are the clinical signs that indicate onset or progression of unilateral vestibular hypofunction. These signs were obtained with only 1 injection in 81% of patients. EBM RATING: C

The effect of surgical removal of the extraosseous portion of the endolymphatic sac in patients suffering from Menière's disease

1996 ◽  
Vol 110 (11) ◽  
pp. 1008-1011 ◽  
Author(s):  
William P. R. Gibson
Keyword(s):  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Drainage Procedure ◽  
Significant Difference ◽  
Ménière's Disease ◽  
Attacks Of Vertigo

AbstractBetween April 1990 and June 1996, the extraosseous portion of endolymphatic sac has been removed from the affected ear in 77 patients suffering from Menière's disease. Removal of the extraosseous part of the endolymphatic sac without any drainage procedure did not increase the frequency or severity of the attacks of vertigo in any patient. The results of 43 patients with unilateral disease who had a follow-up period of two years are presented. Only eight of the patients had more than two recurrent attacks of vertigo lasting over two minutes within the two years after the surgery, and in three of these patients the severity of the attacks was greatly reduced. In 56 per cent of the operated ears, the hearing deteriorated at least 10 dBHL across five audiometric frequencies (250 Hz, 500 Hz. 1 kHz. 2 kHz and 3 kHz). To the author, endolymphatic sac removal appeared to provide better relief from vertigo than a simple drainage procedure with less tendency for recurrence several months or years after the initial surgery. At present, the statistical analysis of the results shows no significant difference between removal of the extraosseous portion of the endolymphatic sac and the ‘so called’ endolymphatic sac drainage procedures.

scholarly journals A Randomized Trial of Chinese Diaoshi Jifa on Treatment of Dizziness in Meniere’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Yong-Xin Sun ◽  
Yuan Wang ◽  
Xunming Ji ◽  
Xiaoguang Wu ◽  
Yong Zhao ◽  
...  
Keyword(s):  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Functional Domain ◽  
Menière's Disease ◽  
Significant Difference ◽  
Ménière's Disease ◽  
The Difference ◽  
Experimental Group

Background. Meniere’s disease is characterized by refractory dizziness and hearing disturbance. We aimed to investigate the efficacy and tolerance of Diaoshi Jifa, a Chinese hand skill for treating dizziness in Meniere’s disease.Methods. An open-labeled, randomized, controlled intervention trial was conducted. Twenty-seven patients diagnosed with Meniere’s disease were randomly allocated to control group or experimental group. Both groups were assessed by DHI (dizziness handicap inventory (DHI)) questionnaire score before and within 24 hours of receiving treatment, respectively.Results. Twenty-six participants completed the study, and no adverse event was reported due to Diaoshi Jifa treatment. The difference in the DHI scores between baseline and posttreatment reached significant difference in both groups (63.88±19.94versus10.25±9.77and54.36±17.97versus49.6±20.50). Significant difference in DHI scores was observed between the two groups after treatment (10.25±9.77versus49.6±20.50). Further investigation of DHI subscales in the experimental group revealed significant improvement posttreatment in the physical domain, functional domain, and emotional domain. Although higher rate of improvement in the emotional domain compared to physical or functional domains was found, the difference was not statistically significant.Conclusions. Diaoshi Jifa might be a fast, effective, and well-tolerated method for alleviating dizziness in Meniere’s disease.

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