scholarly journals Static Positional Nystagmus in the Healthy Vestibular System

2019 ◽  
Vol 30 (10) ◽  
pp. 883-895
Author(s):  
M. Dawn Nelson ◽  
Larissa Mann ◽  
Christine Nicholson ◽  
Mark Lehman
Keyword(s):  
Neurological Disorders ◽  
Current Data ◽  
Descriptive Statistics ◽  
Slow Phase ◽  
Positional Nystagmus ◽  
Clinical Criteria ◽  
Slow Phase Velocity ◽  
The Mean ◽  
Horizontal Nystagmus ◽  
Vertical Nystagmus

AbstractA repeat of the seminal 1973 study on static positional nystagmus (PN) using more accurate recording techniques.The purpose was to further characterize PN and, using current data, introduce new clinical criteria for its identification.Static PN was recorded in ten positions with vision denied. Each position was analyzed using age, gender, presence, direction, and persistence of nystagmus while taking into account the number of beats and mean slow-phase velocity (SPV).One hundred healthy patients who were asymptomatic with no known neurological disorders were tested.No intervention was used.Analysis of variance, descriptive statistics, and confidence intervals were used to describe results.Results showed 74% of normal participants had horizontal nystagmus in at least one position. Only 7% of the observed nystagmus was persistent. The average SPV was 2°/sec. The mean number of positions in which nystagmus was observed was three. Neither age nor gender influenced the occurrence of nystagmus. Forty-three percent of the participants had vertical nystagmus in at least one position; however, the SPV was 2°/sec or less.The present study demonstrated that intermittent or persistent PN in four or fewer positions should not be considered pathological when the SPV is 4°/sec or less (n = 100). Observance of vertical nystagmus in one position should not be considered pathological if the SPV is 2°/sec or less. Suggested positions for positional testing should include seated-upright, supine, head right, head left, head-hanging, and the precaloric (30° supine) positions. Fixation when PN is observed is indicated.

scholarly journals 022 Patient-initiated event monitoring for acute vertigo

2019 ◽  
Vol 90 (e7) ◽  
pp. A8.2-A8
Author(s):  
Allison S Young ◽  
Corinna Lechner ◽  
Andrew P Bradshaw ◽  
Hamish G MacDougall ◽  
Deborah A Black ◽  
...  
Keyword(s):  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Vestibular Disorders ◽  
Positional Nystagmus ◽  
Low Velocity ◽  
Event Monitoring ◽  
Superior Semicircular Canal Dehiscence ◽  
Positional Vertigo ◽  
Horizontal Nystagmus ◽  
Vertical Nystagmus

IntroductionThe diagnosis of vestibular disorders may be facilitated by analysing patient-initiated capture of ictal nystagmus.MethodsAdults with a history of recurrent vertigo were taught to self-record spontaneous and positional-nystagmus at home while symptomatic, using video-goggles. Patients with final diagnoses of disorders presenting with recurrent vertigo were analysed: 121 patients with Ménière’s Disease (MD), Vestibular Migraine (VM), Benign Positional Vertigo (BPV), Episodic Ataxia Type II (EAII), Vestibular Paroxysmia (VP) or Superior Semicircular Canal Dehiscence (SSCD) were included.ResultsOf 43 MD patients, 40 showed high-velocity spontaneous horizontal-nystagmus (median slow-phase velocity (SPV) 39.7 degrees/second (°/s); Twenty-one showed horizontal-nystagmus reversing direction within 12-hours (24 on separate days). In 44 of 67 patients with VM, low velocity spontaneous horizontal (n=28, 4.9°/s), up-beating (n=6, 15.5°/s) or down-beating-nystagmus (n=10, 5.1°/s) was observed; Sixteen showed positional-nystagmus only, and seven had no nystagmus. Spontaneous horizontal-nystagmus with SPV >12.05°/s had a sensitivity and specificity of 95.3% and 82.1% for MD. Nystagmus direction-change within 12-hours was highly specific (95.7%) for MD. Spontaneous vertical-nystagmus was highly specific (93.0%) for VM. In the seven BPV patients, spontaneous-nystagmus was absent or <3°/s, and characteristic paroxysmal positional nystagmus was observed in all cases. Patients with central and MD-related positional vertigo demonstrated persistent nystagmus. Two patients with EAII showed spontaneous vertical nystagmus, one patient with VP showed short bursts of horizontal-torsional nystagmus lasting 5–10s, and one patient with SSCD demonstrated paroxysmal torsional down-beating nystagmus when supine.ConclusionsPatient-initiated vestibular event-monitoring is feasible and could facilitate rapid and accurate diagnosis of episodic vestibular disorders.

Capturing acute vertigo

Neurology ◽  
2019 ◽  
Vol 92 (24) ◽  
pp. e2743-e2753 ◽  
Author(s):  
Allison S. Young ◽  
Corinna Lechner ◽  
Andrew P. Bradshaw ◽  
Hamish G. MacDougall ◽  
Deborah A. Black ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Vestibular Disorders ◽  
Positional Nystagmus ◽  
Event Monitoring ◽  
Positional Vertigo ◽  
Horizontal Nystagmus ◽  
Vertical Nystagmus ◽  
Paroxysmal Positional Vertigo

ObjectiveTo facilitate the diagnosis of vestibular disorders by patient-initiated capture of ictal nystagmus.MethodsAdults from an Australian neurology outpatient clinic reporting recurrent vertigo were recruited prospectively and taught to self-record spontaneous and positional nystagmus at home while symptomatic, using miniature video-oculography goggles. Consenting patients with ictal videorecordings and a final unblinded clinical diagnosis of Ménière disease (MD), vestibular migraine (VM), or benign paroxysmal positional vertigo (BPPV) were included.ResultsIctal eye videos of 117 patients were analyzed. Of 43 patients with MD, 40 showed high-velocity spontaneous horizontal nystagmus (median slow-phase velocity [SPV] 39.7°/s; 21 showed horizontal nystagmus reversing direction within 12 hours [24 on separate days]). In 44 of 67 patients with VM, spontaneous horizontal (n = 28, 4.9°/s), upbeating (n = 6, 15.5°/s), or downbeating nystagmus (n = 10, 5.1°/s) was observed; 16 showed positional nystagmus only, and 7 had no nystagmus. Spontaneous horizontal nystagmus with SPV >12.05°/s had a sensitivity and specificity of 95.3% and 82.1% for MD (95% confidence interval [CI] 0.84–0.99, 0.71–0.90). Nystagmus direction change within 12 hours was highly specific (95.7%) for MD (95% CI 0.85–0.99). Spontaneous vertical nystagmus was highly specific (93.0%) for VM (95% CI 0.81–0.99). In the 7 patients with BPPV, spontaneous nystagmus was absent or <3°/s. Lying affected-ear down, patients with BPPV demonstrated paroxysmal positional nystagmus. Median time for peak SPV to halve (T50) was 19.0 seconds. Patients with VM and patients with MD demonstrated persistent positional nystagmus (median T50; 93.1 seconds, 213.2 seconds). T50s <47.3 seconds had a sensitivity and specificity of 100% and 77.8% for BPPV (95% CI 0.54–1.00, 0.64–0.88).ConclusionPatient-initiated vestibular event monitoring is feasible and could facilitate rapid and accurate diagnosis of episodic vestibular disorders.

Efficacy of histaminergic drugs in experimental motion sickness

2008 ◽  
Vol 17 (5-6) ◽  
pp. 313-321
Author(s):  
E.I. Matsnev ◽  
E.E. Sigaleva
Keyword(s):  
Phase Velocity ◽  
Healthy Volunteers ◽  
Motion Sickness ◽  
Slow Phase ◽  
High Susceptibility ◽  
Double Blind ◽  
Slow Phase Velocity ◽  
Betahistine Dihydrochloride ◽  
The Mean ◽  
Oculomotor Activity

The purpose of this investigation was to evaluate the efficacy of the histaminergic drug "Betahistine dihydrochloride" in experimental motion sickness in 10 healthy volunteers (mean age 19.4 y.o.) with high susceptibility to motion sickness. Motion sickness was modeled using Coriolis (precession) accelerations (cumulative Coriolis stimulation test – CCST). Each subject took 32 mg of "Betahistine dihydrochloride" or placebo under "double – blind" conditions 1 hour before testing. The duration and slow phase velocity of the post-rotational nystagmus, the pursuit eye tracking test, and the latency, velocity and accuracy of saccades were estimated. The tolerability level of the CCST in volunteers in the betahistine series was shown to be significantly (p < 0.001) higher, as compared to placebo and baseline. The mean illusory sensations score for the experimental series was significantly lower than that in the placebo and baseline series (p < 0.01). It was found that "Betahistine" demonstrated antimotion sickness efficacy and improved oculomotor activity (increased gain during pursuit movements, faster and more accurate saccades).

Nystagmus characteristics of healthy controls

2020 ◽  
Vol 30 (6) ◽  
pp. 345-352
Author(s):  
Allison S. Young ◽  
Sally M. Rosengren ◽  
Mario D’Souza ◽  
Andrew P. Bradshaw ◽  
Miriam S. Welgampola
Keyword(s):  
Upright Position ◽  
Community Dwelling ◽  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Healthy Controls ◽  
Positional Nystagmus ◽  
Low Velocity ◽  
Video Oculography ◽  
Significant Difference ◽  
Horizontal Nystagmus

BACKGROUND: Healthy controls exhibit spontaneous and positional nystagmus which needs to be distinguished from pathological nystagmus. OBJECTIVE: Define nystagmus characteristics of healthy controls using portable video-oculography. METHODS: One-hundred and one asymptomatic community-dwelling adults were prospectively recruited. Participants answered questions regarding their audio-vestibular and headache history and were sub-categorized into migraine/non-migraine groups. Portable video-oculography was conducted in the upright, supine, left- and right-lateral positions, using miniature take-home video glasses. RESULTS: Upright position spontaneous nystagmus was found in 30.7% of subjects (slow-phase velocity (SPV)), mean 1.1±2.2 degrees per second (°/s) (range 0.0 – 9.3). Upright position spontaneous nystagmus was horizontal, up-beating or down-beating in 16.7, 7.9 and 5.9% of subjects. Nystagmus in at least one lying position was found in 70.3% of subjects with 56.4% showing nystagmus while supine, and 63.4% in at least one lateral position. While supine, 20.8% of subjects showed up-beating nystagmus, 8.9% showed down-beating, and 26.7% had horizontal nystagmus. In the lateral positions combined, 37.1% displayed horizontal nystagmus on at least one side, while 6.4% showed up-beating, 6.4% showed down-beating. Mean nystagmus SPVs in the supine, right and left lateral positions were 2.2±2.8, 2.7±3.4, and 2.1±3.2°/s. No significant difference was found between migraine and non-migraine groups for nystagmus SPVs, prevalence, vertical vs horizontal fast-phase, or low- vs high-velocity nystagmus (<5 vs > 5°/s). CONCLUSIONS: Healthy controls without a history of spontaneous vertigo show low velocity spontaneous and positional nystagmus, highlighting the importance of interictal nystagmus measures when assessing the acutely symptomatic patient.

Vertical nystagmus in normal subjects: Effects of head position, nicotine and scopolamine

2000 ◽  
Vol 10 (6) ◽  
pp. 291-300
Author(s):  
J.I. Kim ◽  
J.T. Somers ◽  
J.S. Stahl ◽  
R. Bhidayasiri ◽  
R.J. Leigh
Keyword(s):  
Nicotine Patch ◽  
Head Rotation ◽  
Normal Subjects ◽  
Head Position ◽  
Slow Phase ◽  
Head Orientation ◽  
Slow Phase Velocity ◽  
Gaze Stability ◽  
Normal Humans ◽  
Vertical Nystagmus

We measured gaze stability in darkness of four normal humans using the search coil technique. Subjects were tested first with their heads erect, and then with their heads positioned 180 degrees upside-down. In each position, subjects held their head stationary for one minute, and then actively performed pitch rotations for 20 sec. All subjects showed sustained chin-beating nystagmus in the upside-down position. Each subject showed a significant increase of slow-phase velocity directed towards their brow after 40 sec in the inverted versus erect position. Pitch head rotation had little effect on subsequent nystagmus, except for transient reversal in one subject. The sustained changes of vertical eye drifts induced by 180 deg change of head position suggest that otolithic factors may contribute to vertical nystagmus in normals. The subjects were retested after wearing a nicotine patch for 2 hours. In three subjects, nicotine induced brow-beating nystagmus; adopting a head-hanging position increased this nystagmus in two subjects. In a third session, subjects were tested after wearing a scopolamine patch for 2 hours; results were generally similar to the control condition. We conclude that normal subjects may show chin-beating (“downbeating”) nystagmus in a head-hanging position in darkness, reflecting a normal, physiological change in otolithic inputs brought about by the head orientation.

Visual Suppression Test

1977 ◽  
Vol 86 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Setsuko Takemori
Keyword(s):  
Phase Velocity ◽  
Slow Phase ◽  
Clinical Test ◽  
Visual Suppression ◽  
Slow Phase Velocity ◽  
Suppression Test ◽  
The Mean ◽  
Caloric Nystagmus ◽  
Visual Suppression Test ◽  
Normal Adults

Visual suppression of caloric nystagmus was studied in normal adults and in 98 clinical cases in order to justify the application of the procedure as a clinical test. The maximum slow phase velocity during ten seconds in darkness and the slow phase velocity during ten seconds in light were taken from the recordings and measured. The mean values of these slow phase velocities were calculated and the mean slow phase velocity in darkness was assigned a value of 100%. The value which the slow phase velocity in light subtracts from the slow phase velocity in darkness, represents the visual suppression. It was determined that visual suppression of the slow phase velocity of caloric nystagmus was 48 ± 10% in 22 normal adults. This was caused by the visual fixation mechanisms. Cases in which lesions were diagnosed in the cerebellum, such as spinocerebellar degeneration and cerebellitis, showed reduced or abolished visual suppression. The lesion side can be determined by this test. Compensation following unilateral sudden loss of inner ear function can be measured by the visual suppression test.

Vestibular Function and Motion Sickness Susceptibility: Videonystagmographic Evidence From Oculomotor and Caloric Tests

2020 ◽  
Vol 29 (2) ◽  
pp. 188-198
Author(s):  
Cynthia G. Fowler ◽  
Margaret Dallapiazza ◽  
Kathleen Talbot Hadsell
Keyword(s):  
Phase Velocity ◽  
Motion Sickness ◽  
Repeated Measures ◽  
Short Form ◽  
Vestibular Function ◽  
Slow Phase ◽  
Test Results ◽  
Normal Range ◽  
Slow Phase Velocity ◽  
Caloric Tests

Purpose Motion sickness (MS) is a common condition that affects millions of individuals. Although the condition is common and can be debilitating, little research has focused on the vestibular function associated with susceptibility to MS. One causal theory of MS is an asymmetry of vestibular function within or between ears. The purposes of this study, therefore, were (a) to determine if the vestibular system (oculomotor and caloric tests) in videonystagmography (VNG) is associated with susceptibility to MS and (b) to determine if these tests support the theory of an asymmetry between ears associated with MS susceptibility. Method VNG was used to measure oculomotor and caloric responses. Fifty young adults were recruited; 50 completed the oculomotor tests, and 31 completed the four caloric irrigations. MS susceptibility was evaluated with the Motion Sickness Susceptibility Questionnaire–Short Form; in this study, percent susceptibility ranged from 0% to 100% in the participants. Participants were divided into three susceptibility groups (Low, Mid, and High). Repeated-measures analyses of variance and pairwise comparisons determined significance among the groups on the VNG test results. Results Oculomotor test results revealed no significant differences among the MS susceptibility groups. Caloric stimuli elicited responses that were correlated positively with susceptibility to MS. Slow-phase velocity was slowest in the Low MS group compared to the Mid and High groups. There was no significant asymmetry between ears in any of the groups. Conclusions MS susceptibility was significantly and positively correlated with caloric slow-phase velocity. Although asymmetries between ears are purported to be associated with MS, asymmetries were not evident. Susceptibility to MS may contribute to interindividual variability of caloric responses within the normal range.

GAMBARAN BEBAN KERJA MENTAL PADA DOSEN FAKULTAS X UNIVERSITAS X

2019 ◽  
Vol 2 (3) ◽  
Author(s):  
Kartiani Dewi ◽  
Suryani S ◽  
Ahmad Yamin
Keyword(s):  
Community Service ◽  
Mental Workload ◽  
Sampling Technique ◽  
Mean Value ◽  
Descriptive Statistics ◽  
Large Contribution ◽  
Mean Dimension ◽  
The Mean ◽  
Quantitative Descriptive ◽  
University Lecturers

Lecturers are responsible for implementing the three main responsibilities in university (Tridharma Perguruan Tinggi) with 12 credits to 16 credits each semester. However, many lecturers feel that the workload is very excessive. The purpose of this study was to describe the mental workload of lecturers at the Faculty of X Padjadjaran University. The method of this research was quantitative descriptive by using a total sampling technique involving 43 lecturers. Data collection used NASA-TLX instruments. Data were analysed using descriptive statistics. The results of the study showed that overall the mental workload of the Faculty of X Padjadjaran University lecturers was included in the high category both in education and teaching assignments (74.4%), research assignments (76.7%), and community service assignments (74.4%). ) Effort dimensions have the highest mean value that is equal to 51.8, while the dimensions that have the lowest mean are Perfomance dimension, namely 9.4, where the greater the mean dimension shows the large contribution in the mental workload felt by the lecturer. The conclusions, this study show that most lecturers have a high mental workload. It is suggested that the lecturers need to have balance numbers of tasks according to their abilities, balance the time working with recreation, and meet the needs of rest. The results of this study need to be followed up by examining methods or efforts that can reduce the lecturers' mental workload.

Descriptive statistics

2017 ◽  
Author(s):  
Andrew Gelman ◽  
Deborah Nolan
Keyword(s):  
Descriptive Statistics ◽  
Metabolic Rates ◽  
World Record ◽  
Linear Combinations ◽  
Record Times ◽  
Starting Point ◽  
Statistics Course ◽  
Scatter Plots ◽  
Economic Indexes ◽  
The Mean

Descriptive statistics is the typical starting point for a statistics course, and it can be tricky to teach because the material is more difficult than it first appears. The activities in this chapter focus more on the topics of data displays and transformations, rather than the mean, median, and standard deviation, which are covered easily in a textbook and on homework assignments. Specific topics include: distributions and handedness scores; extrapolation of time series and world record times for the mile run; linear combinations and economic indexes; scatter plots and exam scores; and logarithmic transformations and metabolic rates.

scholarly journals Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Incomplete Kawasaki Disease ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Echocardiographic Finding ◽  
2D Echocardiography ◽  
Acquired Heart Disease ◽  
The Mean ◽  
One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

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