The Influence of Caffeine on Calorics and Cervical Vestibular Evoked Myogenic Potentials (cVEMPs)

2014 ◽  
Vol 25 (03) ◽  
pp. 261-267 ◽  
Author(s):  
Kathleen McNerney ◽  
Mary Lou Coad ◽  
Robert Burkard
Keyword(s):  
Data Collection ◽  
Vestibular Function ◽  
Stimulus Presentation ◽  
Vestibular Evoked Myogenic Potentials ◽  
Future Research ◽  
Vestibular Evoked Myogenic Potential ◽  
Moderate Amount ◽  
Potential System ◽  
History Of ◽  
Clinically Significant

Background: Prior to undergoing vestibular function testing, it is not uncommon for clinicians to request that patients abstain from caffeine 24 hr prior to the administration of the tests. However, there is little evidence that caffeine affects vestibular function. Purpose: To evaluate whether the results from two tests commonly used in a clinical setting to assess vestibular function (i.e., calorics and the cervical vestibular evoked myogenic potential [cVEMP]) are affected by caffeine. Research Design: Subjects were tested with and without consuming a moderate amount of caffeine prior to undergoing calorics and cVEMPs. Study Sample: Thirty young healthy controls (mean = 23.28 yr; females = 21). Subjects were excluded if they reported any history of vestibular/balance impairment. Data Collection and Analysis: The Variotherm Plus Caloric Irrigator was used to administer the water, while the I-Portal VNG software was used to collect and analyze subjects’ eye movements. The TECA Evoked Potential System was used for the cVEMP stimulus presentation as well as for the data collection. During cVEMP collection, subjects were asked to monitor their sternocleidomastoid muscle contraction with a Delsys EMG monitor. IBM SPSS Statistics 20 was used to statistically analyze the results via paired t-tests. Results: Analysis of the data revealed that ingestion of caffeine did not significantly influence the results of either test of vestibular function. Conclusions: The results revealed that a moderate amount of caffeine does not have a clinically significant effect on the results from caloric and cVEMP tests in young healthy adults. Future research is necessary to determine whether similar results would be obtained from individuals with a vestibular impairment, as well as older adults.

Vestibular evoked myogenic potentials: review

2010 ◽  
Vol 124 (10) ◽  
pp. 1043-1050 ◽  
Author(s):  
R Mudduwa ◽  
N Kara ◽  
D Whelan ◽  
Anirvan Banerjee
Keyword(s):  
Vestibular Function ◽  
Extensive Study ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Evoked Myogenic Potential ◽  
Clinical Role ◽  
Myogenic Potential ◽  
Future Developments ◽  
Early Results ◽  
Clinical Conditions ◽  
Based Medicine

AbstractBackground:Disorders of balance often pose a diagnostic conundrum for clinicians, and a multitude of investigations have emerged over the years. Vestibular evoked myogenic potential testing is a diagnostic tool which can be used to assess vestibular function. Over recent years, extensive study has begun to establish a broader clinical role for vestibular evoked myogenic potential testing.Objectives:To provide an overview of vestibular evoked myogenic potential testing, and to present the evidence for its clinical application.Review type:Structured literature search according to evidence-based medicine guidelines, performed between November 2008 and April 2009. No restrictions were applied to the dates searched.Conclusion:The benefits of vestibular evoked myogenic potential testing have already been established as regards the diagnosis and monitoring of several clinical conditions. Researchers continue to delve deeper into potential new clinical applications, with early results suggesting promising future developments.

scholarly journals Emerging Use of Epidiolex (Cannabidiol) in Epilepsy

2020 ◽  
Vol 25 (6) ◽  
pp. 485-499 ◽  
Author(s):  
Renad Abu-Sawwa ◽  
Brielle Scutt ◽  
Yong Park
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
The United States ◽  
Dravet Syndrome ◽  
Future Research ◽  
Epileptic Syndromes ◽  
History Of ◽  
Clinically Significant ◽  
Antiepileptic Medications

The first plant-derived, purified pharmaceutical-grade cannabidiol (CBD) medication, Epidiolex, was approved in the United States by the FDA on June 25, 2018. Its approval for patients ≥ 2 years of age with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS) markedly altered the treatment of medically refractory seizures in these disorders. This state-of-the-art review will discuss the history of CBD, its current pharmacology and toxicology, evidence supporting its use in a variety of epileptic syndromes, common side effects and adverse effects, and pharmacokinetically based drug-drug interactions. Owing to the importance in considering side effects, adverse effects, and drug-drug interactions in patients with medically refractory epilepsy syndromes, this review will take a deeper look into the nuances of the above within a clinical context, as compared to the other antiepileptic medications. Furthermore, despite the limited data regarding clinically significant drug-drug interactions, potential pharmacokinetic drug-drug interactions with CBD and other antiepileptics are theorized on the basis of their metabolic pathways. The article will further elucidate future research in terms of long-term efficacy, safety, and drug interactions that is critical to addressing unanswered questions relevant to clinical practice.

scholarly journals Genomic investigation of clinically significant coagulase-negative staphylococci

2021 ◽  
Author(s):  
Kevin Cole ◽  
Bridget Atkins ◽  
Martin Llewelyn ◽  
John Paul
Keyword(s):  
High Resolution ◽  
Genomic Analysis ◽  
Staphylococcal Infection ◽  
Clinical Samples ◽  
Future Research ◽  
Emerging Pathogens ◽  
Coagulase Negative Staphylococci ◽  
Content Type ◽  
History Of ◽  
Clinically Significant

Introduction. Coagulase-negative staphylococci have been recognized both as emerging pathogens and contaminants of clinical samples. High-resolution genomic investigation may provide insights into their clinical significance. Aims. To review the literature regarding coagulase-negative staphylococcal infection and the utility of genomic methods to aid diagnosis and management, and to identify promising areas for future research. Methodology. We searched Google Scholar with the terms ( Staphylococcus ) AND (sequencing OR (infection)). We prioritized papers that addressed coagulase-negative staphylococci, genomic analysis, or infection. Results. A number of studies have investigated specimen-related, phenotypic and genetic factors associated with colonization, infection and virulence, but diagnosis remains problematic. Conclusion. Genomic investigation provides insights into the genetic diversity and natural history of colonization and infection. Such information allows the development of new methodologies to identify and compare relatedness and predict antimicrobial resistance. Future clinical studies that employ suitable sampling frames coupled with the application of high-resolution whole-genome sequencing may aid the development of more discriminatory diagnostic approaches to coagulase-staphylococcal infection.

Case Study: Depersonalization and Vestibular Impairment

2021 ◽  
Author(s):  
Yini Sun ◽  
Allison Coltisor ◽  
Gary P. Jacobson ◽  
Richard A. Roberts
Keyword(s):  
Vestibular Function ◽  
Retrospective Chart Review ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Vestibular Evoked Myogenic Potential ◽  
Episodic Vertigo ◽  
Data Collection And Analysis ◽  
Vestibular Function Testing ◽  
Function Testing

Abstract Background We describe herein the case of a patient whose primary complaints were episodic vertigo and “depersonalization,” a sensation of detachment from his own body. Purpose This case study aims to further clinical knowledge and insight into the clinical evaluation of vertiginous patients with complaints of depersonalization. Research Design This is a case study. Data Collection and Analysis A retrospective chart review of vestibular function testing done on a vertiginous patient with complaints of depersonalization was performed. Results Vestibular function testing revealed absent cervical and ocular vestibular evoked myogenic potentials on the left side with normal vHIT or video Head Impulse Test, videonystagmography, and rotational chair results, suggesting peripheral vestibular impairment isolated to the left saccule and utricle. Conclusion The otolith end organ impairment explains the patient's postural deviation to the left side during attempts to ambulate. We recommend that clinicians should be attentive to patient complaints of depersonalization and perform vestibular evoked myogenic potential testing to determine whether evidence of at least a unilateral peripheral otolith end organ impairment exists.

Tone-induced cervical and ocular vestibular-evoked myogenic potentials: comparing abnormalities in traumatic and non-traumatic vestibular disease

2018 ◽  
Vol 132 (10) ◽  
pp. 906-910 ◽  
Author(s):  
N S Longridge ◽  
A I Mallinson
Keyword(s):  
Companion Paper ◽  
High Rate ◽  
Vestibular Evoked Myogenic Potentials ◽  
Tertiary Referral ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Disease ◽  
Myogenic Potential ◽  
Number Of Patients ◽  
History Of ◽  
Vestibular Assessment

AbstractBackgroundOtolithic function is poorly understood, but vestibular-evoked myogenic potential testing has allowed the documentation of pathology in patients who complain of imbalance.MethodsSeventy-four patients with traumatic and non-traumatic vestibular disease were sequentially assessed at a tertiary referral neuro-otology unit in a teaching hospital. A detailed history of all patients was taken and standard vestibular assessment was conducted using the technique described in the companion paper. The results of both groups of patients were analysed and the rate of abnormalities was assessed.ResultsThere was a high rate of abnormalities, including bilateral pathology, in a significant number of patients. Many patients in both groups inexplicably failed to recover.ConclusionVestibular-evoked myogenic potentials are helpful in documenting pathology, including bilateral pathology, which is outlined in the literature as being exceedingly difficult to compensate for.

Vestibular evaluation in children with otitis media with effusion

2015 ◽  
Vol 129 (4) ◽  
pp. 326-336 ◽  
Author(s):  
E A Kolkaila ◽  
A A Emara ◽  
T A Gabr
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potentials ◽  
Control Group ◽  
Dizziness Handicap Inventory ◽  
Vestibular Evoked Myogenic Potential ◽  
Bedside Test ◽  
Bedside Tests ◽  
Serous Otitis Media

AbstractBackground:Fifty per cent of children with serous otitis media may have some balance disturbances.Objective:To evaluate vestibular function in children with otitis media with effusion.Methods:The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air–bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing.Results:Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group.Conclusion:The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

Vestibular evoked myogenic potentials in patients with fibromyalgia syndrome

2010 ◽  
Vol 124 (6) ◽  
pp. 610-615 ◽  
Author(s):  
Y A Bayazit ◽  
F Celenk ◽  
A G Gunduz ◽  
B Gunduz ◽  
N Ondag ◽  
...  
Keyword(s):  
Fibromyalgia Syndrome ◽  
Vestibular Evoked Myogenic Potentials ◽  
Future Research ◽  
Vestibular Evoked Myogenic Potential ◽  
Objective Indicator ◽  
Statistical Comparison ◽  
Myogenic Potential ◽  
Control Subjects ◽  
Significant Difference ◽  
Interpeak Latency

AbstractObjective:To assess vestibular evoked myogenic potentials in patients with fibromyalgia syndrome.Methods:Twenty-four patients with fibromyalgia syndrome (two men and 22 women) and 21 female controls were included in the study. All patients underwent vestibular evoked myogenic potential testing.Results:Statistical comparison of fibromyalgia patients with control subjects showed a significant difference with respect to n23 latencies and interpeak latencies (p < 0.05). There was no significant difference in p13 latencies, nor in p13 amplitudes, n23 amplitudes or interpeak amplitudes (p > 0.05).Conclusions:Although patients with fibromyalgia syndrome generally have subjective neurotological symptoms, clinical and laboratory assessments usually fail to detect any objective abnormality. However, it is possible to detect abnormalities on vestibular evoked myogenic potential testing in such patients, indicating dysfunction in the vestibulospinal pathway, possibly in the saccule. Elongation of the n23 latency and of the interpeak latency of waves p13–n23, during vestibular evoked myogenic potential testing, may be a useful, objective indicator demonstrating neurotological involvement in fibromyalgia syndrome patients. Future research investigating the mechanisms of this latency elongation may help increase understanding of the pathogenesis of fibromyalgia syndrome.

Missing names from the Fungal Name Repositories found in the literature related to Chinese fungi

Phytotaxa ◽  
2019 ◽  
Vol 411 (1) ◽  
pp. 1-22
Author(s):  
KE WANG ◽  
YONG-HUI WANG ◽  
MING-JUN ZHAO ◽  
PAUL M. KIRK ◽  
YI-JIAN YAO
Keyword(s):  
Data Collection ◽  
Future Research ◽  
Fungal Taxonomy ◽  
High Quality ◽  
Transmission Of Information ◽  
History Of

Fungal taxonomy has a history of more than 260 years, with authors publishing over 475,000 names. Three online Fungal Name Repositories were established to manage registration of new names. During data collection for a project to develop a modern Checklist of Fungi in China and the first Redlist assessment of macrofungi in China, 532 names of Chinese fungi, distinguished in 5 different categories, were found missing from the three repositories. The absence of these names from the repositories badly hampered the transmission of information on fungi. Managing and checking these names is important in maintaining the high quality of fungal taxonomy and provides a sound basis for any future research involving fungi.

scholarly journals Cervical Vestibular-Evoked Myogenic Potentials: Norms and Protocols

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Suwicha Isaradisaikul ◽  
Niramon Navacharoen ◽  
Charuk Hanprasertpong ◽  
Jaran Kangsanarak
Keyword(s):  
Vestibular Function ◽  
Tone Burst ◽  
Contralateral Side ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normative Values ◽  
Vestibular Evoked Myogenic Potential ◽  
Reference Guide ◽  
Inferior Vestibular Nerve ◽  
Set Up ◽  
Vestibular Function Test

Vestibular-evoked myogenic potential (VEMP) testing is a vestibular function test used for evaluating saccular and inferior vestibular nerve function. Parameters of VEMP testing include VEMP threshold, latencies of p1 and n1, and p1-n1 interamplitude. Less commonly used parameters were p1-n1 interlatency, interaural difference of p1 and n1 latency, and interaural amplitude difference (IAD) ratio. This paper recommends using air-conducted 500 Hz tone burst auditory stimulation presented monoaurally via an inserted ear phone while the subject is turning his head to the contralateral side in the sitting position and recording the responses from the ipsilateral sternocleidomastoid muscle. Normative values of VEMP responses in 50 normal audiovestibular volunteers were presented. VEMP testing protocols and normative values in other literature were reviewed and compared. The study is beneficial to clinicians as a reference guide to set up VEMP testing and interpretation of the VEMP responses.

scholarly journals Impact of Stimulus Polarity on oVEMP Response Using the Belly-Tendon Electrode Montage

2019 ◽  
Vol 30 (05) ◽  
pp. 357-362
Author(s):  
Daniel J. Romero ◽  
Blythe H. Kitner ◽  
Matthew J. Wilson ◽  
Kaylee J. Smith
Keyword(s):  
Data Collection ◽  
Middle Ear ◽  
Upright Position ◽  
Response Amplitude ◽  
Stimulus Parameter ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Data Collection And Analysis ◽  
History Of ◽  
Contralateral Eye

AbstractOne stimulus parameter not well established with respect to the ocular vestibular evoked myogenic potential (oVEMP) is stimulus polarity. Many research studies traditionally record oVEMPs using alternating polarity primarily.The purpose of this study was to evaluate the effects of stimulus polarity on the oVEMP response under three different conditions (condensation, rarefaction, and alternating) with updated but established recording procedures—the belly-tendon electrode montage.oVEMPs were assessed with changes in stimulus polarity in the seated upright position.Thirty otologically normal participants (60 ears) with no history of hearing or balance disorders and normal middle ear function.Five hundred–hertz air-conducted tone bursts at 95-dB nHL were used to evoke the oVEMP response while recordings were made from the contralateral eye to acoustical stimulation using the belly-tendon electrode montage. Measurements were made using three polarities: alternating, condensation, and rarefaction. Natus Bio-logic AEP hardware and software was used for all data collection and analysis.Condensation stimulus phase provided the largest response amplitude compared with alternating and/or rarefaction. Rarefaction provided the earliest latency among stimulus polarities.Condensation is a more effective stimulus polarity regarding response amplitude when recording the oVEMP. This study further supports the use of the belly-tendon electrode montage for recording the oVEMP response.

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