Acute Vertigo in a Patient with Long-Term Organic Solvent Exposure: Importance of a Comprehensive Audio-Vestibular Test Battery

2019 ◽  
Author(s):  
Maxime Maheu ◽  
Franc¸ois Champoux ◽  
Adrian Fuente
Keyword(s):  
Organic Solvents ◽  
Vestibular System ◽  
Semicircular Canals ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Solvent Exposure ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Tests ◽  
History Of

Background: Ototoxicity induced by organic solvents has been identified in several groups of workers.Little is known, however, about the effects of organic solvents on the vestibular system.<br />Purpose: The aim of the study was to comprehensively assess the vestibular system and auditory functionsin a worker exposed to organic solvents.<br />Research Design: Both behavioral and physiological auditory and vestibular evaluations wereperformed.<br />Results: No auditory-related findings associated with solvent exposure were found. The vestibulo-ocularreflex gain was abnormal for all semicircular canals with significant catch-up saccades, as measured bythe video head impulse test. The cervical vestibular evoked myogenic potentials was absent in the rightear and small but replicable in the left ear. Ocular vestibular evoked myogenic potential were bilaterallyabsent.<br />Conclusions: The results suggest a case of vestibulotoxicity induced by a long history of organic solventexposure. We suggest that solvent-exposed individuals should be evaluated with a comprehensive batteryof auditory and vestibular tests.<br />

scholarly journals Acute Vertigo in a Patient with Long-Term Organic Solvent Exposure: Importance of a Comprehensive Audio-Vestibular Test Battery

2020 ◽  
Vol 31 (05) ◽  
pp. 363-368
Author(s):  
Maxime Maheu ◽  
François Champoux ◽  
Adrian Fuente
Keyword(s):  
Organic Solvent ◽  
Organic Solvents ◽  
Vestibular System ◽  
Semicircular Canals ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Solvent Exposure ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Tests ◽  
Organic Solvent Exposure

Abstract Background Ototoxicity induced by organic solvents has been identified in several groups of workers. Little is known, however, about the effects of organic solvents on the vestibular system. Purpose The aim of the study was to comprehensively assess the vestibular system and auditory functions in a worker exposed to organic solvents. Research Design Both behavioral and physiological auditory and vestibular evaluations were performed. Results No auditory-related findings associated with solvent exposure were found. The vestibulo-ocular reflex gain was abnormal for all semicircular canals with significant catch-up saccades, as measured by the video head impulse test. The cervical vestibular evoked myogenic potentials was absent in the right ear and small but replicable in the left ear. Ocular vestibular evoked myogenic potential were bilaterally absent. Conclusions The results suggest a case of vestibulotoxicity induced by a long history of organic solvent exposure. We suggest that solvent-exposed individuals should be evaluated with a comprehensive battery of auditory and vestibular tests.

scholarly journals A case series shows independent vestibular labyrinthine function after major surgical trauma to the human cochlea

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Stefan K. Plontke ◽  
Torsten Rahne ◽  
Ian S. Curthoys ◽  
Bo Håkansson ◽  
Laura Fröhlich
Keyword(s):  
Case Series ◽  
Vestibular Function ◽  
Semicircular Canals ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Surgical Trauma ◽  
Cochlear Function ◽  
Receptor System ◽  
Tertiary Referral Center ◽  
Significant Difference

Abstract Background The receptors for hearing and balance are housed together in the labyrinth of the inner ear and share the same fluids. Surgical damage to either receptor system was widely believed to cause certain permanent loss of the receptor function of the other. That principle, however, has been called into question because there have been anecdotal reports in individual patients of at least partial preservation of cochlear function after major surgical damage to the vestibular division and vice versa. Methods We performed specific objective vestibular function tests before and after surgical trauma (partial or subtotal cochlear removal) for treatment of intracochlear tumors in 27 consecutive patients in a tertiary referral center. Vestibular function was assessed by calorics (low-frequency response of the lateral semicircular canal), vestibulo-ocular reflex by video head impulse test (vHIT) of the three semicircular canals, cervical and ocular vestibular evoked myogenic potentials (cVEMP, saccule and oVEMP, utricle). Preoperative and postoperative distributions were compared with paired t-tests. Results Here we show that there was no significant difference between pre- and post-operative measures for all tests of the five vestibular organs, and that after major surgical cochlear trauma, the vestibular receptors continue to function independently. Conclusions These surprising observations have important implications for our understanding of the function and the surgery of the peripheral auditory and vestibular system in general and open up new possibilities for the development, construction and evaluation of neural interfaces for electrical or optical stimulation of the peripheral auditory and vestibular nervous system.

scholarly journals 084 Separating stroke from vestibular neuritis by vestibular function test parameters

2019 ◽  
Vol 90 (e7) ◽  
pp. A27.1-A27
Author(s):  
Zeljka Calic ◽  
Benjamin Nham ◽  
Rachel Taylor ◽  
Allison Young ◽  
Craig Anderson ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Vestibular Function ◽  
Vestibular Neuritis ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Saccade Amplitude ◽  
Vestibular Tests ◽  
Acute Vestibular Syndrome ◽  
Significant Difference ◽  
Catch Up

IntroductionVestibular neuritis (VN) and posterior circulation stroke (PCS) are the commonest causes of acute vestibular syndrome (AVS). We aim to identify discriminators of VN from PCS by testing all five vestibular end-organs in patients presenting with AVS.MethodsThree-dimensional video-head impulse test (v-HIT), cervical and ocular-vestibular evoked myogenic potentials (c-and oVEMP) and subjective visual horizontal (SVH) tests were performed in 22 patients with VN and 22 with PCS. Ipsilesional horizontal, anterior and posterior canal (HC, AC, PC) v-HIT gain and first catch-up saccade characteristics, VEMP amplitude asymmetry-ratios were compared.ResultsAll VN and 6 PCS patients had positive clinical HIT. Mean time to testing was 4.7 days for VN, 7.0 days for PCS. VN mean ipsilesional HC and AC first saccade amplitude was larger, peak-velocities faster and onset latencies earlier compared to PCS (p<0.05). No significant difference between VN and PCS in first saccade characteristics was found in PC. Ipsilesional first saccade amplitude, peak-velocity and duration were significantly different between PCS and controls for all canals (p<0.05). A gain <0.68 and first saccade amplitudes >2.2°separated VN from PCS with sensitivities of 95.5% and 86.4% and specificities of 72.7% and 63.6%. First saccade amplitude of >0.91°identified PCS from controls with sensitivity of 68.2% and specificity of 70%. Abnormality rates for AC cVEMP, BC oVEMP and SVH were 42.9%, 50% and 91% for VN and 38.1%, 9% 72% for PCS.Conclusion v-HIT gain and catch-up saccade metrics are useful separators of VN from PCS. Detailed saccade analysis complements existing vestibular tests.

scholarly journals Early Assessment of Vestibular Function after Unilateral Cochlear Implant Surgery

2019 ◽  
Vol 25 (Suppl. 1-2) ◽  
pp. 50-59 ◽  
Author(s):  
Maurizio Barbara ◽  
Rita Talamonti ◽  
Anna Teresa Benincasa ◽  
Silvia Tarentini ◽  
Chiara Filippi ◽  
...  
Keyword(s):  
Short Form ◽  
Statistical Significance ◽  
Round Window ◽  
Vestibular Function ◽  
Semicircular Canals ◽  
Vestibular Evoked Myogenic Potentials ◽  
Diagnostic Tools ◽  
Head Impulse Test ◽  
Early Assessment ◽  
Window Approach

Introduction: Cochlear implantation (CI) has been reported to negatively affect vestibular function. The study of vestibular function has variably been conducted using different types of diagnostic tools. The combined use of modern, rapidly performing diagnostic tools could prove useful for standardization of the evaluation protocol. Methods: In a group of 28 subjects undergoing CI, the video head impulse test (vHIT), the cervical vestibular evoked myogenic potentials (cVEMP) and the short form of the Dizziness Handicap Inventory (DHI) questionnaire were investigated preoperatively and postoperatively (implant on and off) in both the implanted and the contralateral, nonimplanted ear. All surgeries were performed with a round window approach (RWA), except for 3 otosclerosis cases in which the extended RWA (eRWA) was used. Results: The vHIT of the lateral semicircular canal showed preoperative vestibular involvement in nearly 50% of the cases, while the 3 canals were contemporarily affected in only 14% of the cases. In all the hypofunctional subjects, cVEMP were absent. A low VOR gain in all of the investigated superior semicircular canals was found in 4 subjects (14%). In those subjects (21.7%) in whom cVEMP were preoperatively present and normal on the operated side, the absence of a response was postoperatively recorded. Discussion/Conclusion: The vestibular protocol applied in this study was found to be appropriate for distinguishing between the CI-operated ear and the nonoperated ear. In this regard, cVEMP was found to be more sensitive than vHIT for revealing a vestibular sufferance after CI, though without statistical significance. Finally, the use of RWA surgery apparently did not reduce the occurrence of signs of vestibular impairment.

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness

2018 ◽  
Vol 29 (02) ◽  
pp. 175-186 ◽  
Author(s):  
Anuj Kumar Neupane ◽  
Krithika Gururaj ◽  
Sujeet Kumar Sinha
Keyword(s):  
Motion Sickness ◽  
Dynamic Environment ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Standard Group ◽  
Asymmetry Ratio ◽  
Vestibular Evoked Myogenic Potential ◽  
Group I ◽  
Significant Difference ◽  
Vestibulo Ocular Reflex

AbstractMotion sickness is a complex autonomic phenomenon caused by the intersensory conflict among the balancing systems, resulting in a mismatch of signals between static physical conditions of the susceptible individual exposed to dynamic environment.The present study was done to assess the sacculocollic reflex pathway and six semicircular canals in individuals susceptible to motion sickness.Standard group comparison was used.A total of 60 participants with an age range of 17–25 yr were included, where group I comprised 30 participants with motion sickness and group II comprised 30 participants without motion sickness. The Motion Sickness Susceptibility Questionnaire–Short was administered to classify the participants into groups with or without motion sickness.The cervical vestibular-evoked myogenic potential (cVEMP) test and video head impulse test (vHIT) were administered to all participants. The Shapiro–Wilk test revealed normal distribution of the data (p > 0.05). Hence a parametric independent sample t test was done to check significant difference in cVEMP and vHIT parameters between the two groups.The present study revealed no significant difference for cVEMP latencies and amplitude in individuals with motion sickness. However, significantly higher cVEMP asymmetry ratio was observed in individuals with motion sickness. Though the vestibulo-ocular reflex (VOR) gain values showed no significant difference between the two groups except for the right anterior left posterior plane, the asymmetry in VOR gain values revealed significant difference between the groups, suggesting asymmetry as a better parameter than absolute VOR gain values. Also, the presence of refixation saccades in 100% of the individuals with motion sickness accorded with various studies reported earlier with vestibular-related pathologies.Presence of higher asymmetry ratio in cVEMP and vHIT test results plus refixation saccades to stabilize the gaze in vHIT can suggest some amount of vestibular anomalies in individuals with motion sickness.

Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

2020 ◽  
Vol 40 (01) ◽  
pp. 018-032 ◽  
Author(s):  
Rachael L. Taylor ◽  
Miriam S. Welgampola ◽  
Benjamin Nham ◽  
Sally M. Rosengren
Keyword(s):  
Vestibular System ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Disorders ◽  
Complementary Information ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Otolith Function ◽  
Utricular Function ◽  
Canal Dehiscence

AbstractVestibular-evoked myogenic potentials (VEMPs) are short-latency, otolith-dependent reflexes recorded from the neck and eye muscles. They are widely used in neuro-otology clinics as tests of otolith function. Cervical VEMPs are recorded from the neck muscles and reflect predominantly saccular function, while ocular VEMPs are reflexes of the extraocular muscles and reflect utricular function. They have an important role in the diagnosis of superior canal dehiscence syndrome and provide complementary information about otolith function that is useful in the diagnosis of other vestibular disorders. Like other evoked potentials, they can provide important localizing information about lesions that may occur along the VEMP pathway. This review will describe the VEMP abnormalities seen in common disorders of the vestibular system and its pathways.

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.

Changes in Vestibular Evoked Myogenic Potentials after Meniere Attacks

2005 ◽  
Vol 114 (9) ◽  
pp. 717-721 ◽  
Author(s):  
Shih-Wei Kuo ◽  
Ting-Hua Yang ◽  
Yi-Ho Young
Keyword(s):  
Semicircular Canals ◽  
The Other ◽  
Spontaneous Nystagmus ◽  
Vestibular Evoked Myogenic Potentials ◽  
Ménière’S Disease ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Lesion Side ◽  
Important Idea ◽  
Healthy Side

Objectives: The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. Methods: From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. Results: At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Conclusions: Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks.

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.

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