[Auditory-evoked brainstem response in a schwannoma of the VIIIth cranial nerve: an anatomophysiological and functional correlation. Our experience]. / Respuesta evocada auditiva de tronco en el schwannoma del VIII par: correlación anatomofisiológica y funcional. Nuestra experiencia.

INTRODUCTION: Schwannomas are tumors charasteristically originated from the nerve sheath. They expande eccentrically from the nerve promoting a disturbance in the neural function either due to vascular compresion or to the effect of the tumor itself on the nerve, disturbance that can be evidenced with the Auditory-evoked Brainstem Response (ABR), fact that constituted the base for their diagnosis in the past. The new radiological techniques developed over the last decades have made possible an earlier diagnosis, and therefore changed their prognosis in terms of nerve function. Diagnosis is more certain today with these techniques so it could seem that ABR may not have any longer a role in the management of this condition. OBJECTIVE: To describe the most frequent ABR patterns in those patients suffering from acoustic schwannoma related to the size of the tumour and the remanent audition thresholds, and to determine the value of this test in our practice. MATERIAL AND METHODS: We describe the ABR features found in our series of 72 patients. Whose diagnosis was done between 1997 and 2003 in relation to the size of the tumour and the residual auditory function. RESULTS AND CONCLUSIONS: ABR has a good sensibility for detection of acoustic schwannoma. This sensibility decreases in small-sized tumours, specially in intracanalicular ones. ABR patterns do not relate to the size of the tumour but they do to the auditory function. The authors defend ABR to be a very valuable test due to the information and accesibility they provide.

[Benign paroxysmal vertigo in childhood]. / Vértigo benigno paroxístico de la infancia.

Benign paroxysmal vertigo of childhood is a clinical disorder that usually begins at age 4. The child's otoneurological examination is normal in the intercrisis and the brief episodes of true vertigo are typical. In this paper we describe six new cases that had a follow-up of at least one year after diagnosis. Only a few of the patients had demonstrated vasomotor migraine, but all the children had a family history of migraine, which supports the hypothesis that this disorder is a migraine equivalent. The pathogenesis may be related with a transitory vascular disturbance that produces ischemia of the vestibular nuclei and pathways, as occurs in other vascular territories during typical migraine. One longer-than-usual episode is reported. Otherwise, the evolution of this condition is favorable.

[Ischemia of the anterior vestibular artery (Lindsay-Hemenway syndrome). Review and comments]. / Isquemia de la arteria vestibular anterior (síndrome de Lindsay-Hemenway). Revisión y comentarios.

INTRODUCTION: The Lindsay and Hemenway syndrome is produced by ischemia in the territory of the anterior vestibular artery and is characterized by an initial episode of acute vertigo followed by benign paroxysmal positional vertigo and decreased or abolished caloric response. OBJECTIVE: To determine the incidence of anterior vestibular artery syndrome in patients with benign paroxysmal positional vertigo. DESIGN: A 3-year retrospective study (January 1994 to December 1996). SETTING: Patients with benign paroxysmal positional vertigo of the Zamora and Salamanca (Spain) health districts seen in two outpatients clinics. STUDY SUBJECTS: Ninety-eight patients with benign paroxysmal positional vertigo. RESULTS: Sixteen patients diagnosed as anterior vestibular artery syndrome were revised (16.3%). CONCLUSIONS: Although the literature is scarce, the incidence of Lindsay-Hemenway syndrome seems to be underestimated.

[Questionnaire for disability assessment in vestibular pathology]. / Cuestionario para la evaluación de la minusvalía en patología vestibular (CEMPV).

The QADVP (questionnaire for assessment of disabled by vestibular pathology) is self-employed and consists of a series of 46 questions divided into 3 scales (emotional, functional and organic) from which direct and proportionate scores (both for each scale and as a whole for the full questionnaire) are gained. The aim of the paper is to show its application-way, the outcome of assessments and the disability degree drawn out from the scores. A prospective study fulfilled within 2 years term (May, 1st 1994 until May, 1st 1996) between patients of the Health Area of Zamora, seen at the ENT outpatients Department. The validation's study (reliability, homogeneity and discriminatory power in each scale and of the whole questionnaire) was made from a sample of 30 patients suffering of recurring-paroxysmal vestibular disease of several etiologies. In order to establish the handicap degree the questionnaire was employed in 60 patients suffering postural-paroxysmal vertigo or Ménière disease, grouped in 4 homogenous sets after the evolutive time. The series in each scale and globally for the whole questionnaire make sharp 4 levels of handicap (from I to IV). Zero degree is equivalent to absence of vestibular disorder. The QADVP is a measuring tool allowing: assessment several degrees of incapacity, to control the development of the disorder and try therapeutic changes.

[Anxiety and vertigo]. / Ansiedad y vértigo.

AIM OF THE STUDY: To determinate the prevalence of anxiety associated with vertigo of vestibular origin. DESIGN: A retrospective study. SETTING: Patients from Salamanca's University Hospital (Neuro-Otology). PATIENTS: 138 patients with asymptomatic vestibular dysfunction (group A: with filiated disease and group B: with unfiliated disease). INSTRUMENTATION: Structured anamnese and STAI questionnary (State-Trait-Anxiety-Scale) were realized in the whole collective. RESULTS: Anxiety (elevated score in STAI-scale) was detected in 48.6% patients and more differences between groups A and B were not significant. With logistic regression anxiety is related with previous symptomatological experiences and subjective global incapacity. Anxiety is clearly connected with the symptoms in the intercritic periods. CONCLUSION: Anxiety is associated with vestibular disease and it follows a parallel course.

[The anamnesis in old people with equilibrium disorder]. / La anamnesis en el anciano con patología del equilibrio.

Equilibratory troubles in aged individuals are the consequence of changes in vestibular, visual, proprioceptive, neuro-muscular and skeletal systems. Often related as well, to iatrogenic effects induced by pharmacological treatments. Its assessment is not easy at all because elderly population undergo physiological inability and so offer great difficulties in both diagnosis and management. At least informative data related to the equilibration must be collected: feelings, positional and postural unleashing factors, evolutive pattern, intercrises symptoms, cochlear and neurologic findings. Pharmacological treatments, associated pathologies and psycho-affective conditions as well. In the anamnestic model proposed by the AA. other helpful data in order to arouse clinical suspicion on vasculocerebral and vertebrobasilaris pathologies are contemplated. A sample concerning 51 patients more than 70-year-old with the gained descriptive results in detailed.

[Nystagmic response after bithermal caloric stimulation in elderly subjects: latency, culmination, and finalization]. / Respuesta nistágmica tras estimulación calórica bitermal en ancianos: latencia, culminación y finalización.

We analysed the nystagmic response poscaloric stimulation in 38 healthy elderly persons. Latence, culmination, lasting, central nystagmic frequency and interaural difference are analysed. We establish the normal pattern for the nystagmic response.

[Vestibular symptomatology and response to treatment with heterocyclic drugs]. / Sintomatología vestibular y respuesta al tratamiento con fármacos heterocíclicos.

Around 40 percent of the patients that we consult due to vertigo of a probable vestibular origin present an associated depressive syndrome. A study with patients with depressive symptoms and vestibular pathology of diverse aetiology in inactive phase is presented. Treatment using amitriptyline improves de evolutive prognosis of vestibular manifestations while observing a lower reappearance of symptomatology.

[Vertigo in the elderly patient]. / Algunas consideraciones sobre el vertigo en el paciente anciano.

Among the 52 patients, aged 70 and older, who came at office for vertigo, one or more specific diagnoses were made in 36 patients (69.23 percent). The most common diagnoses being benign positional vertigo (29 percent) and Ménière's disease (15.4 percent). Other associated pathologies were identified in 38 patients (73.1 percent). The mechanisms involved are discussed.

[The anamnesis as a global strategy with the vestibular patient. A model presentation]. / La anamnesis como estrategia global ante el enfermo vestibular. Presentación de un modelo.

An anamnesis model for management patient with vertigo or dizziness caused by disturbance of vestibular system were presented. Data were sorted in eight axis: Axis I (symptoms), Axis II (physical examination), Axis III (electrophysiological findings), Axis IV (associate pathology), Axis V (laboratory tests), Axis VI (psychosocial), Axis VII (therapeutic response) and Axis VIII (familiar antecedents).

[Trial of amitriptyline versus flunarizine as treatment of vestibular diseases. A preliminary study]. / Ensayo de amitriptilina versus flunarizina como tratamiento en patología vestibular. Estudio preliminar.

109 patients with vestibular disease were included in two different treatments with amitriptyline (Group A:53 patients with depressive symptoms), or flunarizine (Group B: 56 patients). Vertiginous symptoms, basic vestibular exploration, depressive disorder, cochlear symptoms, vegetative disorders and headache were evaluated. Among the patients treated with amitriptyline a significant decrease in the vertiginous symptoms were observed. The possible mechanism of action were analyzed too.