Postural stability in patients with different types of head and neck trauma in comparison to healthy subjects.

OBJECTIVE: Dizziness is a common complaint in patients following mild head or neck trauma, but neurological signs are usually rare or absent. The aim of the study was to compare postural control in patients with different types of head and neck trauma to healthy subjects. METHODS: Balance function was evaluated by computerized dynamic platform posturography (CDPP) in 57 dizzy patients with whiplash injury (n = 11), mild head trauma without loss of consciousness (HTNLC) (n = 23), whiplash injury and mild head trauma without loss of consciousness (WHTNLC) (n = 12) and mild head trauma with loss of consciousness (n = 11) and in 14 healthy subjects. RESULTS: Compared to healthy subjects and after adjustment for inter-group age differences, sway index (SI) was significantly higher in patients with WHTNLC in three of the tests. There were no significant differences within the patient group according to type of injury. When time following the injury was considered, the SI was non-significantly higher within the first week after trauma compared to other time intervals. CONCLUSION: The severity of the postural abnormality in patients with head and/or neck trauma is not uniform and is influenced by the type of trauma.

Balance performance in adult epilepsy patients.

PURPOSE: To evaluate the magnitude of subclinical balance dysfunction in adult epilepsy patients and to assess the relative contribution of different variables to balance impairment. METHODS: Balance performance was evaluated by computerized dynamic platform posturography (CDPP) in 25 adult patients following a generalized tonic-clonic seizure (GTCS) and in 11 healthy subjects. RESULTS: The GTCS was a breakthrough seizure in 20 patients with epilepsy and a first seizure in 5. Seven of the patients had localization-related epilepsy and 13 had generalized epilepsy. Mean epilepsy duration was 6.6 years. Nineteen of the patients were treated with antiepileptic drugs (AEDs), 16 on monotherapy and three on polytherapy. Brain CT scan and EEG abnormalities were found in 7 and 14 patients, respectively. None of the patients had clinical signs of balance dysfunction. Postural function, measured by Sway Index (SI), was worse in the patients compared to controls. A lower SI was found in patients who did not receive AEDs, had one or two seizures, had a disease duration of less than a year and had a generalized epilepsy. CONCLUSIONS: Although the study group was small and heterogeneous and only a small number of parameters have reached statistical significance, it seems that posturography can be helpful in the evaluation of postural stability in adult patients with epilepsy.

Posturography in MS patients treated with high dose methylprednisolone.

OBJECTIVES: To evaluate the sensitivity of the balance sway index (SI) to drug-induced functional changes during acute relapse in patients with MS. METHODS: Dynamic posturography was used to derive the SI in 11 healthy subjects and 13 MS patients before and after intravenous high dose methylprednisolone (HDMP). RESULTS: In both groups, SI was lower in the least demanding task and increased with test complexity. Compared to the healthy group, patients were distinguished by a higher SI both prior to and following administration of HDMP (p < 0.008). However, the effect of the drug on patients' SI was unremarkable. Total Expanded Disability Status Scale score was lower after treatment compared to pre-treatment values (p < 0.001), with significantly lower mean score recorded in patients with pyramidal and cerebellar abnormalities (p = 0.017 and p = 0.011, respectively). DISCUSSION: The SI measure of dynamic posturography is not sensitive to short-term HDMP-induced functional changes during acute relapse in patients with MS. Further studies are needed to evaluate modified balance protocols and the possible long-term treatment effects of HDMP on SI.

Ocular dominance and balance performance in healthy adults.

PURPOSE: To evaluate the effect of ocular dominance on balance performance in healthy adult subjects. METHODS: Ocular dominance was determined in 24 healthy subjects using the hole-in-the-paper test. Balance function was evaluated by computerized dynamic platform posturography (CDPP). Sway index (SI), antero-posterior sway (APS) and lateral sway (LS) were served as outcome parameters. RESULTS: The outcome parameters did not differ significantly between dominant and non-dominant eye fixation both in static and angular balance tests (SI-5.47+/-0.42, 6.23+/-0.52, p=0.146 and 18.4+/-1.07, 19.11+/-1.15, p=0.142, respectively; APS--2.26+/-4.68, -5.1+/-4.6, p=0.082 and -1.94+/-3.33, -3.64+/-2.6, p=0.48, respectively; LS--1.21+/-1.46, -1.12+/-1.66 p=0.94 and -1.98+/-1.16, -1.55+/-1.39, p=0.69, respectively). CONCLUSIONS: Ocular dominance does not seem to affect postural function in the monovision and far viewing condition.