RESUMO
OBJECTIVE: Chronically increased blood glucose levels may affect the vestibular system by damaging cells and neural structures in diabetes mellitus (DM). We aimed to search the effects of neurovascular degeneration on the vestibular system in type 2 DM and prediabetic patients by using air-conducted ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials. DESIGN: Prospective study. STUDY SAMPLE: Thirty diabetic, 30 prediabetic patients, and 31 age- and sex-matched controls having no peripheral or central vestibular disease, were enrolled. All participants were evaluated by audiovestibular tests, oVEMP, and cVEMP. RESULTS: In the diabetic group, mean values of both oVEMP and cVEMP p1, n1 latencies were significantly longer compared to the prediabetic group and the control group, whereas latencies were similar in prediabetic and the control groups. Bilateral neural dysfunction was recognized in both tests and lateralization was not seen in VEMP asymmetric ratios. In the diabetic group, prevalence of pathological p1 and n1 latencies in oVEMP were 30.4% and 37.5%, whereas they were 53.7%, 59.3% in cVEMP, respectively. p1 latencies of cVEMP and oVEMP were positively correlated with HbA1c and fasting plasma glucose level in the diabetic group. CONCLUSION: Subclinical vestibular neuropathy can be a newly defined diabetes-related complication.
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Estado Pré-Diabético/fisiopatologia , Neuronite Vestibular/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia , Estimulação Acústica/métodos , Adulto , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/fisiologia , Músculos Oculomotores/fisiologia , Estado Pré-Diabético/complicações , Estudos Prospectivos , Potenciais Evocados Miogênicos Vestibulares , Testes de Função Vestibular/métodos , Neuronite Vestibular/etiologiaRESUMO
The patient was admitted to our clinic with the complaint of swelling in his left post-auricular region. The medical history revealed that he underwent thyroid surgery eight years ago and the specimen was reported as papillary thyroid carcinoma. Following required analyses, total thyroidectomy and biopsy from mastoid region were performed. Total thyroidectomy specimen was proved thyroid papillary microcarcinomas at five foci of the thyroid gland, while biopsy samples obtained from the mastoid region were reported as metastatic papillary thyroid carcinoma. The patient underwent radioactive iodine, followed by radiotherapy. In this article, we present a 61-year-old male patient with papillary thyroid carcinoma metastatic to the temporooccipital region, accompanied by multiple cranial nerve paralysis.