Optimizing the pharmacological component of integrated balance therapy.

UNLABELLED: Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for Ménières disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with Ménières disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In Ménières disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-Ménières disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with Ménières disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with Ménières disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.

Otimizando o componente farmacológico da terapia integrada da vertigem / Optimizing the pharmacological component of integrated balance therapy

A farmacoterapia é opção importante no tratamento das vestibulopatias periféricas. OBJETIVO: Identificar a medicação que otimiza a terapia integrada da vertigem (TIV) na doença de Ménière e em outras vestibulopatias periféricas. MATERIAL E MÉTODO: Estudo de casos em que pacientes com doença de Ménière ou outras vestibulopatias periféricas receberam TIV com betaistina, cinarizina, clonazepam, flunarizina, Ginkgo biloba ou sem medicação durante 120 dias. RESULTADOS: Na doença de Ménière, TIV com qualquer um dos medicamentos foi mais eficaz do que TIV sem medicação, após 60 dias; a betaistina foi mais efetiva que todas as outras drogas, após 60 e 120 dias. Nas outras vestibulopatias periféricas, diferenças significantes foram observadas entre TIV com betaistina, cinarizina, clonazepam ou flunarizina e TIV sem medicação após 60 dias e todas as drogas foram mais efetivas que TIV sem medicação após 120 dias; betaistina, cinarizina ou clonazepam foram igualmente efetivos e betaistina foi mais efetiva que flunarizina e Ginkgo biloba. Os tratamentos foram bem tolerados. CONCLUSÕES: TIV incluindo medicação é mais efetiva que sem medicação na doença de Ménière ou em outras vestibulopatias periféricas. Betaistina foi o medicamento mais efetivo na doença de Ménière e tão eficaz quanto cinarizina ou clonazepam em outras vestibulopatias periféricas.

Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for MénièreÆs disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with MénièreÆs disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In MénièreÆs disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-MénièreÆs disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with MénièreÆs disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with MénièreÆs disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.

Contribuição do Mismatch Negativity na avaliação cognitiva de indivíduos portadores de esclerose múltipla / Mismatch Negativity contribution in Multiple Sclerosis patients

O Mismatch Negativity (MMN) é um potencial evocado auditivo endógeno, gerado por mudanças no processo de discriminação que ocorrem no córtex auditivo que avalia a memória sensorial auditiva. OBJETIVOS: Avaliar se, quando presente, o MMN pode ser utilizado como um índice funcional do córtex auditivo supratemporal e correlacionar com comprometimento cognitivo, avaliado pelo Teste Auditivo Compassado de Adição Seriada (PASAT). MATERIAL E MÉTODOS: Um grupo controle e outro com diagnóstico definido de EM foram submetidos ao registro do MMN com estímulos auditivos com variação de duração e de freqüência. O grupo de EM foi submetido ao PASAT. As latências e as amplitudes negativas do MMN foram comparadas entre os grupos. Os escores do PASAT foram correlacionados com a presença ou ausência do MMN nos dois protocolos de estimulação auditiva. RESULTADOS: O MMN esteve presente em 60 por cento dos indivíduos no grupo de EM no protocolo de estimulação auditiva com variação de duração, e em 45 por cento no protocolo de estimulação auditiva com variação de freqüência. Encontrou-se uma correlação estatisticamente significante entre a ausência da onda do MMN com a presença de comprometimento cognitivo avaliado pelo PASAT. CONCLUSÕES: A ausência do MMN se correlaciona com comprometimento cognitivo avaliado pelo PASAT.

Mismatch Negativity is a functional index of the supratemporal auditory cortex. AIM: The aim of the present study on Mismatch Negativity (MMN) in multiple sclerosis (MS) patients was to evaluate if the MMN can be correlated with cognitive deficits assessed by the Paced Auditory Addition Task - PASAT. METHOD: a clinical study in forty females and 20 males separated in two groups: control individuals and those with a definite diagnosis of MS underwent a duration and frequncy MMN. The MMN latencies and negative amplitudes obtained from the MS group were compared to the ones from the control group. The scores from the Paced Auditory Addition Task were correlated either with the presence or the absence of MMN. RESULTS: MMN was found in 60 percent of the individuals with multiple sclerosis within the auditory stimulation protocol with varied durations, and in 45 percent within the auditory stimulation protocol with frequency variations. There were no statistically significant differences in latencies and amplitudes when compared to controls. We found a statistically significant correlation for the lack of MMN wave together with cognitive disorder asserted by the PASAT. CONCLUSIONS: The MMN correlated to the cognitive deficit assessed by the PASAT.

Mismatch negativity contribution in multiple sclerosis patients.

UNLABELLED: Mismatch Negativity is a functional index of the supratemporal auditory cortex. AIM: The aim of the present study on Mismatch Negativity (MMN) in multiple sclerosis (MS) patients was to evaluate if the MMN can be correlated with cognitive deficits assessed by the Paced Auditory Addition Task--PASAT. METHOD: a clinical study in forty females and 20 males separated in two groups: control individuals and those with a definite diagnosis of MS underwent a duration and frequency MMN. The MMN latencies and negative amplitudes obtained from the MS group were compared to the ones from the control group. The scores from the Paced Auditory Addition Task were correlated either with the presence or the absence of MMN. RESULTS: MMN was found in 60% of the individuals with multiple sclerosis within the auditory stimulation protocol with varied durations, and in 45 % within the auditory stimulation protocol with frequency variations. There were no statistically significant differences in latencies and amplitudes when compared to controls. We found a statistically significant correlation for the lack of MMN wave together with cognitive disorder asserted by the PASAT. CONCLUSIONS: The MMN correlated to the cognitive deficit assessed by the PASAT.

Da influência do sexo, da intensidade do estímulo e do perímetro cefálico nas latências da audiometria de tronco encefálico / The influence of sex, intensity estimulation and encephalic perimeter in the latency of brain stem audiometry

O presente estudo foi realizado para avaliar a influência das variaçöes da intensidade do estímulo sonoro, do sexo e do perímetro cefálico nas latências absolutas e interpicos da Audiometria do Tronco Encefálico. O estudo foi realizado através da estimulaçäo ipsilateral com click nao filtrado com intensidade decrescentes, em 40 indivíduos audiologicamente normais, sendo 20 d0 sexo masculino e 20 do sexo feminino. As ondas I,III e V e seus interpicos foram mensuradas em todas as intensidades em que estavam presentes. Os resultados mostram que as latências absolutas e interpicos säo globalmente mais precoces no sexo feminino em todas as intensidades estudadas. As latências absolutas variam com a intensidade do estímulo em ambos os sexos, o que näo foi observado com as latências interpicos. Näo observamos correlaçäo entre o perímetro cefálico e as latências das ondas do ABR.

Potenciais de latência média em indivíduos normais: estudo sobre a latência das ondas

Os autores realizaram um estudo dos potenciais de média latência em 37 indivíduos considerados normais em ambos os ouvidos, determinaram os valores médios, desvios padröes e limites de confiança para as ondas PO, Pa e Pb e fizeram consideraçöes a respeito da possível utilizaçäo clínica destes potenciais, identificaçäo de lesöes situadas nas vias auditivas do tálamo e córtex cerebral, assim como para determinaçäo de limiares auditivos de forma objetiva.