RESUMO
OBJECTIVES: To prospectively follow patients with vestibular neuritis (VN), to compare the recovery pattern of canal and otolith dysfunction, and to determine which tests best predict symptom recovery. METHODS: Between March 2006 and December 2006, 51 consecutive patients with unilateral VN were enrolled within 7 days of onset (average 3 days). Otolith function tests included ocular torsion (OT), subjective visual vertical (SVV), and vestibular evoked myogenic potential (VEMP), and canal function tests included head-shaking nystagmus (HSN), caloric stimulation, and head-thrust testing. Patients returned for two follow-up evaluations at approximately 1 week and 6 weeks after the initial evaluation. RESULTS: On the first examination, all patients had abnormal HSN, caloric, and head-thrust test results, and at least one otolith-related test abnormality: abnormal tilt of SVV (48/51, 94%), abnormal OT (42/51, 82%), or abnormal VEMPs (25/51, 49%). The degree of SVV tilts correlated with the degree of OT for one or both eyes (p < 0.05). Skew deviation was observed in 7 patients (14%), and a complete ocular tilt reaction was detected in only 2 patients. On follow-up, otolith test results returned to normal more rapidly than canal test results. The head-thrust test was the best predictor of symptom recovery. Eighty percent of patients who continued to report dizziness at the last follow-up visit had a positive head-thrust test result, whereas only 10% of patients who were not dizzy had a positive head-thrust test result. CONCLUSION: Otolith-related test abnormalities improve more rapidly than canal-related test abnormalities after vestibular neuritis. If patients have a positive head-thrust test result on follow-up, they are more likely to be dizzy.
Assuntos
Membrana dos Otólitos/fisiopatologia , Recuperação de Função Fisiológica , Testes de Função Vestibular/métodos , Neuronite Vestibular/diagnóstico , Neuronite Vestibular/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes Calóricos/estatística & dados numéricos , Tontura/diagnóstico , Tontura/etiologia , Tontura/fisiopatologia , Feminino , Movimentos da Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Sensibilidade e Especificidade , Testes de Função Vestibular/normasRESUMO
Neuro-vasculo-Behçet's disease is considered a venous vessel disease generally in the form of cerebral venous thrombosis. Arterial involvement has been rarely reported. We present a patient with neuro-Behçet's disease who developed reversible basilar artery occlusion. To the best of our knowledge, this is the first case of neuro-Behçet's disease presenting with reversible basilar artery occlusion. Behçet's disease should be considered in the differential diagnosis of basilar artery occlusion.
Assuntos
Artéria Basilar/patologia , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Ponte/irrigação sanguínea , Ponte/patologia , Insuficiência Vertebrobasilar/diagnóstico , Insuficiência Vertebrobasilar/etiologia , Anti-Inflamatórios/uso terapêutico , Anticoagulantes/uso terapêutico , Artéria Basilar/fisiopatologia , Síndrome de Behçet/fisiopatologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ponte/fisiopatologia , Esteroides/uso terapêutico , Resultado do Tratamento , Insuficiência Vertebrobasilar/fisiopatologiaRESUMO
A 68 year old woman presented with bilateral sudden simultaneous hearing loss and transient spontaneous vertigo as a sole manifestation of vertebrobasilar insufficiency. Extensive investigation to exclude other causes was unremarkable. Magnetic resonance imaging of the brain, including diffusion images, showed no abnormalities. A magnetic resonance angiogram showed severe stenosis of the middle third of the basilar artery. A pure tone audiogram showed moderate sensorineural-type hearing loss bilaterally. The localisation and mechanism of an isolated cochleovestibular dysfunction are discussed.
Assuntos
Surdez/diagnóstico por imagem , Surdez/etiologia , Insuficiência Vertebrobasilar/complicações , Insuficiência Vertebrobasilar/diagnóstico por imagem , Vertigem/diagnóstico por imagem , Vertigem/etiologia , Idoso , Surdez/patologia , Feminino , Humanos , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Radiografia , Insuficiência Vertebrobasilar/patologia , Vertigem/patologiaRESUMO
The authors report two patients with cerebellar infarctions in the territory of the medial branch of the posterior inferior cerebellar artery who had vertigo, spontaneous ipsilesional nystagmus, and contralesional truncal lateropulsion. Although one of the two patients had slight dysmetria, overall signs closely mimicked those of acute peripheral vestibulopathy. The authors suggest that interruption of nodulouvular inhibitory projections to vestibular nuclei may account for the vestibular signs.
Assuntos
Doenças Cerebelares/diagnóstico , Infarto Cerebral/diagnóstico , Nistagmo Patológico/etiologia , Vertigem/etiologia , Doenças Vestibulares/diagnóstico , Idoso , Doenças Cerebelares/complicações , Infarto Cerebral/complicações , Diagnóstico Diferencial , Feminino , Humanos , Doenças do Labirinto/diagnóstico , Imageamento por Ressonância Magnética , MasculinoRESUMO
A 58-year-old man described a short history of dyspnea and a preceding flu like illness with roentgenographic features of an interstitial lung disease. An open lung biopsy specimen from him showed bronchiolitis obliterans with organizing pneumonia (BOOP). Adenovirus was isolated from a throat swab. There was both clinical and radiographic improvement with supportive care. We herein report a first case of BOOP associated with adenovirus in Korea.