A Case of Rotational Vertebral Artery Syndrome Treated by Posterior Cervical Decompression / 대한이비인후과학회지

Rotational vertebral artery syndrome (RVAS) is a rare disease entity. RVAS is characterized by recurrent attacks of vertigo, nystagmus, ataxia, and tinnitus, which is elicited by head-rotation when the contralateral dominant vertebral artery is compressed, leading to an acute reduction of blood flow in the vertebrobasilar territory. A 50-year-old female presented with a whirling type vertigo which, when turning her head to the left, compressed the dominant right vertebral artery, as documented by the dynamic neck angiography. The patient underwent posterior cervical decompression of the foramina transversaria and the surrounding soft tissues at the level of C1-C2. The patients's symptom disappeared after the surgery and she has been followed up for the last four months without the recurrence of vertigo.

Immunohistochemical Study on beta1- and beta2-Adrenergic Receptors in Rat Vestibular Nuclei / 대한평형의학회지

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the localizations of beta1- and beta2-adrenergic receptors (ARs) in rat vestibular nuclei by immunohistochemical staining procedure. MATERIALS AND METHODS: Twelve male Sprague-Dawley rats were used in this study. Primary antibodies for the beta1- and beta2-ARs were used. The sections were treated with a biotinylated goat anti-rabbit antibody. The sections were then incubated in avidin-biotin-peroxidase reagent and processed with immunoperoxidase using 3.3'-diaminobenzidine tetrahydrochloride. RESULTS: beta1-AR and beta2-AR immunopositive neurons were found to be distributed throughout the four major vestibular nuclei. Both receptors were primarily detected in neuronal somata and their proximal dendrites. beta1-AR and beta2-AR were moderately expressed in the superior vestibular nucleus, lateral vestibular nucleus, medial vestibular nucleus, and spinal vestibular nucleus. CONCLUSION: The present study demonstrates, for the first time, that beta1-AR and beta2-AR receptors are localized in rat vestibular nuclei. Furthermore, this study may provide additional speculation into the role of ARs during vestibular signal processing. Further studies are needed to clarify the roles played by beta1-ARs and beta2-ARs through physiologic and functional studies.

Two Cases of Vestibular Pseudoneuritis Presenting Positive Sign on Head Impulse Test / 대한평형의학회지

At emergency room, most patients who presented with abrupt isolated vertigo without neurologic deficits were diagnosed as common vestibular disorder including vestibular neuritis. However posterior circulation stroke also can be a cause of the isolated vestibular vertigo. This condition is called vestibular pseudoneuritis. It is very important to differentiate vestibular pseudoneuritis from common vestibular disorder because of requiring different management and avoiding severe complication. Previous studies reported that head impulse test is one of bedside tests which represents unilateral vestibular hypofunction. Most patients of the vestibular neuritis shows positive head impulse test. However the head impulse test can be positive in central origin vertigo. So it is necessary to interpret the results of the test with caution. We report 2 cases of vestibular pseudoneuritis which showed positive head impulse test with a review of the related literatures.

A Case of Bilateral Pseudocyst of the Auricle / 대한이비인후과학회지

A pseudocyst of the auricle is a benign idiopathic, uncommon condition, which typically presents as a unilateral painless swelling over the anterior aspect of the auricle. If left untreated, the permanent deformity of the pinna may occur. Many modalities of treatment have been reported but the definitive treatment still remains controversial because of the high recurrence rate. It seems predominantly only one sided with most of the bilateral lesions developing asynchronously, and only a few cases have reported on simultaneous involvement of both pinna. We experienced a case of a 23-years-old man with an endochondral pseudocyst of simultaneous involvement of his both auricles. This is the first report in Korea, so we report this case with a review of the literature.

Two Cases of Central Origin Vertigo Mimicking Acute Vestibular Neuritis / 대한평형의학회지

Vestibular neuritis (VN) is characterized by the acute onset of vertigo, nausea and vomiting, in the absence of hearing loss or tinnitus. Cerebellar and brain stem infarction represents approximately 2.3% of acute strokes overall. Those can result from occlusion of the superior cerebellar artery, anterior inferior cerebellar artery, or the posterior inferior cerebellar artery. Central vertigo such as cerebellar or brain stem infarction may present with nonspecific symptoms similar to those of VN. Patients with isolated vertigo due to cerebral infarction may pose a significant diagnostic challenge to the neurotologists. It is know n for being frequently misdiagnosed, often with consequent disability. We report 2 cases of cerebral infarction mimicking VN initially with a review of the related literatures.

Herpes Zoster Oticus Involving Superior And Inferior Vestibular Nerve Without Facial Nerve Palsy

Herpes zoster oticus (HZO) is characterized by auricular vesicles, facial palsy and vestibulocochlear dysfunction. The 8th cranial nerve can be most frequently involved. Rarely, it may be associated with the involvement of 5th, 6th, 9th, 11th or 12th cranial nerve. However, only few cases of HZO involving vestibular nerve without facial nerve palsy have been previously reported. We experienced an unusual case of 38-year-old woman who presented with auricular vesicles, otalgia, and vertigo of whilrling nature but not with facial palsy. Vestibular evoked myogenic potential (VEMP) and caloric tests that were performed to determine which division of vestibular nerve was involved demonstrated that decreased responses in this case. We report a case of HZO involving superior and inferior vestibular nerve without facial palsy that was confirmed by VEMP and caloric tests with a review of literature.

A Case Report of Lou Gehrig's Disease Presenting with Rhinolalia Aperta in Its Early Stage / 대한이비인후과학회지

Lou Gehrig's disease, also called amyotrophic lateral sclerosis, is a chronic progressive motor neuron disease of an unknown etiology, characterized by upper and lower motor neuron degeneration with a resultant progressive weakness of bulbar muscles or the extremities. The early symptoms may include twitching, cramping, muscle weakness of distal extremities and slurred nasal speech. Rhinolalia aperta is abnormal speech attributable to inadequate velopharyngeal closure. Hypernasality is thequality of voice in which the emission of air through the nose is excessive due to velopharyngeal insufficiency so that the voice is highpitched and speech intelligibility deteriorates. We experienced a rare case of Lou Gehrig's disease presenting with rhinolia aperta in its early stage. We report the case with a literature review.