[The peculiar features of the clinical course of Meniere's disease associated with benign paroxysmal positional vertigo]. / Osobennosti klinicheskogo techeniia bolezni Men'era, assotsiirovannoi s dobrokachestvennym paroksizmal'nym pozitsionnym golovokruzheniem.

AIM: The objective of the present study was to evaluate the frequency of occurrence and clinical features of vertigo spells in the patients presenting with Ménière's disease (MD) associated with benign paroxysmal positional vertigo (BPPV). METHODS: A total of 104 patients with MD were available for the observation. All of them underwent the comprehensive examination that included the audiological study and vestibular tests, such as the Dix-Hallpike test and the roll-test for BPPV diagnostics. A structured questionnaire was used to calculate the average number of vertigo spells per month during the period of 6 months and the mean duration of the vertigo spells; the presence or the absence of changes in hearing ability during the spells as well as the severity of vertigo were determined with the use of the 10-point visual analogue scale. RESULTS: The patients suffering from BPPV associated with Meniere's disease presented with the following clinical features which distinguished them from the patients with idiopathic BPPV (p<0.05): (1) a higher percentage of female patients; (2) a longer duration of clinical symptoms; (3) the frequent involvement of the horizontal semicircular canal; (4) a greater incidence of canal paresis; (5) more therapeutic sessions needed for the recovery in conjunction with a higher rate of recurrence. CONCLUSION: The frequency of association of MD and BPPV was estimated at 14.4%. Such association of MD was more frequently observed in the elderly patients (older than 60 years) (p<0.05). The clinical manifestations of the vertigo spells in the patients having MD associated with BPPV occurred with an enhanced frequency; their mean duration was relatively short due to the presence of both long and short positional vertigo attacks characterized by the absence of hearing changes during the spells and the equal severity of vertigo (p < 0,05).

[The peripheral vestibular disorders encountered in the routine out-patient practical work]. / Perifericheskie vestibuliarnye rasstroistva v ambulatornoi praktike.

The objective of the present study was to elucidate the frequency of causes underlying the development of dizziness and vertigo in the patients seeking advice and care at an outpatient healthcare facility. A total of 590 patients with complaints of dizziness and vertigo were examined. It was found out that the peripheral disorders of the vestibular analyzer were the most frequent causes of dizziness and vertigo in the majority of the examined patients. These conditions were documented to occur in more than 65% of the patients. The most common forms of peripheral vestibular disorders were benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuronitis. The central vestibular disorders occurred considerably less frequently than peripheral ones and were diagnosed only in 10.9% of the patients. The results of the study provided a basis for the development of the algorithm forthe bedside examination of the patients presenting with vertigo and dizziness associated with peripheral vestibular disorders. It is emphasized that such examination should include, besides the standard neurological studies, the neuro-otological tests making it possible to detect the most common forms of peripheral vestibular disorders.

[Assessment of functioning of the internal ear in patients with labyrinthine hydrops and in normal subjects by means of phase audiometry].

A method for the diagnosis of labyrinthine hydrops is proposed that takes advantage of specific physiological features of internal ear functioning. Namely, the basal membrane of the inner ear exposed to a low-frequency tone undergoes synchronous sinusoidal oscillations along its entire length; simultaneously, sensitivity of the organ of Corti changes periodically. Under normal conditions, perception of 1,000 Hz tonal signals at the background of a low-frequency masker varied substantially depending on the phase during which the signal came. In the maximum discharging phase that corresponded to a 270 degree deviation of the basal membrane from its initial position, it was maximally displaced towards the vestibule staircase, and perception of the test tone was most affected. Patients with hydrops of the internal ear exhibited phase-independent constant perception of high-frequency tonal signals against the background test tone. It is concluded that the method of phase audiometry can be used in large research centres for the comprehensive evaluation of cochlear-vestibular function during hydrops formation.

[The characteristics of vestibular-visual interaction in patients with cochleovestibular disorders under galvanic stimulation]. / Osobennosti vestibulozritel'nogo vzaimodeistviia u bol'nykh s khokhleovestibuliarnymi narusheniiami pri gal'vanicheskoi stimuliatsii.

The paper deals with the problem of vestibular-visual interactions in pathogenesis of cochleovestibular diseases. The investigations were made on the original unit for registration of visual illusions in response to galvanic stimulation of vestibular structures. The examination covered patients with Meniere's disease, peripheral and central cochleovestibular syndrome, otogenic arachnoiditis. Emergence of visual illusions was related to the degree of vestibular abnormality and threshold stimulation. The greatest compensation of the equilibrium function at the expense of vision was reported in patients with central vestibular disorders. Further studies into the vestibular reactions seem important for elucidation of cochleovestibulopathy pathogenesis.