Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.848
Filtrar
1.
Med Sci (Paris) ; 36(6-7): 581-591, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32614308

RESUMO

Following partial or total loss of peripheral vestibular inputs, a phenomenon called central vestibular compensation takes place in the hours and days following the injury. This neuroplasticity process involves a mosaic of profound rearrangements within the brain stem vestibular nuclei. Among them, the setting of a new neuronal network is maybe the most original and unexpected, as it involves an adult reactive neurogenesis in a brain area not reported as neurogenic so far. Both the survival and functionality of this newly generated neuronal network will depend on its integration to pre-existing networks in the deafferented structure. Far from being aberrant, this new structural organization allows the use of inputs from other sensory modalities (vision and proprioception) to promote the restoration of the posture and equilibrium. We choose here to detail this model, which does not belong to the traditional niches of adult neurogenesis, but it is the best example so far of the reparative role of the adult neurogenesis. Not only it represents an original neuroplasticity mechanism, interesting for basic neuroscience, but it also opens new medical perspectives for the development of therapeutic approaches to alleviate vestibular disorders.


Assuntos
Encéfalo/citologia , Neurogênese/fisiologia , Neurônios/fisiologia , Postura/fisiologia , Doenças Vestibulares/reabilitação , Núcleos Vestibulares/lesões , Adulto , Células-Tronco Adultas/citologia , Células-Tronco Adultas/fisiologia , Animais , Encéfalo/fisiologia , Humanos , Células-Tronco Neurais/fisiologia , Plasticidade Neuronal/fisiologia , Doenças Vestibulares/fisiopatologia , Núcleos Vestibulares/patologia , Núcleos Vestibulares/fisiologia , Vestíbulo do Labirinto/lesões , Vestíbulo do Labirinto/patologia , Vestíbulo do Labirinto/fisiologia
2.
J Headache Pain ; 21(1): 56, 2020 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448118

RESUMO

BACKGROUND: Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis and/or the presence of vestibular symptoms can predict balance dysfunction in migraineurs. METHODS: The study included 49 women diagnosed with migraine with aura, 53 without aura, 51 with chronic migraine, and 54 headache-free women. All participants answered a structured questionnaire regarding migraine features and presence of vestibular symptoms, such as dizziness/vertigo. The participants performed the Modified Sensory Organization Test on an AMTI© force plate. The data were analysed using a linear mixed-effect regression model. RESULTS: The presence of vestibular symptoms did not predict postural sway, but the subdiagnosis was a significant predictor of postural sway. Migraine with aura patients exhibited more sway than migraine patients without aura when the surface was unstable. Additionally, we found high effect sizes (ES > 0.79) for postural sway differences between patients with chronic migraine or with aura compared to controls or migraine without aura, suggesting that these results are clinically relevant. CONCLUSIONS: The subdiagnosis of migraine, instead of the presence of vestibular symptoms, can predict postural control impairments observed in migraineurs. This lends support to the notion that balance instability is related to the presence of aura and migraine chronicity, and that it should be considered even in patients without vestibular symptoms.


Assuntos
Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/fisiopatologia , Equilíbrio Postural/fisiologia , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/fisiopatologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Valor Preditivo dos Testes , Inquéritos e Questionários , Vertigem/diagnóstico , Vertigem/epidemiologia , Vertigem/fisiopatologia , Doenças Vestibulares/epidemiologia , Adulto Jovem
3.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 99-106, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1090548

RESUMO

Abstract Introduction Peripheral vestibular disorders can lead to cognitive deficits and are more common in elderly patients. Objective To evaluate and correlate cognitive, balance and gait aspects in elderly women with chronic peripheral vestibular dizziness, and to compare them with elderly women without vestibular disorders. Methods Twenty-two women presenting peripheral vestibular dizziness episodes for at least six months participated in the study. The individuals were categorized by dizziness severity level: moderate (n = 11) or severe (n = 11). The control group (n = 11) included women showing no vestibulopathy, light-headedness or dizziness. Cognitive assessments and semi-static and dynamic balance assessments were performed with the Balance Master (Neurocom International, Inc., Clackamas, OR), while the Dizziness Handicap Inventory provided a score for the severity of the symptoms. The groups were submitted to statistics of inference and correlation between cognitive, balance and stability variables. Results The group with severe dizziness showed higher sway speed of the center of pressure in the anteroposterior direction, smaller step length, and slower gait than the control group. Regarding the cognitive variables, the group with severe dizziness symptoms presented significant correlations with stability and gait variables. Conclusion The relationship between cognitive aspects, balance and gait was stronger in women with severe dizziness than in those with no vestibulopathy.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Doenças Vestibulares/complicações , Transtornos das Sensações/etiologia , Tontura/complicações , Equilíbrio Postural/fisiologia , Índice de Gravidade de Doença , Doenças Vestibulares/fisiopatologia , Doenças Vestibulares/reabilitação , Transtornos Cognitivos/etiologia , Tontura/fisiopatologia , Marcha/fisiologia
4.
Phys Ther Sport ; 42: 68-74, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935640

RESUMO

OBJECTIVE: To examine differences between male and female adolescents on measures of balance, vestibular and oculomotor function within 3 weeks of concussion among a group of pediatric patients presenting to a sports medicine clinic. DESIGN: Medical record review. SETTING: Sports medicine clinic. PARTICIPANTS: 197 female (median age = 15.2 years) and 381 male (median age = 14.6 years) pediatric patients seen for a concussion, evaluated 9.3 ± 5.2 (mean ± SD) days post-concussion. MAIN OUTCOME MEASURES: Patients completed Balance Error Scoring System (BESS), tandem gait, gaze stability, and near point of convergence (NPC) tests. RESULTS: A higher proportion of female patients exhibited abnormal NPC (22% vs. 14%; p = 0.017), gaze stability (53% vs. 43%; p = 0.028), and tandem gait tests (20% vs. 13%; p = 0.026) compared to male patients. Multivariable analysis indicated an independent association between female sex and increased odds of abnormal NPC (adjusted odds ratio [aOR] = 1.79, 95% CI = 1.07-3.00), and tandem gait tests (aOR = 1.96, 95% CI = 1.12-3.41) following concussion. CONCLUSIONS: Our results indicate that within the first three weeks of a concussion, female pediatric patients demonstrated increased odds of exhibiting abnormal near point of convergence, and tandem gait test performance compared to male patients.


Assuntos
Traumatismos em Atletas/fisiopatologia , Concussão Encefálica/fisiopatologia , Movimentos Oculares/fisiologia , Músculos Oculomotores/fisiopatologia , Equilíbrio Postural/fisiologia , Doenças Vestibulares/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia , Adolescente , Traumatismos em Atletas/complicações , Concussão Encefálica/complicações , Feminino , Marcha/fisiologia , Humanos , Masculino , Doenças Vestibulares/etiologia , Testes de Função Vestibular
5.
Exp Brain Res ; 238(2): 427-437, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31938844

RESUMO

The mechanism underlying cybersickness during virtual reality (VR) exposure is still poorly understood, although research has highlighted a causal role for visual-vestibular sensory conflict. Recently established methods for reducing cybersickness include galvanic vestibular stimulation (GVS) to mimic absent vestibular cues in VR, or vibration of the vestibular organs to add noise to the sensory modality. Here, we examined if applying noise to the vestibular system using noisy-current GVS affects sickness severity in VR. Participants were exposed to one of the two VR games that were classified as either moderately or intensely nauseogenic. The VR content lasted for 50 min and was broken down into three blocks: 30 min of gameplay during exposure to either noisy GVS (± 1750 µA) or sham stimulation (0 µA), and 10 min of gameplay before and after this block. We characterized the effects of noisy GVS in terms of post-minus-pre-exposure cybersickness scores. In the intense VR condition, we found a main effect of noisy vestibular stimulation on a verbal cybersickness scale, but not for questionnaire measures of cybersickness. Participants reported lower cybersickness scores during and directly after exposure to GVS. However, this difference was quickly extinguished (~ 3-6 min) after further VR exposure, indicating that sensory adaptation did not persist after stimulation was terminated. In contrast, there were no differences between the sham and GVS group for the moderate VR content. The results show the potential for reducing cybersickness with non-invasive sensory stimulation. We address possible mechanisms for the observed effects, including noise-induced sensory re-weighting.


Assuntos
Enjoo devido ao Movimento/fisiopatologia , Sensação/fisiologia , Doenças Vestibulares/fisiopatologia , Vestíbulo do Labirinto/fisiologia , Adolescente , Adulto , Estimulação Elétrica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enjoo devido ao Movimento/etiologia , Doenças Vestibulares/complicações , Realidade Virtual , Adulto Jovem
6.
Audiol Neurootol ; 25(1-2): 96-108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31968338

RESUMO

BACKGROUND: A combined vestibular and cochlear prosthesis may restore hearing and balance to patients who have lost both. To do so, the device should activate each sensory system independently. OBJECTIVES: In this study, we quantify auditory and vestibular interactions during interleaved stimulation with a combined 16-channel cochlear and 6-channel vestibular prosthesis in human subjects with both hearing and vestibular loss. METHODS: Three human subjects were implanted with a combined vestibular and cochlear implant. All subjects had severe-to-profound deafness in the implanted ear. We provided combined stimulation of the cochlear and vestibular arrays and looked for interactions between these separate inputs. Our main outcome measures were electrically evoked slow-phase eye velocities during nystagmus elicited by brief trains of biphasic pulse stimulation of the vestibular end organs with and without concurrent stimulation of the cochlea, and Likert scale assessments of perceived loudness and pitch during stimulation of the cochlea, with and without concurrent stimulation of the vestibular ampullae. RESULTS: All subjects had no auditory sensation resulting from semicircular canal stimulation alone, and no sensation of motion or slow-phase eye movement resulting from cochlear stimulation alone. However, interleaved cochlear stimulation did produce changes in the slow-phase eye velocities elicited by electrical stimulation. Similarly, interleaved semicircular canal stimulation did elicit changes in the perceived pitch and loudness resulting from stimulation at multiple sites in the cochlea. CONCLUSIONS: There are significant interactions between different sensory modalities during stimulation with a combined vestibular and cochlear prosthesis. Such interactions present potential challenges for stimulation strategies to simultaneously restore auditory and vestibular function with such an implant.


Assuntos
Cóclea/fisiopatologia , Implantes Cocleares , Perda Auditiva Neurossensorial/cirurgia , Audição/fisiologia , Equilíbrio Postural/fisiologia , Doenças Vestibulares/cirurgia , Vestíbulo do Labirinto/fisiopatologia , Percepção Auditiva/fisiologia , Implante Coclear/métodos , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade , Canais Semicirculares/cirurgia , Resultado do Tratamento , Doenças Vestibulares/fisiopatologia
7.
Arch. Soc. Esp. Oftalmol ; 95(1): 38-41, ene. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195316

RESUMO

El síndrome de Kabuki es una enfermedad genética rara debida a una mutación genética en los genes KMT2D y KDM6A, que afecta a múltiples órganos, entre ellos los ojos, en la mayoría de los pacientes. Las características clínicas más típicas son: facies peculiar, baja estatura, anormalidades esqueléticas y bajo coeficiente intelectual. Las manifestaciones oculares más frecuentes son el estrabismo, la ptosis y los defectos refractivos. Presentamos una serie de casos de 5 pacientes (3 mujeres), 4 de ellos con estrabismo en forma de esotropía, hiperacción de oblicuos inferiores e hipofunción de oblicuos superiores asociado a un síndrome V. Son pocos los casos publicados de síndrome de Kabuki que describan las afectaciones oftalmológicas y las estrabológicas. Podría ser conveniente la realización de resonancias magnéticas orbitarias para detectar cambios en los trayectos musculares que estén relacionados con la patología de los movimientos oculares encontrados


Kabuki syndrome is a rare genetic disorder, caused by mutation in the KMT2D or KDM6A genes, which affects several organs in the majority of patients, among which are the eyes. The most typical clinical characteristics are mental retardation, postnatal growth retardation, skeletal anomalies, and characteristic facial features. As the eyes are affected in most of the cases, ophthalmological examination is recommended for the early detection of ocular anomalies, in order to prevent visual impairment. The most frequent ocular signs are strabismus, ptosis, and refractive anomalies. A series of cases of Kabuki syndrome is described in five children, four of whom exhibited strabismus with esotropia, over action of inferior oblique muscles, and under action of superior oblique muscles associated with a V pattern. Most published papers do not report or might underestimate the ocular problems. It may be appropriate to perform orbital magnetic resonances in order to detect changes in the muscle paths that are related to the pathology of the eye movements found


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Anormalidades Múltiplas/fisiopatologia , Face/anormalidades , Doenças Hematológicas/fisiopatologia , Transtornos da Motilidade Ocular/genética , Doenças Vestibulares/fisiopatologia , Anormalidades Múltiplas/genética , Astigmatismo/genética , Blefaroptose/genética , Proteínas de Ligação a DNA/genética , Face/fisiopatologia , Mutação da Fase de Leitura , Doenças Hematológicas/genética , Hiperopia/genética , Proteínas de Neoplasias/genética , Estrabismo/genética , Estrabismo/cirurgia , Doenças Vestibulares/genética
8.
Audiol Neurootol ; 25(1-2): 6-24, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31533097

RESUMO

BACKGROUND: In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing. SUMMARY: Vestibular co-stimulation with a CI is based on "spread of excitation," which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular co-stimulation can be functionally used in patients with bilateral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activation of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implanted electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspecific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to induce a more unspecific stimulation. Although all three applications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicability and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the patient population who serves to gain from such technologies.


Assuntos
Terapia por Estimulação Elétrica , Doenças Vestibulares/terapia , Vestíbulo do Labirinto/fisiopatologia , Implante Coclear , Eletrodos Implantados , Humanos , Reflexo Vestíbulo-Ocular/fisiologia , Doenças Vestibulares/fisiopatologia
9.
Arch Soc Esp Oftalmol ; 95(1): 38-41, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31740281

RESUMO

Kabuki syndrome is a rare genetic disorder, caused by mutation in the KMT2D or KDM6A genes, which affects several organs in the majority of patients, among which are the eyes. The most typical clinical characteristics are mental retardation, postnatal growth retardation, skeletal anomalies, and characteristic facial features. As the eyes are affected in most of the cases, ophthalmological examination is recommended for the early detection of ocular anomalies, in order to prevent visual impairment. The most frequent ocular signs are strabismus, ptosis, and refractive anomalies. A series of cases of Kabuki syndrome is described in five children, four of whom exhibited strabismus with esotropia, over action of inferior oblique muscles, and under action of superior oblique muscles associated with a V pattern. Most published papers do not report or might underestimate the ocular problems. It may be appropriate to perform orbital magnetic resonances in order to detect changes in the muscle paths that are related to the pathology of the eye movements found.


Assuntos
Anormalidades Múltiplas/fisiopatologia , Face/anormalidades , Doenças Hematológicas/fisiopatologia , Transtornos da Motilidade Ocular/genética , Doenças Vestibulares/fisiopatologia , Anormalidades Múltiplas/genética , Astigmatismo/genética , Blefaroptose/genética , Criança , Pré-Escolar , Proteínas de Ligação a DNA/genética , Face/fisiopatologia , Feminino , Mutação da Fase de Leitura , Doenças Hematológicas/genética , Humanos , Hiperopia/genética , Masculino , Proteínas de Neoplasias/genética , Estrabismo/genética , Estrabismo/cirurgia , Doenças Vestibulares/genética
10.
Otol Neurotol ; 41(1): e70-e75, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31789799

RESUMO

OBJECTIVE: Persistent postural perceptual dizziness (PPPD) is a clinical condition characterized by unsteadiness present on most days for a period of at least 3 months. The aim of our work was to assess vestibular function, the role of anxiety, and possible interactions between visual and vestibular systems in patients with PPPD. STUDY DESIGN: Cross-sectional prospective study. SETTING: Tertiary referral center. PATIENTS: Twenty-five PPPD patients. INTERVENTIONS: Clinical history was collected before examination; vestibular function was assessed through bedside examination, video and functional head impulse test (video-HIT, f-HIT). The latter test was based on having the patient identify an optotype displayed on a computer screen during passive head rotations. The test was repeated while optokinetic stimulation (OKS) was given on the screen. Results were compared with those of 25 controls. State and trait anxiety levels were measured with the State-Trait Anxiety Inventory (STAI) questionnaire. Anxiety before and after vestibular examination was assessed using a VAS scale. MAIN OUTCOME MEASURE: Results of video and functional HIT with and without OKS. RESULTS: Video-HIT and f-HIT showed normal values in all subjects. f-HIT with OKS provoked more reading errors in patients than in controls. The interaction of group per time detected different decreasing trends between the two groups (p = 0.0002).Patients presented a reduction in anxiety levels after examination. Nine patients fulfilled diagnostic criteria for vestibular migraine, eight of whom presented nystagmus either to positional tests or vibration test. Only anxiety levels before testing were predictive of worsening of f-HIT with optokinetic stimulation (p = 0.0007). CONCLUSIONS: Our data support the hypothesis that increased anxiety may play a role in visuo-vestibular interactions; moreover, they are not inconsistent with the hypothesis that OKS might provoke a "threatening effect," leading to gaze bias during examination.


Assuntos
Tontura/diagnóstico , Tontura/fisiopatologia , Teste do Impulso da Cabeça/métodos , Doenças Vestibulares/diagnóstico , Adulto , Idoso , Ansiedade/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nistagmo Optocinético/fisiologia , Estudos Prospectivos , Doenças Vestibulares/fisiopatologia
11.
Acta Otolaryngol ; 140(1): 40-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31769324

RESUMO

Background: The vestibular function in patients of large vestibular aqueduct syndrome (LVAS) has not been clarified yet.Aims/objectives: To investigate the characteristic of otolithic organ in LVAS patients, we accessed their ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs).Material and methods: This study was carried out between 29 bilateral LVAS patients and 35 healthy controls. Parameters of VEMPs were analyzed.Result: In children patients, response rate for oVEMP was 93.47% and 86.95% for cVEMP. No statistical significance was found compared to their controls. In adult patients, response rate for oVEMP was 83.33% and 75% for cVEMP, which were statistically lower than their controls. In comparison to parameters of VEMPs, no statistical significance were found in children group. Amplitude of oVEMP was significantly higher and that of cVEMP was lower in LVAS adults. N1 latencies were significantly longer and P1 latencies were shorter in adult patients than in controls of cVEMP. Thresholds and N1-P1 intervals of VEMP were found no statistical significance in adult group.Conclusions and significance: We discovered a severer otolithic dysfunction in adults than in children patients. We recommend cVEMP a more effective and sensitive method than oVEMP in assessment of LAVS adult patients.


Assuntos
Aqueduto Vestibular , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/fisiopatologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Síndrome , Adulto Jovem
12.
Audiol Neurootol ; 25(1-2): 72-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31825921

RESUMO

OBJECTIVES: Bilateral vestibulopathy is a clinical syndrome in which laboratory testing plays a crucial diagnostic role. We aimed to establish the frequency of detection of that finding in a tertiary level hospital considering the new methods of laboratory vestibular examination nowadays in use, with respect to the conventional caloric and rotatory chair test approaches. DESIGN: Two similar time periods (5 years) were retrospectively evaluated, and the demographic, clinical data and test results from 4,576 patients were reviewed. In the first period, the diagnosis was based on caloric and rotatory chair tests and, in the second, on the video head impulse test. RESULTS: Of the patients included, 3.77% in the first period and 4.58% in the second met the criteria for bilateral vestibular hypofunction; there was no significant difference between both periods. CONCLUSIONS: The functional vestibular evaluation to detect bilateral deficiency makes no significant difference to the number of patients diagnosed with a bilateral vestibulopathy. New diagnostic categories probably depend not only on the availability and accessibility of complete vestibular and visual-vestibular evaluation, but also on recent advances in defining vestibular disorders. Bilateral vestibular hypofunction manifests with very different patterns. Progress in more detailed definition (clinical and laboratory) is needed, in particular when all 6 semicircular canals and both maculae are available for testing.


Assuntos
Reflexo Vestíbulo-Ocular/fisiologia , Doenças Vestibulares/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia , Idoso , Testes Calóricos , Feminino , Teste do Impulso da Cabeça , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Canais Semicirculares/fisiopatologia
13.
Geriatr Gerontol Int ; 20(1): 42-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31742857

RESUMO

AIM: This study investigated the evolution of vestibular disorders in dizzy older adults from young-old to middle-old to oldest-old individuals, which has been less examined in detail so far. METHODS: A total of 3714 older patients with vertigo/dizziness in a university hospital were retrospectively reviewed and divided into three groups; namely, the young-old group aged 65-74 years (n = 2307), the middle-old group aged 75-84 years (n = 1176) and the oldest-old group aged ≥85 years (n = 231). All patients underwent an inner ear test battery comprising audiometry, caloric test, cervical and ocular vestibular-evoked myogenic potential tests, and foam posturography. RESULTS: The ratios between peripheral and central vestibular disorders ranged from the young-old (60:40%) and middle-old (36:64%) to the oldest-old (25:75%) groups. These results show a decreasing sequence in the prevalence of peripheral vestibular disorders (i.e. benign paroxysmal positional vertigo or Meniere's disease), and an increasing sequence in that of central vestibular disorders (i.e. vertebrobasilar artery insufficiency) from young-old to middle-old to oldest-old patients. Furthermore, the mean Romberg quotients (value from eyes closed divided by that from eyes open) of the sway area on the foam pad were 1.99 ± 0.93, 2.10 ± 1.06 and 2.62 ± 1.78 in the young-old, middle-old and oldest-old groups, respectively, showing a significant difference among them. CONCLUSIONS: Older patients with central vestibular disorders might be more prone to imbalance and falls than those with peripheral vestibular disorders, partly because patients in the latter group retain other reflex systems; that is, the visuomotor reflex to stabilize the gaze and maintain balance. Hence, adequate vision is important in maintaining balance for older adults with vertigo/dizziness. Geriatr Gerontol Int 2020; 20: 42-46.


Assuntos
Doenças Vestibulares/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Tontura/epidemiologia , Feminino , Humanos , Masculino , Doença de Meniere/epidemiologia , Prevalência , Estudos Retrospectivos , Insuficiência Vertebrobasilar/epidemiologia , Doenças Vestibulares/fisiopatologia , Vestíbulo do Labirinto/fisiopatologia
14.
Audiol Neurootol ; 25(1-2): 60-71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31678979

RESUMO

INTRODUCTION: To determine the impact of a head-referenced cochlear implant (CI) stimulation system, BalanCI, on balance and postural control in children with bilateral cochleovestibular loss (BCVL) who use bilateral CI. METHODS: Prospective, blinded case-control study. Balance and postural control testing occurred in two settings: (1) quiet clinical setting and (2) immersive realistic virtual environment (Challenging Environment Assessment Laboratory [CEAL], Toronto Rehabilitation Institute). Postural control was assessed in 16 and balance in 10 children with BCVL who use bilateral CI, along with 10 typically developing children. Children with neuromotor, cognitive, or visual deficits that would prevent them from performing the tests were excluded. Children wore the BalanCI, which is a head-mounted device that couples with their CIs through the audio port and provides head-referenced spatial information delivered via the intracochlear electrode array. Postural control was measured by center of pressure (COP) and time to fall using the WiiTM (Nintendo, WA, USA) Balance Board for feet and the BalanCI for head, during the administration of the Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). The COP of the head and feet were assessed for change by deviation, measured as root mean square around the COP (COP-RMS), rate of deviation (COP-RMS/duration), and rate of path length change from center (COP-velocity). Balance was assessed by the Bruininks-Oseretsky Test of Motor Proficiency 2, balance subtest (BOT-2), specifically, BOT-2 score as well as time to fall/fault. RESULTS: In the virtual environment, children demonstrated more stable balance when using BalanCI as measured by an improvement in BOT-2 scores. In a quiet clinical setting, the use of BalanCI led to improved postural control as demonstrated by significant reductions in COP-RMS and COP-velocity. With the use of BalanCI, the number of falls/faults was significantly reduced and time to fall increased. CONCLUSIONS: BalanCI is a simple and effective means of improving postural control and balance in children with BCVL who use bilateral CI. BalanCI could potentially improve the safety of these children, reduce the effort they expend maintaining balance and allow them to take part in more complex balance tasks where sensory information may be limited and/or noisy.


Assuntos
Implante Coclear , Implantes Cocleares , Equilíbrio Postural/fisiologia , Doenças Vestibulares/cirurgia , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento , Doenças Vestibulares/fisiopatologia
15.
Rev. ORL (Salamanca) ; 11(1): 7-17, 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193117

RESUMO

INTRODUCCIÓN Y OBJETIVO: La disfunción vestibular periférica implica a los órganos vestibulares o a los nervios vestibulares, produciendo una gran variedad de síntomas y signos clínicos. MÉTODO: Revisión narrativa. DISCUSIÓN: El otoneurólogo es el encargado de realizar una evaluación exhaustiva para llegar a identificar el trastorno que presenta el paciente que acude con vértigo o desequilibrio. La clave diagnóstica es la anamnesis profunda completada con un cuidadoso examen otoneurológico. Además, las nuevas tecnologías de estudio que han surgido en este campo permiten un cambio en la definición, caracterización y tratamiento de estas patologías. CONCLUSIONES: En la presente revisión narrativa se describirán los dos grandes grupos de deficiencia vestibular periférica: la vestibulopatía unilateral y bilateral


INTRODUCTION AND OBJECTIVE: Peripheral vestibular dysfunction involve the vestibular organs or the vestibular nerve producing a wide variety of symptoms and clinical signs. METHOD: Narrative revision. DISCUSSION: The otoneurologist is responsible for conducting an exhaustive evaluation to identify the pathology presented by the patient who has vertigo or imbalance. The key to the diagnosis is the deep history completed with a careful otoneurological examination. CONCLUSIONS: In the present narrative review, the two large groups of peripheral vestibular deficiency will be described: unilateral and bilateral vestibulopathy


Assuntos
Humanos , Vestibulopatia Bilateral/diagnóstico , Vestibulopatia Bilateral/fisiopatologia , Doenças Vestibulares/etiologia , Vestíbulo do Labirinto/fisiopatologia , Doenças Vestibulares/fisiopatologia , Doenças Vestibulares/reabilitação , Vertigem/diagnóstico , Recidiva
16.
Rev. ORL (Salamanca) ; 11(1): 19-28, 2020.
Artigo em Espanhol | IBECS | ID: ibc-193118

RESUMO

INTRODUCCIÓN Y OBJETIVO: La compensación vestibular es el conjunto de procesos que se ponen en marcha cuando tiene lugar una lesión a nivel vestibular sea cual sea el origen y la magnitud de la misma. a vez establecida la lesión los mecanismos de compensación del daño son variados y se establecen diferentes líneas de actuación. Para conocer cómo mejorar el estado de nuestros pacientes es importante saber cómo funciona la compensación vestibular y a qué niveles podemos actuar para acelerar el proceso de recuperación. CONCLUSIONES: Es importante conocer los mecanismos de compensación vestibular para adecuar la terapia a cada paciente y así mejorar su calidad de vida


INTRODUCTION AND OBJECTIVE: Vestibular compensation is the term used to describe the mechanisms triggered when there is damage in the vestibular system regardless of its origin. When suffering from an injure in vestibular area there are a wide range of compensatory responses that will involve different approaches. In order to improve the quality of life for our patients and to correctly work with them to accelerate the restoration process it is important to become acquainted with how vestibular compensation works. CONCLUSIONS: Vestibular compensation mechanisms are important to adapt the therapy to each patient and thus improve their quality of life


Assuntos
Humanos , Doenças Vestibulares/reabilitação , Doenças Vestibulares/fisiopatologia , Núcleos Vestibulares/lesões , Vestíbulo do Labirinto/lesões , Testes de Função Vestibular/métodos , Equilíbrio Postural , Vestíbulo do Labirinto/fisiopatologia , Qualidade de Vida , Núcleos Vestibulares/anatomia & histologia , Nistagmo Patológico/reabilitação , Neurofarmacologia
17.
Rev. ORL (Salamanca) ; 11(1): 89-95, 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-193124

RESUMO

La rehabilitación vestibular es fundamental en el tratamiento de la inestabilidad puesto que actúa sobre la compensación, mejorando el equilibrio y la calidad de vida del paciente. El objetivo de este artículo es presentar la utilidad y aspectos prácticos de la posturografía dinámica computarizada en el diseño de un programa de rehabilitación vestibular


Vestibular rehabilitation is essential in the treatment of unsteadiness as it works on compensation improving patient balance and quality of life. The objective of this article is to introduce the usefulness and practical aspects of computerized dynamic posturography in the vestibular rehabilitation program design


Assuntos
Humanos , Doenças Vestibulares/reabilitação , Equilíbrio Postural/fisiologia , Vertigem/fisiopatologia , Vertigem/reabilitação , Testes de Função Vestibular/métodos , Doenças Vestibulares/fisiopatologia
18.
Braz. j. otorhinolaryngol. (Impr.) ; 85(6): 788-798, Nov.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1055509

RESUMO

Abstract Introduction: People with vestibular loss present a deficit in the vestibular system, which is primarily responsible for promoting postural control, gaze stabilization, and spatial orientation while the head moves. There is no effective treatment for a bilateral loss of vestibular function. Recently, a vestibular implant was developed for people with bilateral loss of vestibular function to improve this function and, consequently, the quality of life of these patients. Objective: To identify in the scientific literature evidence that vestibular implants in people with vestibular deficit improves vestibular function. Methods: One hundred and forty six articles were found from five databases and 323 articles from the gray literature mentioning the relationship between vestibular implant and vestibular function in humans. The PICOS strategy (Population, Intervention, Comparison and Outcome) was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed according to the bias risk assessment of the Joanna Briggs Institute through the critical assessment checklist Joanna Briggs institute for quasi-experimental studies and the Joanna Briggs institute critical assessment checklist for case reports. Results: Of the 21 articles included in reading the full text, 10 studies were selected for the qualitative analysis in the present systematic review. All ten articles analyzed through the critical assessment checklist Joanna Briggs institute showed a low risk of bias. The total number of samples in the evaluated articles was 18 patients with vestibular implants. Conclusions: Taken together, these findings support the feasibility of vestibular implant for restoration of the vestibulo-ocular reflex in a broad frequency range and illustrate new challenges for the development of this technology.


Resumo Introdução: Pessoas com perda vestibular apresentam um déficit no sistema vestibular, o qual é o principal responsável pelo controle postural, pela estabilização do olhar e orientação espacial enquanto a cabeça se movimenta. Não há tratamento efetivo para uma perda vestibular bilateral. Recentemente, foi desenvolvido um implante vestibular para pessoas com perda vestibular bilateral para melhorar essa função e, consequentemente, a qualidade de vida desses pacientes. Objetivo: Identificar na literatura científica evidências de que o implante vestibular melhora a função vestibular de pessoas com déficit vestibular. Método: Cento e quarenta e seis artigos foram encontrados em cinco bases de dados e 323 arti-gos da literatura cinzenta, mencionando a relação entre implante vestibular e função vestibular em humanos. A estratégia PICOS (População, Intervenção, Comparação e Desfechos) foi uti-lizada para definir os critérios de elegibilidade. Os estudos que preencheram os critérios de inclusão para esta segunda etapa foram incluídos em uma síntese qualitativa, e cada tipo de estudo foi analisado de acordo com a avaliação de risco de viés do Joanna Briggs Institute através da critical appraisal checklist for quasi-experimental studies e da critical appraisa lchecklist for case reports. Resultados: Dos 21 artigos incluídos cujos textos completos foram lidos, 10 foram selecionados para a análise qualitativa na presente revisão sistemática. Todos os dez artigos analisados ??através da critical appraisal checklist mostraram um baixo risco de viés. O número total de amostras nos artigos avaliados foi de 18 pacientes com implantes vestibulares. Conclusões: Em conjunto, esses achados apoiam a viabilidade do implante vestibular para a restauração do reflexo vestíbulo-ocular em uma ampla faixa de frequências e ilustram novos desafios para o desenvolvimento desta tecnologia.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Vestibulares/cirurgia , Vestíbulo do Labirinto/fisiologia , Implante Coclear , Qualidade de Vida , Testes de Função Vestibular , Doenças Vestibulares/fisiopatologia , Distribuição por Sexo , Distribuição por Idade , Potenciais Evocados , Doença de Meniere/fisiopatologia
19.
J Clin Neurophysiol ; 36(6): 396-404, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31688322

RESUMO

The brainstem contains ocular motor and vestibular structures that, when damaged, produce specific eye movement disorders. In this review, we will discuss three brainstem syndromes with characteristic ocular motor and vestibular findings that can be highly localizing. First, we will discuss the lateral medullary (Wallenberg) syndrome, focusing on ocular lateropulsion, saccadic dysmetria, and the ocular tilt reaction. Second, we will review the medial longitudinal fasciculus syndrome including the ocular tilt reaction, nystagmus, and the vestibular-ocular reflex. Lastly, we will discuss hypertrophic olivary degeneration and oculopalatal tremor, which may develop weeks to months after a brainstem or cerebellar lesion. In these syndromes, the clinical ocular motor and vestibular examination is instrumental in localizing the lesion.


Assuntos
Encefalopatias , Tronco Encefálico , Transtornos da Motilidade Ocular , Doenças Vestibulares , Encefalopatias/complicações , Tronco Encefálico/patologia , Tronco Encefálico/fisiopatologia , Humanos , Transtornos da Motilidade Ocular/etiologia , Transtornos da Motilidade Ocular/fisiopatologia , Síndrome , Doenças Vestibulares/etiologia , Doenças Vestibulares/fisiopatologia
20.
Hum Mov Sci ; 68: 102526, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31669803

RESUMO

We translated a well-established laboratory paradigm to study sensory integration into a Head-Mounted-Display (HMD). In the current study, a group of 23 individuals with unilateral vestibular dysfunction and 16 age-matched controls observed moving spheres projected from the Oculus Rift. We confirmed increased visual weighting with an unstable surface and decreased visual weighting (i.e., reweighting) with increased visual amplitude. We did not observe significant differences in gains and phases between individuals with vestibular dysfunction and age-matched controls. The vestibular group increased sway in mid and high frequencies significantly more than controls with the change in surface or visual amplitude. Mild visual perturbations within HMDs carry the potential to become a useful portable assessment of postural control in individuals with vestibular disorders.


Assuntos
Equilíbrio Postural/fisiologia , Óculos Inteligentes , Doenças Vestibulares/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Interface Usuário-Computador , Vestíbulo do Labirinto/fisiopatologia , Realidade Virtual
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...