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Arq Neuropsiquiatr 2019 Jan;77(1):25-32

Universidade Federal de Santa Maria, Departamento de Fonoaudiologia, Santa Maria, RS, Brasil.

Objective: Changes in postural balance and visual complaints are frequent consequences of stroke. We aimed to investigate the symptoms and the vestibular and oculomotor functions of patients with dizziness post ischemic and hemorrhagic stroke and compare the results among them.

Methods: Fifty patients with dizziness after stroke were evaluated through a clinical anamnesis and computerized vector electronystagmography: calibration of ocular movements, spontaneous nystagmus, semi-spontaneous nystagmus, pendular tracking, optokinetic nystagmus, rotary chair testing, and the caloric test. Read More

Otol Neurotol 2018 Dec;39(10):1222-1228

Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota.

Objective: To characterize patient tolerance and nonmonetary cost burdens of vestibular testing. Rigorously acquired data are essential for patient counseling and to determine if proposed additions/modifications to current protocols improve quality, experience, and efficiencies of care.

Study Design: Prospective observational study. Read More

Semin Hear 2018 Aug 20;39(3):257-274. Epub 2018 Jul 20.

Department of Audiology, Boys Town National Research Hospital, Omaha, Nebraska.

Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Read More

J Am Acad Audiol 2018 Jul/Aug;29(7):587-595

Department of Rehabilitation Science, University at Buffalo, Buffalo, NY.

Background: When patients are given instructions before vestibular function testing, they are often asked to refrain from ingesting caffeine 24 h before testing. However, research regarding the effects of caffeine on the outcome of vestibular function testing is limited.

Purpose: To evaluate whether the results from rotational chair tests are influenced by caffeine. Read More

Eur J Paediatr Neurol 2018 Jul 30;22(4):667-673. Epub 2018 Mar 30.

Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA; Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Introduction: Migraine variant disorders of childhood include benign paroxysmal torticollis of infancy (BPTI) and benign paroxysmal vertigo of childhood (BPVC). This study aimed to review our experience with BPTI and BPVC and determine the incidence of children transitioning between each of these disorders and to vestibular migraine (VM).

Methods: We retrospectively reviewed the medical records of patients seen at the Balance and Vestibular Program at Boston Children's Hospital between January 2012 and December 2016 who were diagnosed with BPTI, BPVC, and/or VM. Read More

Otol Neurotol 2018 Apr;39(4):e274-e279

Division of Otology-Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.

Objective: To describe the electrocochleography (ECochG) findings in patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus.

Design: Retrospective case series.

Setting: Tertiary care center. Read More

Otol Neurotol 2018 Feb;39(2):e108-e112

Department of Otorhinolaryngology-Head & Neck Surgery.

Objectives: The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls.

Study Design: Retrospective review.

Patients And Methods: A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Read More

J Prosthet Dent 2018 Jun 14;119(6):987-993. Epub 2017 Oct 14.

Professor and Chair, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.

Statement Of Problem: A recommended minimum thickness for monolithic zirconia restorations has not been reported. Assessing a proper thickness that has the necessary load-bearing capacity but also conserves dental hard tissues is essential.

Purpose: The purpose of this in vitro study was to evaluate the effect of thickness and surface modifications on monolithic zirconia after simulated masticatory stresses. Read More

Ear Hear 2017 Nov/Dec;38(6):e352-e358

1Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Department of Otolaryngology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; 3Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 4Department of Psychology, University of Tehran, Tehran, Iran; 5Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 6Department of Audiology, Jondi Shapour University of Medical Sciences, Ahvaz, Iran; and 7Department of Psychology, Shahid Beheshti University, Tehran, Iran.

Objectives: Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. Read More

Otolaryngol Head Neck Surg 2017 02 14;156(2):312-320. Epub 2016 Nov 14.

3 Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Objective There is a lack of consensus regarding the indications for vestibular testing in the evaluation of dizziness and balance disorders. Geographic variation in health services utilization is associated with lack of consensus. To understand the variation in current practice, we investigated the patterns of use of vestibular testing and diagnosis codes for dizziness and balance disorders among individuals ≥65 years of age across different regions of the United States. Read More

Brain Inj 2016 ;30(12):1501-1514

a Department of Diagnostic Radiology , Wayne State University School of Medicine , Detroit , MI , USA.

Background: Case reports are presented on four Veterans, aged 29-46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry and neuroimaging procedures were used to characterize their injuries. Read More

Otolaryngol Head Neck Surg 2016 07;155(1):42-7

Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.

Objective: We used a national otolaryngology practice-based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder.

Study Design: Database review.

Setting: The Creating Healthcare Excellence through Education and Research (CHEER) practice-based research network of academic and community providers

Subjects And Methods: Dizzy patients in the CHEER retrospective database were identified through ICD-9 codes; vestibular testing procedures were identified with CPT codes. Read More

J Prosthet Dent 2016 Oct 5;116(4):558-563. Epub 2016 May 5.

Professor, Chair and Program Director, Division of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.

Statement Of Problem: Laboratory studies of tooth preparation often involve single values for all variables other than the one being tested. In contrast, in clinical settings, not all variables can be adequately controlled. For example, a new dental rotary cutting instrument may be tested in the laboratory by making a specific cut with a fixed force, but, in clinical practice, the instrument must make different cuts with individual dentists applying different forces. Read More

Int J Pediatr Otorhinolaryngol 2016 Apr 1;83:104-8. Epub 2016 Feb 1.

Department of Otolaryngology and Communication Enhancement (J.R.B., B.A.C., GW.Z.), Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology (J.R.B., GW.Z.), Harvard Medical School, Boston, MA, USA.

Objective: Describe the clinical presentation and recovery of vestibular neuritis in children and adolescents.

Study Design: Retrospective case series.

Setting: Pediatric tertiary care center. Read More

Audiol Res 2015 Jan 9;5(1):120. Epub 2015 Mar 9.

Cleveland Clinic , USA.

Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. Read More

Eur J Paediatr Neurol 2016 Jan 22;20(1):85-92. Epub 2015 Oct 22.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.

Objective: Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic.

Methods: Twenty-eight patients ≤18 years old with a diagnosis of VM were identified from 208 patients seen at the Balance and Vestibular Program at Boston Children's Hospital from July 2012-July 2014, after excluding 12 patients with a history of major otologic or neurologic surgery, recent concussion, or additional vestibular disorders. Read More

Laryngoscope 2016 Feb 30;126(2):460-3. Epub 2015 Jul 30.

Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, U.S.A.

Objectives/hypothesis: The purpose of this study is to examine the range of vestibulo-ocular reflex (VOR) gain on rotary chair (RC) testing in subjects without ear and vestibular problems stratified by age and gender.

Study Design: Prospective cross-sectional study.

Methods: One hundred subjects ranging in age from 6 to 78 years underwent RC testing. Read More

Int J Pediatr Otorhinolaryngol 2015 Aug 29;79(8):1283-7. Epub 2015 May 29.

The Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; The Department of Otology and Laryngology, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

Objectives: VHIT is the first vestibular test to evaluate all six semicircular canals. This test has advantages over the rotary chair and caloric tests in evaluating children since it does not require fear-inducing darkness or provocation of dizziness. The goal of this study was to review our initial experience with VHIT in children and adolescents at a pediatric vestibular program. Read More

J Am Acad Audiol 2015 May;26(5):518-23

Vestibular/Balance Laboratory, Auditory and Vestibular Research Enhancement Award Program, VA Medical Center, Mountain Home, TN.

Background: Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been developed to provide an objective assessment to the clinical test. Read More

Laryngoscope 2016 Mar 25;126(3):727-31. Epub 2015 May 25.

Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

Objectives/hypothesis: Subjective visual vertical (SVV) is a vestibular test commonly used in adults that has not been well studied in children. In this test, the patient aligns a projected line with the perceived true vertical. Deviation of >2° is usually associated with utricular dysfunction and may also be seen with central vestibular lesions. Read More

Acta Otolaryngol 2015 Jul 26;135(7):685-91. Epub 2015 Mar 26.

ENT Department, Hospital das Clínicas, University of São Paulo School of Medicine , São Paulo , Brazil.

Conclusions: Balance was improved at 365 days after CI in all patients. Caloric test findings were important determinants of balance outcomes over a year after CI. Pre-operative vestibular assessment findings should be documented because postural recovery over time depends on this information. Read More

J Neurotrauma 2016 Jan 1;33(1):71-81. Epub 2015 Jul 1.

2 Audiology and Speech Pathology Center, Walter Reed National Military Medical Center , Bethesda, Maryland.

The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. Read More

Eur Arch Otorhinolaryngol 2016 Mar 21;273(3):719-25. Epub 2015 Feb 21.

Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

The objective of this study was to evaluate long-term vestibulocochlear functional outcomes of patients operated for unilateral vestibular schwannoma via the retro-sigmoid approach. Patients who underwent vestibular schwannoma resection via retro-sigmoid approach between 2004 and 2008 at our institution, without prior surgical or radio-surgical therapy were considered to be eligible for this study. Preoperative auditory and vestibular symptoms were assessed retrospectively. Read More

J Prosthet Dent 2015 Apr 11;113(4):336-42. Epub 2015 Feb 11.

Associate Professor, Chair and Program Director, Division of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, New York.

Statement Of Problem: Laboratory studies of tooth preparation are often performed under a limited range of conditions involving single values for all variables other than the 1 being tested. In contrast, in clinical settings not all variables can be tightly controlled. For example, a new dental rotary cutting instrument may be tested in the laboratory by making a specific cut with a fixed force, but in clinical practice, the instrument must make different cuts with individual dentists applying a range of different forces. Read More

J Am Acad Audiol 2014 Mar;25(3):244-52

Vestibular/Balance Research Laboratory, VA Medical Center, Mountain Home, TN; Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN.

Background: The observation or measurement of eye movement can aid in the detection and localization of vestibular pathology due to the relationship between the function of the vestibular sensory receptors in the inner ear and the eye movements produced by the vestibulo-ocular reflex (VOR). The majority of bedside and laboratory tests of vestibular function involve the observation or measurement of horizontal eye movements (i.e. Read More

J Prosthet Dent 2014 Jul 14;112(1):51-8. Epub 2014 Apr 14.

Private practice, Milan, Italy.

Statement Of The Problem: Rotary and nonrotary cutting instruments are used to produce specific characteristics on the axial and marginal surfaces of teeth being prepared for fixed restorations. Oscillating instruments have been suggested for tooth preparation, but no comparative surface roughness data are available.

Purpose: To compare the surface roughness of simulated tooth preparations produced by oscillating instruments versus rotary cutting instruments with turbine and electric handpieces. Read More

Otol Neurotol 2014 Apr;35(4):577-81

*National Institute on Deafness and Other Communication Disorders, and †National Institute on Allergy and Infectious Diseases, National Institutes of Health, Bethesda; and ‡Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

Objective: To report the auditory and vestibular phenotypes of patients with GATA3 mutation.

Study Design: Case series of 6 patients.

Setting: Tertiary referral center. Read More

J Prosthet Dent 2014 Jan 15;111(1):56-63. Epub 2013 Nov 15.

Associate Professor, Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY.

Statement Of Problem: As single-use rotary cutting instruments and electric handpieces become more available, the performance of these instruments with electric as compared to turbine handpieces requires evaluation. In addition, if rotary cutting instruments marketed as single-use instruments are used for multiple patients, the effects on their performance of cleaning, sterilization, and repeated use are of interest to the clinician.

Purpose: The purpose of the study was to evaluate how the cleaning, autoclaving, and repeated use of single-use and multiuse rotary cutting instruments, with either a turbine or electric handpiece, affected their performance. Read More

HNO 2013 Aug;61(8):692-8

Tinnitus-Klinik Dr. Hesse , Krankenhaus Arolsen, Große Allee 50, 34454, Bad Arolsen, Deutschland.

Background: For vestibular disorders competence in otorhinolaryngology (ENT) is required to diagnose disorders in the complete vestibular system. It seems difficult, however, to evaluate otolithic functions although the influence and importance regarding vestibular dysfunction could be relevant. Currently it is possible to unilaterally diagnose different functions of the saccule by recording cervically registered vestibular evoked myogenic potentials (c-VEMP). Read More

Arch Otolaryngol Head Neck Surg 2012 Jun;138(6):584-7

Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, Duke University Medical Center, Durham, NC 27710, USA.

The evaluation of the patient with recurrent vertigo requires knowledge of vestibular anatomy and physiology. The patient's medical history and physical examination provide the majority of the information necessary for diagnosis. Many diagnostic tests are available to the clinician to aid in the diagnosis. Read More

Otolaryngol Clin North Am 2011 Apr;44(2):273-90, vii

Program in Audiology and Communication Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8042, St Louis, MO 63110, USA.

In this article the author describes in detail the adaptation of adult vestibular testing techniques to the pediatric population. Assessment tools discussed include video-oculography (VOG), computerized rotary chair (CRC), computerized dynamic posturography (CDP), and vestibular evoked myogenic potentials (VEMPs). As with hearing impairment, the earlier a vestibular disorder is identified, the earlier remediation strategies may begin. Read More

Am J Otolaryngol 2011 Nov-Dec;32(6):522-7. Epub 2011 Feb 8.

Department of Otolaryngology, University of Miami Ear Institute, University of Miami Miller School of Medicine, FL 33136, USA.

Objectives: The objective of this study was to determine the association of the bedside test of head-shaking nystagmus (HSN) with patients' self-perceived dizziness handicap as well as this test's sensitivity and specificity in unilateral peripheral vestibular hypofunction.

Study Design: A retrospective case-control study was performed.

Setting: The study was held at an academic, tertiary referral center. Read More

Audiol Neurootol 2010 5;15(4):241-6. Epub 2009 Nov 5.

Department of Neurology, Emory University, Atlanta, GA 30322, USA.

Introduction: An estimated one-fourth to one-third of patients with migraine will experience vertigo associated with their migraine attacks. Vestibular migraine frequently presents as a diagnostic challenge as objective neurological findings consistent with this entity have not been well described.

Objective: The aim of this study is to characterize eye movements of patients presenting with nystagmus during attacks of migrainous vertigo. Read More

Otol Neurotol 2009 Sep;30(6):800-5

Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA.

Objective: To identify the predictive capabilities of caloric and rotational testing to distinguish peripheral from nonperipheral vestibular causes of vertigo.

Study Design: Retrospective case review.

Setting: Academic tertiary care vestibular function test center. Read More

Neurotoxicol Teratol 2004 Nov-Dec;26(6):825-37

Behavioral Toxicology Laboratories, Division of Neurotoxicology, HFT-132, USFDA's National Center for Toxicological Research, 3900 NCTR Road, Jefferson, AR 72079-9502, USA.

Space motion sickness (SMS) is a problem during the first 72 h of space flight and during transitions from different gravity environments. There currently are no effective drug countermeasures for SMS that also accommodate the retention of optimal cognitive function. This creates a dilemma for astronauts because cognitive skills are particularly important during gravity transitions (e. Read More

J Am Acad Audiol 2004 Apr;15(4):324-33

Division of Audiology, Henry Ford Hospital, Detroit, MI, USA.

Velocity storage (VS), a brainstem function, extends the low-frequency response of the vestibular system. To better understand VS mechanisms and characteristics in humans, we analyzed retrospectively functional measures of gait, electrophysiological measures of vestibular function, and imaging studies in an attempt to determine clinical, electrophysiological, and anatomical correlates of abnormalities in VS. Two cohorts of patients referred to our Risk of Falls Assessment Clinic participated in this investigation. Read More

J Vestib Res 2003 ;13(4-6):215-25

Vestibular Research Laboratory, HNO-Klinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, 12200 Berlin, Germary.

Attention is directed towards the recently developed unilateral tests of saccular and utricular function. Together with the now widely used head-thrust test and the standard caloric test for semicircular canal function, these provide for a more comprehensive unilateral examination of labyrinth function. The efficacy of vestibular evoked myogenic potentials (VEMP) as a direct unilateral test of saccular function is currently being demonstrated in an increasing number of reports. Read More

Otol Neurotol 2002 May;23(3):372-7

Department of Rehabilitation Medicine, Emory University, 1441 Clifton Road NE, Atlanta, GA 30322, U.S.A.

Objective: This study was designed to measure visual acuity during active vertical head movement and to examine its relationship to subjective reports of oscillopsia.

Study Design: This was a prospective, clinical study.

Setting: The study was performed in a tertiary, ambulatory referral center. Read More

Acta Otolaryngol Suppl 2001 ;545:84-7

Vestibular Research Laboratory HNO-Klinik, Universitätsklinikum Benjamin Franklin Freie Universität Berlin, Berlin, Germany.

In the present study, attention is directed to the unilateral response of the otolith system to static and dynamic tilt, as reflected by subjective estimation of the visual vertical (oculogravic perception). Measurements were performed with a variable radius rotary chair, which permits controlled modulation of the centripetal, or radial, acceleration. By limiting the radius, i. Read More

Acta Otolaryngol 2000 Sep;120(6):724-30

Department of Otorhinolaryngology, University Hospital Antwerp (UZA), Edegem, Belgium.

This study provides normative data from computerized electronystagmography (ENG) testing of 40 healthy subjects with an average age of 45 years. The clinical test protocol comprises an extensive vestibular examination with oculomotor, positional, rotary chair and caloric tests. The results show that with a computerized ENG set-up considerable variabilities of 22% for rotary chair asymmetry and 19% for caloric labyrinth asymmetry remain. Read More

Laryngoscope 2000 Apr;110(4):517-35

Department of Otolaryngology--Head and Neck Srugery, Washington University School of Medicine, St Louis, Missouri, USA.

Objectives/hypothesis: Manual whole-body and head-on-body rotational testing of the vestibuloocular reflex (VOR) is comparable to conventional rotary chair methods with and without visual fixation from 0.025 to 1 Hz.

Study Design: Summary of four previously published trials from our laboratory and a fifth prospective blinded study comparing whole-body and head-on-body rotation with rotational chair results from 0. Read More

J Dev Behav Pediatr 1999 Aug;20(4):211-5

Medical College of Wisconsin Anesthesia Department, Children's Hospital of Wisconsin, Milwaukee 53201, USA.

Twelve children with fibromyalgia and complaints of chronic dizziness were evaluated with both clinical office maneuvers of vestibular function and laboratory tests composed of electronystagmography and sinusoidal harmonic acceleration rotary chair testing. All test results were normal for spontaneous nystagmus with or without visual fixation, oculocephalic reflex, dynamic visual acuity, head-shaking nystagmus, Quix test, and Dix-Hallpike maneuver. Electronystagmography test results were essentially normal for saccades, gaze, Dix-Hallpike, pendular tracking, and caloric evaluation. Read More

J Vestib Res 1998 May-Jun;8(3):273-82

Department of Otolaryngology-Head and Neck Surgery, Washington University, School of Medicine, Saint Louis, Missouri, USA.

New methods of rotational testing of the vestibulo-ocular reflex (VOR) using manually generated or patient-generated sinusoidal head movements have recently been advocated for clinical use in circumstances where conventional rotary chair testing methods are not feasible. However, studies seeking to provide evidence for the validity of these methods by comparing their results with an accepted "gold-standard" have been conspicuously absent in the literature. In this study, we compared results for VOR gain, phase, and asymmetry obtained using whole-body and head-on-body rotational stimuli with those obtained by conventional rotary chair testing in 35 subjects with either unilateral or bilateral vestibular deficits over the range of frequencies from 0. Read More

Ann Neurol 1996 Apr;39(4):529-35

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Chronic inflammatory demyelinating polyneuropathy (CIDP) has occasionally been associated with clinical or laboratory evidence (magnetic resonance imaging,[MRI], visual evoked response, and brainstem auditory evoked response [BAER] of cranial neuropathy. In most cases, the relationship of cranial nerve involvement to CIDP remains unclear. A 45-year-old woman noted foot numbness, limb weakness, gait and postural instability, and oscillopsia. Read More

J Am Acad Audiol 1995 May;6(3):264-70

Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55905, USA.

Menière's disease is a vestibular disturbance characterized by episodic vertigo, tinnitus, and fluctuant hearing loss. The long-term effectiveness of available medical and nonablative surgical treatments has been variable, with frequent symptom recurrence. Vestibular neurectomy and labyrinthectomy, surgically ablative techniques, provide more permanent relief from vertiginous attacks. Read More

J Vestib Res 1992 ;2(2):123-31

Department of Otolaryngology, Wayne State University, Detroit, Michigan.

Analysis of low-frequency (0.01 to 0.16 Hz), sinusoidal rotary chair responses of 24 patients with bilateral caloric weakness revealed a wide range of vestibulo-ocular reflex (VOR) impairment. Read More

Laryngoscope 1991 Jul;101(7 Pt 1):695-8

Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO.

The vestibulo-ocular reflex (VOR) is usually evaluated by whole-body rotary chair oscillation in darkness, but is limited to ambulatory patients. In order to develop a portable method of VOR assessment, eye movements from 10 normal subjects were studied under three conditions: 1. whole-body rotary chair oscillation in the dark and in the light with a head mounted blank field, 2. Read More

Otolaryngol Head Neck Surg 1991 Jan;104(1):67-71

Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109.

Patients with bilateral peripheral vestibular dysfunction present a substantial diagnostic and therapeutic challenge to the otologist. Caloric irrigations that suggest bilateral weakness may mislead the clinician when considerable peripheral function remains. Rotary chair testing at several frequencies is helpful in confirming the degree of residual function and may identify patients who have a better prognosis in rehabilitation. Read More

Ann Otol Rhinol Laryngol 1990 Jul;99(7 Pt 1):539-42

Division of Audiology, Henry Ford Hospital, Detroit, Michigan 48202.

The head-shaking nystagmus (HSN) test has been reported to be a sensitive screening test for the presence of peripheral and central vestibular system disease. Previous investigations have utilized few subjects who were drawn from well-defined patient populations. The purpose of the present investigation was twofold: first, to determine the prevalence of HSN in a large unselected population of dizzy patients seen in an otology and neurotology practice, and second, to determine the sensitivity and specificity of this evaluation in the detection of vestibular system abnormalities as reflected by results of electronystagmography and rotary chair testing. Read More

Neurol Clin 1990 May;8(2):269-85

Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.

Sinusoidal harmonic acceleration has become a common method used in diagnostic vestibular testing. When properly used, it can produce normal and abnormal patterns that can be interpreted in the context of the nature of the stimulus and the physiologic processes that describe the responses to it. Thus, the aim of this review is to present specific information regarding the sinusoidal harmonic acceleration stimulus and vestibular physiology in a way that will hopefully aid in test interpretation. Read More