RESUMO: O objetivo deste estudo foi avaliar os efeitos da reabilitação do equilíbrio corporal (RE), por meio do ambiente de realidade virtual Nintendo Wii™ em uma idosa com disfunção vestibular crônica em relação à avaliação clínica e funcional. Trata-se de um relato de caso de H.F.A., do sexo feminino, 62 anos, com queixa de desequilíbrio corporal, vertigem, zumbido e dor de cabeça há cinco anos. Já havia sido tratada com medicamentos supressores, mas não obteve sucesso. A RE consistiu em doze sessões com jogos do Wii Fit Plus, duas vezes por semana, com duração de 60 minutos cada sessão. Como métodos de avaliação foram aplicados o Questionário Funcional Multidimensional Brasileiro (BOMFAQ), Dizziness Handicap Inventory (DHI), Dynamic Gait Index (DGI) e posturografia computadorizada (Balance Rehabilitation Unit). Foram escolhidos dez jogos do Wii Fit Plus e Balance Board. Após o tratamento, a paciente apresentou remissão da tontura e redução da intensidade e frequência do zumbido e da dor de cabeça. Houve melhora na capacidade funcional, qualidade de vida (DHI antes RE = 22 pontos; após RE = 02 pontos) e estabilidade dinâmica (DGI antes RE = 18 pontos; após RE = 24 pontos), aumento da área do limite de estabilidade (antes RE = 52 cm 2 ; após RE = 171 cm 2) e redução da oscilação corporal em diferentes condições sensoriais. A reabilitação por meio da tecnologia dos jogos Wii™ Fit Plus foi bem sucedida na promoção da melhora clínica e funcional de uma paciente com distúrbio do equilíbrio corporal de origem vestibular.

Investigou-se a associação entre equilíbrio postural (EP) e as variáveis sociodemográficas e clínico-funcionais de idosos internados na enfermaria de uma Clínica Médica. Os idosos com faixa etária mais elevada, declínio da função cognitiva, pior estado nutricional, pior força de preensão palmar, maior número de hipóteses diagnósticas, presença de doenças de olhos e anexos, déficit auditivo e/ou visual, quedas no último ano, maior tempo de início de tontura do tipo rotatória, e provenientes do pronto-socorro, apresentaram pior EP.

Objectives: Evaluate the efficacy of a balance rehabilitation program in older persons with chronic vestibular disease. Methods: Prospective clinical trial conducted from September 2011 to December 2012. Setting: University center for balance disorders. Eligible patients (over 60 years old) with chronic vestibular disease underwent 12 to 16 sessions of individual body balance rehabilitation program (BRP). Each session lasted 60 minutes, twice per week, and was associated with diet orientation and daily exercises for labyrinth stimulation. Before and after therapy, the following data were collected: patient complaints, the Functional Gait Assessment, the Brazilian OARS Multidimensional Functional Assessment Questionnaire, the Dizziness Handicap Inventory (DHI) and static posturography parameters (limit of stability and balance functional reserve in ten visual, vestibular, and somatosensory conflicts). Results: Of 20 patients, 90.9% were female, with mean age of 71.70 years old. After BRP, there was reduction of most of symptoms (dizziness, imbalance and nausea), improvement in functional capacity ( P < 0.05), gait stability ( P = 0.003) and reduction in DHI scores ( P = 0.001). The limit of stability measure increased ( P = 0.001) and also the body balance functional reserve, mainly in conditions 2, 3 and 4 ( P = 0.001) and 5 ( P = 0.020). Conclusions: A body balance rehabilitation program was effective in reduction of symptoms, fall risk, and dizziness impact on quality of life in elderly patients with vestibular disorders, improving functional capacity, gait stability, and increasing the limit of stability and the balance functional reserve.

POSTERS Otology/Neurotology Vertebrobasilar Artery Aneurysms: An Uncommon Cause of VertigoCatherine Hart, MD (presenter); Myles L. Pensak, MD Objective: Review our experience with vertebrobasilar artery aneurysms and discuss factors which may enable clinicians to distinguish between these potentially life-threatening posterior circulation aneurysms and other conditions with similar presentations.Method: Case series with chart review. The charts of patients who underwent surgical management of posterior circulation aneurysms at a tertiary care center between December 1995 and February 2008 were reviewed.Results: A total of 57 patients (40 females, 17 males) with an average age of 52.8 years (range, 27-79 years) were included. A total of 44 patients were white, 5 were African American, and 8 were unspecified. Aneurysms of the posterior communicating artery and posterior inferior cerebellar artery were most common, occurring in 28 (49%) and 26 (46%) of patients, respectively. The most common initial symptoms were headache in 31 patients (54%) and acute mental status changes in 18 patients (32%). Eight patients (14%) presented acutely with dizziness or vertigo. 26 patients (46%) underwent suboccipital craniotomy with aneurysm clipping. Fifteen (26%) underwent frontotemporal craniotomy, and 5 (9%) underwent a combined neurosurgical-neurotologic approach. There were 8 deaths.by guest on June 4, 2016