In view of the steadily rising demand for treatment of dystonia with botulinum toxin (BT), a relatively expensive neurologic paralytic agent, an exploratory study was undertaken to assess the extent to which dystonia and BT treatment affect the quality of people's lives. One hundred thirty adults with a current diagnosis of dystonia completed two generic measures of health-related quality of life (HRQoL) at regular intervals over a minimum of 6 months. One hundred two participants were receiving regular injections of BT; 28 were not taking BT. The HRQoL instruments used were the EuroQol and the Short Form 36 health survey questionnaire (SF-36). Compared with general population samples, study participants reported greater impairment on all EuroQol and SF-36 dimensions and gave a lower rating to their own health status. Participants with nonfocal dystonia had significantly more problems with usual activities than participants with focal dystonia, and a higher number had problems with mobility and self-care. The groups reported similar levels of pain and emotional well-being. Small improvements in HRQoL were seen after the administration of BT, although few of these were statistically significant. The study results offer further psychometric evidence for the discriminant and construct validity of both the EuroQol and the SF-36.

Many cochlear implant candidates express hopes of enjoying music following implantation. Our aim was to assess the appreciation of music after cochlear implantation in adult patients. Thirty-five out of 45 cochlear implantees (78%) from the North East Programme responded to a questionnaire. Only 16 out of 35 patients (46%) listened to music after implantation. Enjoyment of music on a self-assessment scale was graded a mean of 8.7/10 before deafness but only 2.6/10 after implantation. Listening to music after implantation was more likely in younger patients, those with higher speech perception scores and those with a shorter length of deafness, but was not found to be related to gender, type of implant, processing strategy, time since implant or music enjoyment before becoming deaf. Appreciation of music after cochlear implantation is disappointingly low. Future developments in implant technology should strive to improve satisfaction with music listening.

The Oromandibular Dystonia Questionnaire (OMDQ-25) is the first reliable and valid instrument to measure health-related quality of life in patients with oromandibular dystonia.

A series of 15 patients with intractable benign paroxysmal positional vertigo (BPPV) who had fenestration and occlusion of the posterior semicircular canal (FOP) surgery commencing in December 1990 are reported. Follow-up was from 14 to 40 months. All patients reported a cure of their positional vertigo. No patient regretted having the surgery. All patients had a negative Dix-Hallpike test post-operatively and the test remained negative for the duration of follow-up. Eight patients had a mild high frequency sensorineural hearing (SNHL) loss post-operatively which had almost recovered six months later. No patient reported any change in their hearing following surgery. Of the 10 patients who did not have pre-operative tinnitus, developed tinnitus but it was not considered significant by them. All patients developed mild unsteadiness following surgery which gradually improved with mobilization and physiotherapy if necessary.The operation preserves hearing, is technically straightforward, well-tolerated and effective.

Many cochlear implant candidates express hopes of enjoying music following implantation. Our aim was to assess the appreciation of music after cochlear implantation in adult patients. Thirty-five out of 45 cochlear implantees (78%) from the North East Programme responded to a questionnaire. Only 16 out of 35 patients (46%) listened to music after implantation. Enjoyment of music on a self-assessment scale was graded a mean of 8.7/10 before deafness but only 2.6/10 after implantation. Listening to music after implantation was more likely in younger patients, those with higher speech perception scores and those with a shorter length of deafness, but was not found to be related to gender, type of implant, processing strategy, time since implant or music enjoyment before becoming deaf. Appreciation of music after cochlear implantation is disappointingly low. Future developments in implant technology should strive to improve satisfaction with music listening.