Background: Patients with Parkinson's disease (PD) have difficulties in performing various motor tasks such as walking, writing and speaking, together with significant balance dysfunction. Despite gains made in the field of pharmacotherapy and deep brain stimulation, dopaminergic medications may produce a limited improvement in postural stability. Sustained improvement in motor skills can be achieved through physiotherapy.Aim of the work: To measure the effect of different modes of therapy in controlling vestibular and/or balance dysfunction in patients with PD.Methodology: This study was conducted on 20 patients suffering from definite PD, subdivided into two subgroups according to the mode of therapy they followed. Subgroup I received medical treatment and physiotherapy, while subgroup II received medical treatment only. The control group consisted of 10 age-and sex-matched normal subjects. All participants were evaluated using videonystagmography (VNG), Computerized Dynamic Posturography (CDP) including sensory impairment, automatic motor and voluntary motor assessment. In addition, patients were evaluated using functional limitation tests and were asked to fill the Freezing of Gait (FOG) questionnaire.Results: This research documents vestibular as well as balance dysfunction in patients with PD. Central vestibular disorders were more common than peripheral ones. The most prevalent balance abnormality was encountered in the sensory organization subtest, though patients showed significant affection in other domains; namely, autonomic motor, voluntary motor and functional limitation. In general, patients receiving both medication and physiotherapy showed better vestibular and balance function than those receiving medication only, and approached the normal values in many test parameters.Conclusions: Since patients with PD receiving physiotherapy in conjunction with medical treatment showed better control of their vestibular and balance functions, efforts should be directed to

Background:The effect of unilateral sensor ineural hearing loss (UHL) on the quality of life is well documented. Studies found a direct link between UHL and educational and social delays. Radiological studies aimed to detect the associated anomalies of the earen countered a wide variation in the rates of incidence. Aim of the work:Our study aims to detect and give an estimate about the rate of incidence of different anomalies. Patients and methods:A review of the medical records of Audiology department in Eldemerdash hospital between 2014 to 2017 was done. Only cases with severe to profound USNHL diagnosed before age of 12 years were included. Clinical examination, full audiological assessment, MRI and CT temporal bone were done for all cases and results were reviewed for each patient.Results: 50 cases were included (8 cases with severe USNHL and 42 cases with profound USNHL). The mean age of diagnosis was 7.6 years.Only16 cases (32%) had risk factors known to contribute to SNHL. The most common abnormality found was cochlear nerve (CN) deficiency in 22 cases (44%).Bilateral findings were present in 4 cases (8%). Conclusion:Radiological evaluation is not only for detection of the cause but also allows proper counselling and exploring the possible options of rehabilitation.

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Background Cochlear implants (CI) can partially or totally revert the effects of sensory deprivation; thus enabling the development of auditory abilities. However, there remains a large amount of variability in speech perception outcome among CI users. Such variability may be attributed to the children’s diverse capabilities in detecting amplitude, temporal and spectral changes in the incoming complex speech signals in quiet and in difficult listening situations. Objective To study whether the newly introduced Acoustic Change Complex (ACC) cortical potential using short duration can be used to document such variability. If used as a tool for cortical discrimination, it will aid in evaluating young children who cannot be tested using behavioral measures. Patients and Methods Cortical auditory evoked potentials were recorded in forty five unilaterally-implanted children ranging in age from 6 to 12 years. Stimuli used to elicit ACC were short duration (500 msec.) speech and tonal stimuli. Spectral change was done using /i/ to /u/ vowels, while temporal change was done using variable gaps-in-1000 Hz tone, ranging from 5 msec. to 200 msec. Auditory evoked responses were compared to behavioral tests which included speech perception test (PBKG) and psychophysical test for temporal resolution. Results ACC potentials were successfully recorded in most of the children evaluated. Generally, ACC were significantly highly detected in temporal changes than spectral change. Individual data showed that poor behavioral performance was associated with higher ACC detection thresholds to gap in tone and poorer % detection to vowel change. Conclusion: ACC potential using short duration stimuli can be recorded in young implanted children in an ordinary clinical setting. However, more research is needed to document the complex behavioral-objective relationship and its ultimate link to speech perception and language development in young CI recipients.

Background Cortical auditory evoked potentials (CAEPs) are brain responses evoked by sound and are processed in or near the auditory cortex. ACC is a cortical auditory evoked potential (P1-N1-P2) elicited by a change within an ongoing sound stimulus. Objective To reach the best stimuli that can elicit ACC and act as an objective tool for assessment of cortical auditory discrimination in normal hearing children. Patients and Methods The present study was originally designed to standardize ACC evoked response in 41 children aged from 2 to 10 years. The mean age in our study group was 6.2 years with no significant difference between males and females. Stimuli used in this study were specifically designed to be used by AEP equipment that is capable of uploading short duration stimuli (500 msec.), thus can be used in a regular AEP lab. ACC was elicited by three groups of stimuli. Gap-in-tones stimuli represent temporal change (6, 10, 30 and 50 msec. gap introduced to 1000 Hz tone separately), frequency pairs stimuli represent frequency change (2%, 4%, 10% and 25% change from base freq. 1000 Hz) and vowel pairs stimuli represent spectral change (/i-u/, /u-i/, /i-a/. /a-i/, /u-a/, /a-u/). ACC response parameters were compared when using the different stimuli as regards percent detectability, morphology, latency and amplitude. Results Gap-in-tones at 6 msec. and 4% frequency change could elicit ACC response in 100% of subjects. For spectral change, /u-i/ was the highest in eliciting ACC (78%) followed by /i-u/ (68.2%) then /a-i/ (58.5%). ACC had the same morphology of the onset response in the majority of subjects, with longer latency and smaller amplitude. ACC amplitude is a better indicator of cortical discrimination compared to latency because it is consistently affected by magnitude of change. Conclusion ACC is a good electrophysiological tool for cortical auditory discrimination for temporal, frequency and spectral change.