Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms

Russo, Francesca; Ralli, Massimo; Seta, Daniele De; Mancini, Patrizia; Lambìase, Alessandro; Artico, Marco; Vincentiis, Marco de; Greco, Antonio

doi:10.1007/s12026-018-9023-6

Cited by 30 publications

(13 citation statements)

References 120 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changes in endolymphatic structures might be associated with autoimmune vasculitis or antibody cross-reactivity. 33 34 Other studies have observed inflammatory cells in the endolymph in animal models of endolymphatic hydrops. 35 36 37 We speculate that if inflammation occurs in the inner ear, changes in the concentrations of water-soluble macromolecular substances (e.g., proteoglycans in endolymph) can also change the specific gravity of the endolymph.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus

Shen

et al. 2021

J Clin Neurol

View full text Add to dashboard Cite

Background and Purpose This study aimed to determine the clinical features, diagnosis, and treatment of patients with persistent geotropic (pG) and persistent apogeotropic (pAG) direction-changing positional nystagmus (DCPN). Methods This retrospective study included 30 patients with pG-DCPN and 44 patients with pAG-DCPN. All patients underwent neurological and neurotological examinations, including an evaluation of gaze-evoked nystagmus, eye-movement tests, and assessments of limb ataxia and balance, as well as magnetic resonance imaging to exclude central causes. The characteristics of positional nystagmus were detected using the supine roll test (SRT) and bow-and-lean test (BLT). The null point (NP) at which the nystagmus disappeared was determined. All patients were treated with the barbecue maneuver, and treatment efficacy was evaluated immediately, 1 week, and 1 month after treatment. Results The history of diseases associated with atherosclerosis, peripheral vestibular disorders, otological disease, and migraine differed significantly between patients with pG-DCPN and pAG-DCPN. The affected sides of persistent horizontal DCPN can be determined using the SRT and the BLT, while determining the second NP and vestibular function as well as performing an audiological evaluation can be used to assist in identifying the affected side. The efficacy rates immediately and 1 week after treatment with the barbecue maneuver were higher in patients with pAG-DCPN than in patients with pG-DCPN. Conclusions pAG-DCPN was more compatible with the characteristics of cupulolithiasis, and pG-DCPN was more likely to be associated with a light cupula rather than canalolithiasis. pAG-DCPN was more likely to be accompanied by a disease associated with atherosclerosis, while pG-DCPN was often accompanied by autoimmune-related diseases and a history of migraine. The associations between pAG-DCPN, pG-DCPN, and the above-mentioned diseases need to be clarified further. The canalith-repositioning maneuver was effective in patients with pAG-DCPN and ineffective in patients with pG-DCPN, but most cases of pG-DCPN are self-limiting.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus

Shen

et al. 2021

J Clin Neurol

View full text Add to dashboard Cite

show abstract

“…Moreover, studies in MD patients demonstrated the presence of antibodies against type II collagen, a component of connective tissue in the inner ear. 37 The best evidence to support the role of autoimmunity in MD is the association of bilateral MD with locus 6p21.33, the leading signal being rs4947296, a common variant located in a noncoding region of the extended major histocompatibility complex. This association was replicated in other cohorts, reaching genome-wide significant differences (p < 10 À8 ), and the risk genotype was found in 15% of bilateral MD patients.…”

Section: Genetic MDmentioning

confidence: 99%

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Pérez-Carpena

Lopez-Escamez

2019

Semin Neurol

View full text Add to dashboard Cite

Meniere's disease (MD) is a set of uncommon disorders with core phenotype of tinnitus, episodic vertigo, and sensorineural hearing loss. MD shows a genetic predisposition and a family history is found in 10% cases, with an autosomal dominant inheritance pattern. It is a multifactorial condition whose onset and development are triggered by the combined effect of genetic and environmental factors. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, endolymphatic hydrops does not fully explain the persistence of tinnitus, hearing loss progression, or the frequency of vertigo attacks.There are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, adding more complexity to the phenotype. This “extended phenotype” can make the diagnosis and clinical management more complex, but it could also lead to a better characterization, understanding, and treatment of MD patients.We have conducted a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management.

show abstract

“…Vertigo and disequilibrium are common symptoms in MS 46,47 . The origin of vertigo can be peripheral, following the involvement of the cochlea 48 , or-mainly-central, due to demyelinating lesions affecting the vestibular pathways such as the vestibular nuclei 46 .…”

Section: Vertigo and Disequilibriummentioning

confidence: 99%

“…In some cases, it may follow the involvement of both the cochlea and the vestibular pathways. The origin of vertigo and disequilibrium in MS patients is more often attributed to stiffness, musculoskeletal weakness and ocular diseases rather than to the involvement of the vestibular pathways and of the inner ear 47,49 .…”

Section: Vertigo and Disequilibriummentioning

confidence: 99%

Otolaryngologic Symptoms in Multiple Sclerosis: A Review

Ralli¹,

Stadio²,

Visconti³

et al. 2018

The International Tinnitus Journal

Self Cite

View full text Add to dashboard Cite

Many symptoms of multiple sclerosis may affect the ear, nose and throat. The most common otolaryngologic symptoms of multiple sclerosis are speech disorders, followed by sleep disorders, vertigo and disequilibrium, dysphagia, smell alterations, and hearing loss. Less common symptoms include sialorrhea, facial palsy, taste alterations, trigeminal neuralgia and tinnitus. The origin of otolaryngologic symptoms in multiple sclerosis is mainly central, although increasing evidence also suggests a peripheral involvement.

show abstract

Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms

Cited by 30 publications

References 120 publications

Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus

Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Otolaryngologic Symptoms in Multiple Sclerosis: A Review

Contact Info

Product

Resources

About