Evidence of Central and Peripheral Vestibular Pathology in Blast-Related Traumatic Brain Injury

Scherer, Matthew R.; Burrows, Holly; Pinto, Robin; Littlefield, Philip D.; French, Louis M.; Tarbett, Aaron K.; Schubert, Michael C.

doi:10.1097/mao.0b013e318210b8fa

Cited by 68 publications

(43 citation statements)

References 44 publications

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“…In one report, static SVV was abnormal in only 11 percent of subjects [27], while in another study, SVV was abnormal in nearly all subjects (96%) [26]. In this latter study, however, it was not specified whether the abnormality was on the static or rotational test, and these are differentially sensitive to a peripheral versus a central locus of damage.…”

Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 81%

“…In the latter study, twothirds of those having abnormal results showed patterns consistent with peripheral injury, whereas the results of the other third, or 8 percent overall, were consistent with central injury. Furthermore, abnormal nystagmus, mostly of central origin and equally distributed across etiology of trauma, was found during videonystagmography in 25 percent of patients in this study [27]. However, abnormal nystagmus was not present in another blast-exposed cohort [6].…”

Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 98%

“…In a study of 31 blast-exposed patients with mTBI, only 1 had spontaneous nystagmus and no patients had failure of fixation suppression [26]. Eye movement abnormalities in phase, gain, and asymmetry were relatively low among those with blast injury during rotary chair testing, with 18 percent demonstrating abnormality in one study [26] and 24 percent in another [27]. In the latter study, twothirds of those having abnormal results showed patterns consistent with peripheral injury, whereas the results of the other third, or 8 percent overall, were consistent with central injury.…”

Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 99%

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Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

Franke¹,

Walker²,

Cifu³

et al. 2012

JRRD

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Abstract-Vestibular symptoms are persistent and problematic sequelae of blast exposure. Several lines of evidence suggest that these symptoms often stem from injury to the central nervous system. Current methods of assessing the vestibular system have described vestibular deficits that follow traumatic brain injury and differentiate blunt and blast trauma but have not examined the full range of vestibular functions that depend on the cerebral structures above the midbrain. Damage to the central vestibular circuits can lead to deficits in vital processes of spatial perception and navigation, in addition to dizziness and disequilibrium, and may also affect emotional functioning, particularly noradrenergically modulated states of anxiety. Perceptual functions can be assessed to determine the extent of central nervous system involvement in vestibular symptoms and to provide greater confidence when vestibular dysfunction is to be excluded. The ability to detect central vestibular dysfunction will significantly enhance our response to the dizziness and balance symptoms that are a common source of distress for Veterans.

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Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 81%

Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 98%

Section: Specific Effects Of Blast On Vestibular Functionmentioning

confidence: 99%

See 1 more Smart Citation

Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

Franke¹,

Walker²,

Cifu³

et al. 2012

JRRD

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“…An important recommendation noted in this review (from Scherer et al [31] ) was that although some patients may appear to be asymptomatic, 30% of these asymptomatic patients had abnormal vestibular findings and nystagmus. Vestibular testing confirms a higher incidence of vestibular and oculomotor dysfunction in patients with blast-related TBI than in asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

“…The outcomes of the review involved reporting specifically on: (i) the description of nystagmus found in patients with TBI; (ii) the time to [29] 2008 [30] 2009 [31] 2011 [32] 2012 …”

Section: Outcomementioning

confidence: 99%

Investigating nystagmus in patients with traumatic brain injury: A systematic review (1996 - 2016)

2017

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Background. Traumatic brain injury (TBI) is a health and socioeconomic concern worldwide. In patients with TBI, post-traumatic balance problems are often the result of damage to the vestibular system. Nystagmus is common in these patients, and can provide insight into the damage that has resulted from the trauma. Objective. To present a systematic overview of published literature regarding nystagmus in patients with TBI. Methods. Nine databases and platforms were searched during October 2016 for articles published between 1996 and 2016. Studies of any research design and published in English that focused on nystagmus in patients with TBI were considered for inclusion. A total of 110 articles were screened once duplicates had been removed, and 29 full-text articles were assessed. Eleven articles were included in the quality appraisal phase (using the McMaster tool), after which 10 articles were included in this review. Results. This review describes nystagmus in 713 patients, and all articles reviewed described the type of assessment method that was used. However, the results lacked comprehensive data regarding the assessment, measurement and description of nystagmus in TBI patients, or the possible link and relationship between nystagmus and TBI. Conclusions. This systematic review indicated that: (i) there is a growing body of evidence that benign paroxysmal positional vertigo should be considered during the medical examination of all patients suffering from head trauma; (ii) all patients with TBI should undergo visual (eye movement) and vestibular examination; and (iii) future studies should include quantitative measurements of eye movements and nystagmus.

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An adaptive vestibular rehabilitation technique

Crane

Schubert

2017

The Laryngoscope

Self Cite

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Evidence of Central and Peripheral Vestibular Pathology in Blast-Related Traumatic Brain Injury

Cited by 68 publications

References 44 publications

Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

Investigating nystagmus in patients with traumatic brain injury: A systematic review (1996 - 2016)

An adaptive vestibular rehabilitation technique

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