Neurological Manifestations Among US Government Personnel Reporting Directional Audible and Sensory Phenomena in Havana, Cuba

Swanson, Randel L.; Hampton, Stephen; Green-McKenzie, Judith; Diaz‐Arrastia, Ramon; Grady, M. Sean; Verma, Ragini; Biester, Rosette C.; Duda, Diana; Wolf, Ronald L.; Smith, Douglas H.

doi:10.1001/jama.2018.1742

Cited by 94 publications

(97 citation statements)

References 38 publications

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“…Hence, the experience of sound and pressure sensations in these locations appears to be a sufficient condition for the appearance of symptoms and clinically abnormal neurosensory findings. The chronic findings originally reported in JAMA by Swanson et al are not inconsistent with either a partially compensated vestibulopathy or mild brain trauma . The relatively high prevalence of chronic symptoms is not atypical for peripheral vestibular disorders .…”

Section: Discussionmentioning

confidence: 73%

“…All of these individuals were evaluated at an academic medical center in the United States between 4 and 60 days after exposure. There is some, but not total overlap with the patients described by Swanson et al In addition, this group saw a larger group of 105 embassy workers who denied any “exposure” to noise or a pressure sensation, neither personally nor in anyone who shared their domicile. These individuals were largely referred to us by self‐ request or request of the embassy although the US Marines stationed at the embassy who were not on the initial list, but were seen at the request of the investigators.…”

Section: Methodsmentioning

confidence: 78%

“…Swanson et al reported preliminary findings from 21 exposed individuals who were evaluated an average of 201 days after the perceived exposure; 20 reported persistent symptoms and displayed signs that resembled aspects of mild traumatic brain injury. More precise characterization of their symptom profiles as well as the identification of the sources of these signs and symptoms is limited, though, by the absence of information regarding the acute presentation of the exposed patients and the early course of their treatment response . The purpose of this study is to describe the acute presentation of individuals who experienced neurosensory symptoms after exposure to a unique sound/pressure phenomenon.…”

Section: Introductionmentioning

confidence: 99%

“…More precise characterization of their symptom profiles as well as the identification of the sources of these signs and symptoms is limited, though, by the absence of information regarding the acute presentation of the exposed patients and the early course of their treatment response. 1 The purpose of this study is to describe the acute presentation of individuals who experienced neurosensory symptoms after exposure to a unique sound/pressure phenomenon.…”

Section: Introductionmentioning

confidence: 99%

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Acute findings in an acquired neurosensory dysfunction

Hoffer

Levin

Snapp

et al. 2018

Laryngoscope Investig Oto

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Background In the Autumn of 2016, diplomatic personnel residing in Havana began to present with symptoms of dizziness, ear pain, and tinnitus that emerged after perception of high frequency noise and/or a pressure sensation. Understanding the acute symptoms of this disorder is important for better defining the disorder and developing optimal diagnostic, preventive, and treatment algorithms. Objectives To define the presenting symptoms in a cohort of patients in the acute time period after perceiving a noise/pressure exposure in Havana. Design/Settings/Participants Review of 25 symptomatic individuals who reported a localized sensation of noise/pressure and 10 asymptomatic individuals (roommates of those affected) who did not experience the sound/pressure. Results Immediately after the exposure, the majority of individuals reported intense ear pain in one or both ears and experienced tinnitus. All of the individuals noticed unsteadiness and features of cognitive impairment. On presentation to our center, dizziness (92%) and cognitive complaints (56%) were the most common symptoms. Formal testing revealed that 100% of individuals had an otolithic abnormality and evidence of cognitive dysfunction. Conclusion and Relevance This study focuses on the acute presentation of a phenomenon in which symptoms emerge after perception of a localized noise/pressure and in which the acute symptomology includes the universal nature of vestibular injuries and select cognitive deficits. The findings presented in this acute group of patients begin to provide a better picture of the initial injury pattern seen after this exposure and may allow for more accurate diagnosis of this disorder in future cases. Level of Evidence Retrospective review

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Section: Discussionmentioning

confidence: 73%

Section: Methodsmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute findings in an acquired neurosensory dysfunction

Hoffer

Levin

Snapp

et al. 2018

Laryngoscope Investig Oto

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show abstract

“…A directional microwave weapon was the most likely cause of debilitating neurological symptoms reported by US diplomats in Cuba who heard strange, unexplained sounds at the onset of their symptoms, says the lead author of a medical team that examined the diplomats and reported preliminary findings in JAMA in March 1. That article noted evidence of brain injury but did not offer an explanation of the cause.…”

mentioning

confidence: 99%