“…Neurologists rarely remember to order audiogram and vestibular function tests, as well as EEG and ECG, in patients with drop attacks [43]. Repeated room tilt illusion attacks—suddenly the whole visual world is tilted or even inverted—might be a related phenomenon: these occur with both MD and migraine, and possibly even with vertebrobasilar TIAs [44, 45]. Fig.…”
Section: Meniere’s Diseasementioning
confidence: 99%
“…There are now official criteria for the diagnosis of VM [64, 67], even though many migraineurs have other, unofficial, balance problems, such as chronic subjective dizziness [68], motion sensitivity [69], motion sickness [70], constant rocking sensations (mal-de-debarquement) [71], room-tilt illusion [45], and generalized imbalance [72]. And, perhaps as a consequence of the vertigo attacks, VM patients have psychological problems such as anxiety [73], panic attacks [74], and phobias [75].…”
Vestibular disorders manifesting as vertigo, chronic dizziness and imbalance are common problems in neurological practice. Here, we review some recent interesting and important advances in diagnosis of vestibular disorders using the video head impulse test and in the management of benign positional vertigo and migrainous vertigo.
“…Neurologists rarely remember to order audiogram and vestibular function tests, as well as EEG and ECG, in patients with drop attacks [43]. Repeated room tilt illusion attacks—suddenly the whole visual world is tilted or even inverted—might be a related phenomenon: these occur with both MD and migraine, and possibly even with vertebrobasilar TIAs [44, 45]. Fig.…”
Section: Meniere’s Diseasementioning
confidence: 99%
“…There are now official criteria for the diagnosis of VM [64, 67], even though many migraineurs have other, unofficial, balance problems, such as chronic subjective dizziness [68], motion sensitivity [69], motion sickness [70], constant rocking sensations (mal-de-debarquement) [71], room-tilt illusion [45], and generalized imbalance [72]. And, perhaps as a consequence of the vertigo attacks, VM patients have psychological problems such as anxiety [73], panic attacks [74], and phobias [75].…”
Vestibular disorders manifesting as vertigo, chronic dizziness and imbalance are common problems in neurological practice. Here, we review some recent interesting and important advances in diagnosis of vestibular disorders using the video head impulse test and in the management of benign positional vertigo and migrainous vertigo.
“…In this case, the mean duration of episodes was 135.33 min (n=47, range 3 s–72 hours). However, with significant outliers removed (cases 15, 30, 31, 34, 43, 49 and 52), the mean duration of episodes is 12.09 min (n=40) 2 6 8–11. With removal of non-numerical values, the mean duration of episodes is 177.83 min (n=34), and with additional removal of outliers as well as non-numerical values the mean duration of episodes is 16.07 min (n=29).…”
BackgroundReversal of vision metamorphopsia (RVM) is a rarely reported disorder characterised by rotation of vision, 180 degrees in the coronal plane. A systematic review and analysis of all available reports of RVM was undertaken to identify the clinical picture, underlying aetiology and proposed pathophysiology and to define anatomical localisation.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used Scopus, Web of Science, Ovid, Medline, Embase, PubMed and CINAHL databases to search for articles about RVM. The available articles were published from 1974 to 2022. We summarised the evidence, analysed the data and represented anatomical localisation to provide information on the clinical patterns for diagnostics and management.ResultsTwenty-eight articles fulfilled the selection criteria, providing 52 cases of reported RVM. Reports focused on the clinical picture and evaluation of neurological signs and symptoms. The most common underlying aetiology was a posterior circulation stroke or interruption of the vestibular system. In the analysis, we demonstrated statistically significant differences between ischaemic and vestibular aetiology in the duration of episodes (p=0.03, Z=2.13) and vomiting (p=0.02, Z=2.28) subgroups. Insults present on brain imaging have been mapped via two-dimensional graphical representations (n=16).ConclusionsThis review intends to raise awareness of this unusual phenomenon. Swift recognition of this disorder is paramount and appropriate management should be tailored to the individual aetiology. Brain mapping and analysis of cases may elucidate the anatomical localisation of the central integrator of visuospatial orientation. We suggest that sensory information may be synthesised by a multinucleated visuospatial system to form a visual representation of extrapersonal verticality.
“…Other authors propose that UDRV can occur with any disintegration between vestibular, visual and somatosensory systems that leads to misperception of verticality, and thus it can be a symptom of peripheral vestibular disorders in addition to central lesions 9. Seventeen cases of tilted or fully inverted vision associated with peripheral vestibular disorders, including Meniere’s disease, vestibular neuritis and vestibular deafferentation, have been described 10.…”
Upside-down reversal of vision (UDRV) is a rare form of metamorphopsia, or visual illusions that can distort the size, shape or inclination of objects. This phenomenon is paroxysmal and transient in nature, with patients reporting a sudden inversion of vision in the coronal plane, which typically remains for seconds or minutes, though occasionally persists for hours or days, before returning to normal. Distorted egocentric orientation (ie, the patient perceives the body to be tilted away from the vertical plane) is even more rare as a co-occurring phenomenon. To the best of our knowledge, this is the first reported case of a veteran who presented with UDRV and distorted egocentric orientation during hospitalisation on an inpatient physical medicine and rehabilitation setting following an elective hip surgery. This case serves not only to document the presence of rare visual illusions, but also illustrates the importance and value of an interdisciplinary team approach.
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