The Effect of Eye Closure Upon the Pathological Vestibular Spontaneous Nystagmus

Mulch, G.; Bonrier, C.

doi:10.3109/00016487609119975

Cited by 6 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 1 summarizes the methods and results for the 10 RCTs with 918 participants that were not included in the quantitative analysis. Most of these studies were excluded because the results lacked sufficient detail (eg, only provided P values, no raw numbers).…”

Section: Resultsmentioning

confidence: 99%

“…Most of these studies were excluded because the results lacked sufficient detail (eg, only provided P values, no raw numbers). Diazepam (4 trials) was the only benzodiazepine studied among these 10 RCTs. In 1 trial, diazepam resulted in lower “severity of vertigo” at 2 hours compared with methylprednisolone.…”

Section: Resultsmentioning

confidence: 99%

“…In 1 trial, diazepam resulted in lower “severity of vertigo” at 2 hours compared with methylprednisolone. The other 3 trials compared diazepam with antihistamines: 2 reported a greater reduction in vertigo symptoms or nystagmus with antihistamines, and 1 reported no difference between diazepam and promethazine with regard to the duration of vertigo . Nine studies included antihistamines against other comparators.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies compared antihistamines against repositioning maneuvers: 1 study reported no difference at 1 month and the other reported that the repositioning maneuver was superior. Five studies compared antihistamines with placebo or no treatment, and all reported benefit with antihistamines across several different primary outcomes.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of Benzodiazepines or Antihistamines for Patients With Acute Vertigo

et al. 2022

View full text Add to dashboard Cite

IMPORTANCE Acute vertigo can be disabling. Antihistamines and benzodiazepines are frequently prescribed as "vestibular suppressants," but their efficacy is unclear.OBJECTIVE To assess the efficacy of antihistamines and benzodiazepines in the treatment of acute vertigo from any underlying cause.DATA SOURCES We searched the PubMed, CENTRAL, EMBASE, CINAHL, Scopus, and ClinicalTrials.gov databases from inception to January 14, 2019, without language restrictions. Bibliographies of the included studies and relevant reviews were also screened. STUDY SELECTIONWe included randomized clinical trials (RCTs) comparing antihistamine or benzodiazepine use with another comparator, placebo, or no intervention for patients with a duration of acute vertigo for 2 weeks or less. Studies of healthy volunteers, prophylactic treatment, or induced vertigo were excluded, as were studies that compared 2 medications from the same class. DATA EXTRACTION AND SYNTHESIS Following Preferred Reporting Items for SystematicReviews and Meta-analyses (PRISMA) guidelines, data were extracted and risk of bias was assessed by 2 authors independently for each study. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESThe predefined primary outcome was change in 10-or 100-point vertigo or dizziness visual analog scale (VAS) scores at 2 hours after treatment. Secondary outcomes included change in nausea VAS scores at 2 hours, use of rescue medication at 2 hours, and improvement or resolution of vertigo at 1 week or 1 month. RESULTSOf the 27 trials identified in the systematic review, 17 contributed to the quantitative meta-analysis and involved a total of 1586 participants. Seven trials with a total of 802 participants evaluated the primary outcome of interest: single-dose antihistamines resulted in significantly more improvement on 100-point VAS scores compared with benzodiazepines (difference, 16.1 [95% CI, 7.2 to 25.0]) but not compared with other active comparators (difference, 2.7 [95% CI, -6.1 to 11.5]). At 1 week and 1 month, neither daily benzodiazepines nor antihistamines were reported to be superior to placebo. RCTs comparing the immediate effects of medications (at 2 hours) after a single dose generally had a low risk of bias, but those evaluating 1-week and 1-month outcomes had a high risk of bias. CONCLUSIONS AND RELEVANCEModerately strong evidence suggests that single-dose antihistamines provide greater vertigo relief at 2 hours than single-dose benzodiazepines. Furthermore, the available evidence did not support an association of benzodiazepine use with improvement in any outcomes for acute vertigo. Other evidence suggested that daily antihistamine use may not benefit patients with acute vertigo. Larger randomized trials comparing both antihistamines and benzodiazepines with placebo could better clarify the relative efficacy of these medications.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Benzodiazepines or Antihistamines for Patients With Acute Vertigo

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Rotating someone in darkness is an artificial condition that is known to reduce the gain of the VOR (10,11). Also the situation of eye closure is known to influence the intensity of nystagmus (12). Moller et al (13) established a significant decrease of gain during rotation at all frequencies with eyes closed compared with eyes open in the dark.…”

Section: Discussionmentioning

confidence: 99%

Influence of Head Position on the Vestibulo-ocular Reflex During Rotational Testing

Stappen

Wuyts²,

Heyning³

1999

Acta Oto-Laryngologica

View full text Add to dashboard Cite

The influence of two static head positions on the horizontal nystagmus induced by sinusoidal rotational stimulation in a group of 24 healthy subjects was investigated. The rotation test was performed with the subject's head in the primary position (upright) and with the head 30 degree pitched down. Computerized electronystagmography was used to measure the maximum slow component velocity of the horizontal nystagmus and to calculate gain, phase and asymmetry. The vestibulo-ocular reflex (VOR) gain obtained during rotation with the head in the primary position was significantly higher than with the head bent 30 degree forward. No other significant differences were found.

show abstract

Spontaneous and positional nystagmus in healthy persons demonstrated only by electronystagmography: Physiological spontaneous nystagmus or ?functional scar??

Mulch

Lewitzki

1977

Arch Otorhinolaryngol

View full text Add to dashboard Cite

We wanted to ascertain whether a physiological horizontal vestibular spontaneous nystagmus is existent, or whether the spontaneous and positional nystagmus seen in clinically healthy persons in the electronystagmogram -- when fixation had been excluded completely -- was always the result of earlier damages to the vestibular system (Jatho). For this purpose we tried to detect a spontaneous and positional nystagmus in 102 healthy persons from 6 age groups (17 each) between 11 and 70 years of age. When the ENG was registered with open eyes in darkness, 63 out of the 102 test persons had a horizontal spontaneous or positional nystagmus, however, under the Frenzel glasses there was a nystagmus in only 2 out of these test persons. With open eyes in darkness, the frequency and intensity was the same in all age groups. With this, we believe to have proved that a physiological horizontal vestibular nystagmus does exist. We share Kornhuber's opinion that the examination with the Frenzel glasses in a dark room, together with the head shaking test and positional test, at the present time represents the best method for differentiating between physiological and pathological spontaneous nystagmus.

show abstract

The Effect of Eye Closure Upon the Pathological Vestibular Spontaneous Nystagmus

Cited by 6 publications

References 15 publications

Efficacy of Benzodiazepines or Antihistamines for Patients With Acute Vertigo

Efficacy of Benzodiazepines or Antihistamines for Patients With Acute Vertigo

Influence of Head Position on the Vestibulo-ocular Reflex During Rotational Testing

Spontaneous and positional nystagmus in healthy persons demonstrated only by electronystagmography: Physiological spontaneous nystagmus or ?functional scar??

Contact Info

Product

Resources

About