Vestibular neuritis: Vertigo and the high-acceleration vestibulo-ocular reflex

Palla, Antonio; Straumann, Dominik; Bronstein, Adolfo M.

doi:10.1007/s00415-008-0935-2

Cited by 47 publications

(42 citation statements)

References 21 publications

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“…No correlation between the total VSS score in patients and adjustment errors when upright was observed, putting the functional relevance of such improvements into question. This discrepancy is in agreement with a previous report showing lack of correlation between SCC function after vestibular neuritis and subjective complaints (Palla et al , 2008).…”

Section: Subjective Judgment Of Vertigo/dizzinesssupporting

confidence: 92%

Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Müller

Bockisch

Tarnutzer

2016

Clinical Neurophysiology

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OBJECTIVE Acute unilateral peripheral-vestibular hypofunction (UVH) shifts the subjective visual vertical (SVV) ipsilesionally, triggering central compensation that usually eliminates shifts when upright. We hypothesized that compensation is worse when roll-tilted. METHODS We quantified SVV errors and variability in different roll-tilted positions (0°, ±45°, ±90°) in patients with chronic UVH affecting the superior branch (SVN; n=4) or the entire (CVN; n=9) vestibular nerve. RESULTS Errors in SVN and CVN were not different. When roll-tilted ipsilesionally 45°(9.6±5.4°vs. -0.2±6.4°, patients vs. controls, p<0.001) and 90°(23.5±5.7°vs. 16.8±8.8°, p=0.003), the patient's SVV was shifted significantly towards the lesioned ear. When upright, only a trend was noted (3.6±2.2°vs. 0.0±1.2°, p=0.099); for contralesional roll-tilts shifts were not different from controls. Variability was larger for CVN than SVN (p=0.046). With increasing disease-duration, adjustment errors decayed for ipsilesional roll-tilt and upright (p0.025). CONCLUSIONS The reason verticality perception was distorted for ipsilesional roll-tilts, may be the insufficient integration of contralesional otolith-input. Similar errors in SVN and CVN suggest a dominant utricular role in verticality perception, albeit the sacculus may improve precision of SVV estimates. SIGNIFICANCE With deficiencies in central compensation being roll-angle dependent, extending SVV-testing to roll-tilted positions may improve identifying patients with chronic UVH. Highlights:• Visual vertical (VV) was measured in 13 patients with chronic unilateral vestibular hypofunction.• VV shifts in the patients were significant only when rolled ipsilesionally.• Thus VV testing in roll-tilted positions is recommended to identify more subtle vestibular deficits. 3 AbstractObjective: Acute unilateral peripheral-vestibular hypofunction (UVH) shifts the subjective visual vertical (SVV) ipsilesionally, triggering central compensation that usually eliminates shifts when upright. We hypothesized that compensation is worse when roll-tilted. Methods

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Section: Subjective Judgment Of Vertigo/dizzinesssupporting

confidence: 92%

Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Müller

Bockisch

Tarnutzer

2016

Clinical Neurophysiology

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“…The poor correlation between severity of subjective symptoms and asymmetry or gain after VN has been noticed before [9]. In the present study we were able to find a significant but modest correlation between objective function deficit and subjective sensation months after the lesion.…”

Section: Discussionsupporting

confidence: 45%

“…In contrast, the ipsilesional horizontal VOR gain in high frequencies improved ultimately in some patients after VN [8]. This recovery was mostly incomplete, occurring later than 4 weeks after the onset of VN, but serial data on the gain improvement were limited to only 10-12 patients [8,9].…”

Section: Introductionmentioning

confidence: 93%

Recovery of the horizontal vestibulo-ocular reflex in motorized head impulse test is common after vestibular loss

Jutila¹,

Aalto²,

Hirvonen³

2012

Acta Oto-Laryngologica

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“…Although there is no consensus on a diagnosis for these patients, explanations for the prolongation of symptoms range from psychological disorders [2][3][4] to defective central compensation of the initial peripheral vestibular insult [5,6]. Amongst reasons for the latter, several authors have hypothesised that increased reliance on, or high sensitivity to, visual input could interfere with full vestibular recovery in some patients.…”

Section: Introductionmentioning

confidence: 99%

Visual dependence and BPPV

et al. 2011

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The increased visual dependence noted in some vestibular patients may be secondary to their vertigo. We examine whether a single, brief vertigo attack, such as in benign paroxysmal positional vertigo (BPPV), modifies visual dependency. Visual dependency was measured before and after the Hallpike manoeuvre with (a) the Rod and Frame and the Rod and Disc techniques whilst seated and (b) the postural sway induced by visual roll-motion stimulation. Three subject groups were studied: 20 patients with BPPV (history and positive Hallpike manoeuvre; PosH group), 20 control patients (history of BPPV but negative Hallpike manoeuvre; NegH group) and 20 normal controls. Our findings show that while both patient groups showed enhanced visual dependency, the PosH and the normal control group decreased visual dependency on repetition of the visual tasks after the Hallpike manoeuvre. NegH patients differed from PosH patients in that their high visual dependency did not diminish on repetition of the visual stimuli; they scored higher on the situational characteristic questionnaire ('visual vertigo' symptoms) and showed higher incidence of migraine. We conclude that long term vestibular symptoms increase visual dependence but a single BPPV attack does not increase it further. Repetitive visual motion stimulation induces adaptation in visual dependence in peripheral vestibular disorders such as BPPV. A positional form of vestibular migraine may underlie the symptoms of some patients with a history of BPPV but negative Hallpike manoeuvre. The finding that they have non adaptable increased visual dependency may explain visuo-vestibular symptoms in this group and, perhaps more widely, in patients with migraine.

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Vestibular neuritis: Vertigo and the high-acceleration vestibulo-ocular reflex

Cited by 47 publications

References 21 publications

Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted

Recovery of the horizontal vestibulo-ocular reflex in motorized head impulse test is common after vestibular loss

Visual dependence and BPPV

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