Vibration‐ and Hyperventilation‐Induced Nystagmus in Patients with Ramsay Hunt Syndrome with Vertigo

Kim, Chang-Hee; Jeong, Kyung-Hwa; Ahn, Sung Hwan; Shin, Dong Hyuk; Kim, Yongwon; Shin, Jung Eun

doi:10.1177/0194599815570283

Cited by 15 publications

(18 citation statements)

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“…[5,8] Involvement of both inner ear end organs and CN VIII was demonstrated by histopathological studies which showed that inflammatory cell infiltration occurred in the vestibular and cochlear nerve ganglia, and a degeneration of inner ear end organs was observed in patients with RHS. [1,16,17] Studies of RHS patients with vestibular deficit have demonstrated that lesioned sites responsible for vestibular disturbance may reside in the vestibular nerve, [5,7,18,19] end organ, [20] or both. [21] Studies in RHS patients with hearing loss have reported that the pattern of hearing loss can be cochlear, retrocochlear, or both.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the observations that the superior vestibular nerve is directly connected to the facial nerve in the internal auditory canal (IAC), [22] the vestibular deficit in the patients with RHS has been often postulated to be attributed to a direct spread of VZV via neural anastomosis. [5,7,18,19] In contrast, a direct connection between the facial nerve and cochlear nerve has not been reported, even though anastomosis between the cochlear nerve and saccular nerve has been observed. [23] Therefore, cochlear deficit may be caused by viral spread from the facial nerve into the cerebrospinal fluid (CSF) or perilymph within the IAC rather than via direction neural connection.…”

Section: Discussionmentioning

confidence: 99%

“…When spontaneous nystagmus was present, it was subtracted from the SPV of VIN. When all the SPVs from the 4 different stimulation sites (both mastoid bones and SCM muscles) were 2°/s or greater or SPVs from both mastoid bones and SCM muscles were 5°/s or greater, [7] VIN was considered abnormal. To conduct hyperventilation-induced nystagmus (HVIN), the patients were instructed to open their mouths and take deep and rapid breaths for 90 seconds.…”

Section: Methodsmentioning

confidence: 99%

“…[4] It was reported that a lesioned site in RHS patients with vertigo may be more likely within the vestibular nerve than the inner ear as a cause for vestibular deficit because the results of vestibular function tests in RHS patients with vertigo were more similar to those in vestibular neuritis patients than those in sudden sensorineural hearing loss with vertigo. [7] RHS patients with vertigo exhibited lower electroneuronography (ENoG) value of facial nerve suggesting more severe nerve degeneration compared with those without vertigo, even though ENoG values were not significantly different between patients with and without hearing loss. [8] …”

Section: Introductionsmentioning

confidence: 99%

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Characteristics of hearing loss in patients with herpes zoster oticus

2016

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Patients with herpes zoster oticus (HZO) may commonly show symptoms associated with 7th and 8th cranial nerve (CN VII and CN VIII) dysfunction. The aim of this study is to investigate the characteristics of hearing loss in patients with HZO and discuss possible mechanisms.Ninety-five HZO patients who showed at least one of the symptoms of CN VII and CN VIII dysfunction between January 2007 and October 2014 were included in this study. Hearing loss was defined when the mean thresholds of pure tone audiometry (PTA) in speech frequency (0.5 kHz + 1 kHz + 2 kHz/3) or isolated high frequency (4 kHz + 8 kHz/2) were greater than 10 dB in the affected ear compared with the healthy ear, and a total of 72 patients were classified as the hearing loss group.The difference of mean PTA thresholds between affected and healthy ears was significantly greater in the high frequency range than in low range (20.0 ± 11.5 dB vs. 12.9 ± 15.7 dB, P = 0.0026) in patients with hearing loss (n = 72). The difference between affected and healthy ear was significantly greater in patients with vertigo (n = 34) than those without vertigo (n = 38) in both the high (P = 0.033) and low (P = 0.024) frequency ranges. In contrast, the differences between affected and healthy ears were not significantly different between patients with facial palsy (n = 50) and those without facial palsy (n = 22) in both the high (P = 0.921) and low (P = 0.382) frequency ranges.In patients with HZO, hearing loss is more severe in the high frequency range than in the low frequency range. Hearing impairment is more severe in patients with vertigo than in those without vertigo in both the high and low frequency ranges, even though the degree of hearing impairment is not significantly different between patients with and without facial palsy. These findings indicate that the mechanisms of viral spread from CN VII to CN VIII may differ between vestibular and audiologic deficits.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionsmentioning

confidence: 99%

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Characteristics of hearing loss in patients with herpes zoster oticus

2016

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“…Nystagmus is repetitive, to-and-fro movement of the eyes that is initiated by slow phases, and may provide importation information in the diagnosis of vestibular disorders. The nystagmus which has been observed in SSNHL_V can be either spontaneous nystagmus without positional component [ 9 , 10 ] or positional nystagmus similar to benign paroxysmal positional vertigo (BPPV). [ 11 – 13 ]…”

Section: Introductionsmentioning

confidence: 99%

Patterns of nystagmus conversion in sudden sensorineural hearing loss with vertigo

Kim

Choi²,

Choi³

et al. 2018

Medicine

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Comparative Analysis of Vestibular Dysfunction and Compensation in Ramsay‐Hunt Syndrome and Vestibular Neuritis

Lovin,

Vrabec

2024

Otolaryngol.--head neck surg.

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ObjectiveTo investigate vestibular loss and compensation in Ramsay‐Hunt syndrome with dizziness (RHS‐D) and vestibular neuritis (VN).Study DesignRetrospective cohort study from 2019 to 2023.SettingTertiary care neurotology practice.MethodsPatients with RHS‐D or VN who underwent videonystagmography, including cervical vestibular evoked myogenic potential (cVEMP), caloric stimulation, rotary chair, and oculomotor testing, were reviewed and stratified by vertigo etiology. The main outcome measures were rates and severity of vestibular loss, as measured by cVEMP and caloric stimulation, and of vestibular compensation, as measured by rotary chair and oculomotor testing.ResultsTen patients were found to have RHS‐D and 22 with VN. Caloric and cVEMP abnormalities were noted in 100 and 70% of RHS‐D patients compared to 60 and 20% with VN (P = .029 and P = .034, respectively). RHS‐D patients were significantly more likely to present with concurrent caloric and cVEMP abnormalities compared to VN (70 and 13%, respectively; P = .009). Vestibular loss appeared more severe in RHS‐D compared to VN suggested by significantly lower mean bithermal slow phase velocity sum (3.8 and 21 degrees per second, respectively), greater canal paresis (78.7 and 40.2%, respectively), and greater cVEMP amplitude asymmetry (64 and 31%, respectively) (P = .014, P < .001, and P = .053, respectively). Regarding vestibular compensation, abnormal gain asymmetry was present in 88% of RHS‐D patients with a mean asymmetry of 31.2 compared to 11% in VN with a mean of 14.0 (P = .019 and P = .003, respectively).ConclusionCompared to VN, RHS‐D patients appear to suffer from a more profound vestibular loss and a worsened ability to compensate for such deficits.

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Vibration‐ and Hyperventilation‐Induced Nystagmus in Patients with Ramsay Hunt Syndrome with Vertigo

Cited by 15 publications

References 38 publications

Characteristics of hearing loss in patients with herpes zoster oticus

Characteristics of hearing loss in patients with herpes zoster oticus

Patterns of nystagmus conversion in sudden sensorineural hearing loss with vertigo

Comparative Analysis of Vestibular Dysfunction and Compensation in Ramsay‐Hunt Syndrome and Vestibular Neuritis

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