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Idiopathic Bilateral Vestibulopathy


Presentation

  • As acoustic stimulation, 95 dB nHL clicks and short tone bursts (500 Hz) were presented, while 3 mA (1 ms) short-duration galvanic stimuli were presented as electrical stimulation. Responses were recorded on the sternocleidomastoid muscles.[ncbi.nlm.nih.gov]
  • As short-duration galvanic stimuli, a 3-mA (1 ms) electricalcurrent was presented [4,5].[docslide.fr]
  • This usually presents in a variety of ways including, but not limited to, general dizziness at rest or with head turning, feelings of unsteadiness liking to being on a boat, or a sense of nausea similar to motions sickness.[physiologicnyc.com]
Skin Lesion
  • She had oscillopsia and unsteadiness of gait when the typical skin lesion of chicken pox was improving.[e-rvs.org]
Benign Paroxysmal Positional Vertigo
  • Benign Paroxysmal Positional Vertigo, or BPPV One of the most common reasons people seek vestibular therapy is for the ever elusive, and always annoying, Benign Paroxysmal Positional Vertigo, or BPPV.[physiologicnyc.com]
  • Diagnosis of single- or multiple-canal benign paroxysmal positional vertigo according to the type of nystagmus. International Journal of Otolaryngology. 2011;2011: 1-13. 6. Hain, TC. Benign paroxysmal positional vertigo.[pthaven.com]
  • Topic Overview What is benign paroxysmal positional vertigo (BPPV)? Vertigo is the feeling that you are spinning or the world is spinning around you. Benign paroxysmal positional vertigo is caused by a problem in the inner ear .[healthlinkbc.ca]
Dysmetria
  • […] features of bilateral vestibulopathy include absence of spontaneous vertigo and nystagmus; inability to walk in the dark or on uneven or soft surfaces, unless by holding on to the wall or objects in the room (ie, use of contact cues); Romberg sign; no dysmetria[medlink.com]

Workup

  • About 20% of cases of bilateral vestibulopathy, however, remain “idiopathic” despite extensive diagnostic workup. 1 Prompted by studies on immune mediated sensorineural hearing loss, 2, 3 we previously demonstrated IgG antibodies against the membranous[jnnp.bmj.com]
  • Purkinje cells) Clinical Features Epidemiology Female: 80% (US study); 15% (European study) White: 98% Age of onset: Mean 60's; Range 39 to 83 Tobacco smoking: 95% Onset Painful paresthesias & dysesthesias Asymmetric; Distal or Proximal No tumor at initial workup[neuromuscular.wustl.edu]
Staphylococcus Aureus
  • Certain bacteria, such as methacillin-resistant staphylococcus aureus (MRSA) are so difficult to treat that ototoxic medications may be required to save a persons life.[dizziness-and-balance.com]
  • Certain bacteria, such as methicillin-resistant Staphylococcus aureus are so difficult to treat that ototoxic medications may be required to save a person's life.[ejo.eg.net]

Treatment

  • Treatment [ edit ] Treatment differs depending on the cause. Each cause has a different treatment, and may involve either medical treatment, surgery, or therapy.[en.wikipedia.org]
  • This delayed diagnosis places patients at risk for unnecessary diagnostic tests and delayed initiation of treatment.[frontiersin.org]
  • Patients will be randomized into 3 arms; 1) Placebo only, 2) Short corticosteroid treatment (3days) 3) Longer corticosteroid treatment (11 days).[clinicaltrials.gov]
  • These decreased in parallel with clinical improvement after immunomodulatory treatment.[jnnp.bmj.com]
  • The treatment options for various forms of BVH could be one of the following four lines of treatment: (a) Preventive treatment through prevention of ototoxicity, (b) therapeutic treatment through medical treatment of the causative underlying disease,[ejo.eg.net]

Prognosis

  • Abstract Generally, the prognosis of vestibular neuronitis is considered favorable due to vestibular compensation.[jstage.jst.go.jp]
  • One can predict prognosis based on the amount of damage done initially, modified by other factors such as age, and other medical problems.[theblackriver.net]
  • MRI Connects Vestibulopathy and Damage From Brain Injury (HealthDay News) — Damage to specific brain regions may be linked to the prognosis of concussion patients with vestibulopathy , according to a study published online April 14 in Radiology .[empr.com]
  • Thus the prognosis of BV is less favourable than assumed.[epub.ub.uni-muenchen.de]

Etiology

  • The etiology of BVP remains unclear in more than 50% of patients: in these cases neurodegeneration is assumed.[ncbi.nlm.nih.gov]
  • Sommer C, Geber C, Young P, Forst R, Birklein F, Schoser B: Polyneuropathies—etiology, diagnosis, and treatment options. Dtsch Arztebl Int 2018; 115: 83–90 VOLLTEXT 1.[aerzteblatt.de]
  • We measured horizontal and vertical semicircular canal function using the video-head-impulse test (vHIT) and hypothesized that specific vHIT-patterns may be linked to certain etiologies.[zora.uzh.ch]
  • Subject Adult; Head Movements; Humans; Male; Nystagmus, Pathologic/complications; Reflex, Vestibulo-Ocular/physiology; Vestibular Diseases/complications; Vestibular Diseases/physiopathology; Vision Disorders/classification; Vision Disorders/etiology;[collections.lib.utah.edu]
  • Canal and saccular function did not vary according to etiology. Further, utricular but not saccular function was significantly correlated with canal function.[springermedizin.de]

Epidemiology

  • Wladislavosky-Waserman P, Facer GW, Mokri B, Kurland LT (1984) Meniere’s disease: a 30-year epidemiologic and clinical study in Rochester, Mn, 1951–1980.[link.springer.com]
  • NMJ, Nerve, Spinal, Ataxia, Antibody & Biopsy, Patient Info Sensory Neuronopathies 14 Paraneoplastic Sensory Neuronopathy with Anti-Hu Antibodies 1 Anti-Hu Antibodies Staining of neuronal nuclei (Cerebellar granule & Purkinje cells) Clinical Features Epidemiology[neuromuscular.wustl.edu]
  • Zingler VC, Cnyrim C, Jahn K et al (2007) Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. Ann Neurol. 61(6):524–532 PubMed CrossRef 3.[springermedizin.de]
  • Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7): 710. 2. Oas JG. Benign paroxysmal positional vertigo: a clinican's perspective. ANn N Y Acad Sci. 2001;942: 201-209. 3.[pthaven.com]
  • E. ( 1969 ) Epidemiological features of diffuse connective tissue disorders in Rochester Minnesota 1951 through 1967. Mayo Clinic Proceedings, 44 : 649. Lake-Bakaar, G., Gibbs, D.[cambridge.org]
Sex distribution
Age distribution

Pathophysiology

  • Understanding the pathophysiology of bilateral vestibulopathy may suggest possible causes for the gradual decline in vestibular function that occurs with normal aging.[thieme-connect.com]
  • Overview The author explains the clinical presentation, pathophysiology, prevention, diagnostic work-up, and management of bilateral vestibulopathy. Gait ataxia and oscillopsia are the key clinical features of bilateral vestibulopathy.[medlink.com]
  • A compilation of research topics from around the world, this book provides the latest knowledge on the neuropathy of the auditory and vestibular eighth cranial nerves, with valuable information on pathophysiology and genetics, new subtypes, and recent[books.google.com]
  • In order to address the latest research in bilateral vestibulopathy, this Research Topic will include themes such as an exploration of the large class of patients with bilateral vestibulopathy currently considered idiopathic, by identifying novel pathophysiologic[frontiersin.org]
  • The character and direction of the nystagmus are specific to the part of the inner ear affected and the pathophysiology.[emedicine.medscape.com]

Prevention

  • Five of the 29 patients (17%) with IBV required assistance to prevent falling with eyes closed/foam rubber.[ncbi.nlm.nih.gov]
  • CK132 STEADI – Stopping Elderly Accidents, Deaths & Injuries Check for Safety Brochure: A Home Fall Prevention Checklist Caregiver Brochure: Protect your Loved Ones from Falling Older Adult Falls: A Growing Danger Stay Independent: Prevent Falls Elderly[tampabayhearing.com]
  • Overview The author explains the clinical presentation, pathophysiology, prevention, diagnostic work-up, and management of bilateral vestibulopathy. Gait ataxia and oscillopsia are the key clinical features of bilateral vestibulopathy.[medlink.com]

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