The nystagmus characteristics of two positions of the horizontal semicircular canal cupulolithiasis / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the characteristics of nystagmus of horizontal semicircular canal cupulolithiasis(HSC-Cup) in Roll test and Dix-Hallpike test.@*Methods@#Between December 2016 and December 2017, a total of 164 patients with BPPV from Tianjin First Center Hospital, 124 HSC-Can BPPV and 40 HSC-Cup BPPV, were involved.The induced nystagmus in Roll test and Dix-Hallpike test were recorded by video-nystagmograph(VNG), whose direction and intensity characteristics were compared in various BPPV.@*Results@#HSC-Can patients were induced a horizontal nystagmus with Roll test, the nystagmus intensity of the disease and healthy side were (41.3±20.1)°/s (mean standard deviation)and(21.9±9.4)°/s respectively, the difference was statistically significant (t=6.709, P<0.05). HSC-Cup patients were induced a horizontal nystagmus that was opposite to the direction of the Roll test, the nystagmus intensity of the disease and the healthy side were (12.9±6.4)°/s and(29.1±9.3)°/s respectively, with significant difference (t=9.066, P<0.05). Among 124 cases of HSC-Can patients, 120 cases of horizontal nystagmus were recorded in the left and right sides of the Dix-Hallpike test in the same direction as the turning direction, the horizontal nystagmus intensity of the disease and the healthy sides were (15.1±10.0)°/s and(9.4±7.4)°/s respectively, the difference was statistically significant (t=2.365, P<0.05). And 40 cases of HSC-Cup patients were recorded at the head of the Dix-Hallpike test in the opposite direction to the horizontal eye earthquake.The horizontal nystagmus intensity of the disease and the healthy side were (5.3±2.8)°/s and(13.9±4.4)°/s respectively, the difference was statistically significant (t=10.579, P<0.05).@*Conclusions@#Characteristic horizontal nystagmus can be induced by HSC-Cup in both roll test and Dix-Hallpike test. Preliminary localization of Dix-Hallpike Test can also be used for HSC-Cup.

Avaliação oculomotora em adultos: um estudo do efeito da idade e de alterações visuais / Oculomotor evaluation in adults: a study of the effect of age and visual alterations

RESUMO Objetivo Avaliar os movimentos oculares de sácadas, perseguição e o nistagmo optocinético em adultos, analisando o efeito da idade e das alterações visuais. Métodos Foram avaliados 40 sujeitos de ambos os gêneros, com faixa etária de 20 a 49 anos de idade, sem queixas auditivas ou vestibulares e que apresentaram avaliação audiológica básica dentro dos padrões da normalidade e ausência de nistagmo espontâneo de olhos abertos, nistagmo semi-espontâneo e nistagmo espontâneo de olhos fechados maior que 6º/s. Todos os participantes foram submetidos às provas de nistagmo espontâneo, nistagmo optocinético, movimentos sacádicos fixos, aleatórios e rastreio pendular, por meio da vectoeletronistagmografia computadorizada. Os achados foram analisados segundo as variáveis idade e presença de alteração visual, do tipo ametropias. Os resultados passaram por análise estatística descritiva e inferencial. Resultados Não houve diferença nas provas de nistagmo optocinético, sacádico fixo, aleatório e rastreio pendular, quando analisadas com relação à idade. Quanto à variável alteração visual, a preponderância direcional do nistagmo, observada na prova do nistagmo optocinético, foi maior em indivíduos com alterações visuais. Nos movimentos sacádicos aleatórios, também se observou diferença em relação à velocidade máxima, sendo maior em indivíduos sem alterações visuais. Conclusão As provas oculomotoras não sofreram influência do fator idade na faixa etária pesquisada, porém, a presença de alterações visuais exerceu influência em alguns dos parâmetros das provas oculomotoras.

ABSTRACT Purpose To evaluate saccadic and pursuit ocular movements and optokinetic nystagmus in adults, analyzing the effect of age and visual alterations. Methods We evaluated 40 subjects of both genders, aged 20-49 years, with no auditory or vestibular complaints and who presented a normal basic audiology evaluation, absence of spontaneous nystagmus with open eyes, semi-spontaneous nystagmus, and spontaneous nystagmus with eyes closed greater than 6º/s. All participants underwent the tests of spontaneous nystagmus, optokinetic nystagmus, fixed and random saccadic movements, and pendular tracking using computerized vectoelectronystagmography. The findings were analyzed according to age and visual changes (ametropias). The results underwent a descriptive and inferential analysis. Results There was no difference in the tests of optokinetic nystagmus, fixed and random saccadic movement, and pendular tracking when analyzed with regard to age. As for the variable presence of visual alteration, directional preponderance of nystagmus, observed in the optokinetic nystagmus test, was higher in individuals with visual alterations. In the random saccadic movement, there was also a difference in relation to the maximum velocity, which was higher in individuals with no visual alterations. Conclusion The oculomotor tests were not affected by the age factor in the studied age group, but the presence of visual alterations exerted influence on some of the parameters of the oculomotor tests.

Influence of head posture on the visual acuity of children with nystagmus / Influência da postura da cabeça na acuidade visual de crianças com nistagmo

Purpose: Evaluate the relationship between the postural alignment of the head and possible interference in the view of children. Methods: We evaluated 11 children between 2 and 7 years of age of both sexes, with the visually impaired, who had nystagmus and head lock position. The test Lea Grating Acuity Test® was used to collect measurements of visual acuity. This applied on two occasions: with and without postural alignment of the head. For reliability of the postural alignment of the head, the slopes were measured by Fisiologic® software. Results: The children had a poorer performance after physiological postural alignment. This poor performance is possible due to loss of position lock nystagmus to gain postural alignment, said to be ideal. Postural compensations were observed, and sharply increased eyestrain. Conclusion: The pursuit of traditional postural alignment affect the visual response of children with visual impairments. .

Objetivo: Avaliar a relação entre o alinhamento postural da cabeça e a possível interferência na visão de crianças. Métodos: Foram avaliadas 11 crianças, entre 2 e 7 anos de idade de ambos os sexos, com o diagnóstico de deficiência visual, que apresentavam nistagmo e posição de bloqueio de cabeça. O teste Lea Grating Acuity Test® foi utilizado para coletar medidas de acuidade visual. Este aplicado em dois momentos: sem e com o alinhamento postural da cabeça. Para confiabilidade do alinhamento postural da cabeça, as inclinações foram medidas pelo software Fisiologic®. Resultados: As crianças apresentaram pior desempenho após o alinhamento postural fisiológico. Este pior desempenho é possível devido à perda da posição de bloqueio do nistagmo para ganho do alinhamento postural, dito como ideal. Foram observadas compensações posturais e maior esforço visual. Conclusão: A busca do alinhamento postural tradicional prejudica a resposta visual de criança com deficiência visual. .

A Case of Sjogren's Syndrome Presented with Vertigo as a Initial Manifestation / 대한평형의학회지

Sjogren's syndrome (SS) can shows various neurologic symptoms as it involves the central, peripheral and autonomic nervous system. However, CNS involvement as a initial manifestation is rare. We report a 21-year old woman who presented with vertigo, gait ataxia, and hiccup lasted about one month due to a discrete dosal medullary lesion in primary SS. The symptoms and lesions improved by the intravenous methylprednisolone therapy