ABSTRACT
INTRODUCTION: Cervical vestibular evoked myogenic potential is a test used in neurotological examination. It verifies the integrity of vestibular function through a muscular response evoked by an acoustic stimulation which activates the saccular macula. Normal standards in adults have been established, however, there are few published data on the normal responses in children.OBJECTIVE: To establish normal standards for vestibular myogenic responses in children without neurotological complaints.METHODS: This study's design is a cohort with cross-sectional analysis. The sample consisted of 30 subjects, 15 females (50%) and 15 males (50%).RESULTS: The age of the subjects ranged between 8 and 13 years, with a mean of 10.2 (± 1.7). P1 peak showed an average latency of 17.26 (± 1.78) ms and a mean amplitude of 49.34 (± 23.07) µV, and the N2 peak showed an average latency of 24.78 (± 2.18) ms and mean amplitude of 66.23 (± 36.18) µV. P1-N2 mean amplitude was 115.6 (± 55.7) µV. There were no statistically significant differences when comparing by gender or by laterality.CONCLUSION: We established normal values of cervical myogenic vestibular responses in children between 8 and 13 years without neurotological complaints.
INTRODUÇÃO: O potencial evocado miogênico vestibular cervical (cVEMP) vem sendo empregado como exame complementar em estudos otoneurológicos. Avalia a função vestibular através da resposta muscular originada a partir de uma estimulação acústica que ativa a mácula sacular. O exame foi padronizado em adultos, entretanto, há escassez de dados publicados sobre as respostas obtidas em crianças.OBJETIVO: Estabelecer valores de normalidade das respostas miogênicas vestibulares em crianças sem queixas otoneurológicas.MÉTODO: Estudo de coorte histórica com corte transversal, de 30 sujeitos sem queixas otoneurológicas, 8 a 13 anos.RESULTADOS: A amostra foi composta de 15 meninos e 15 meninas, com idade média de 10,2 (± 1,7 anos). A curva P1 apresentou uma latência média de 17,26 ms (± 1,78) e uma amplitude média −49,34 µV(± 23,07), enquanto a curva N2 apresentou uma latência média de 24,78 ms (±2,18) e uma amplitude média de 66,23 µV (± 36,18). A amplitude P1−N2 foi 115,6 µV (± 55,7). O índice de assimetria foi de 21,3% (± 18,6). Não foram encontradas diferenças estatisticamente significativas quando comparados os sexos. Da mesma forma, não se observou efeito significativo da lateralidade nos resultados.CONCLUSÃO: Foram estabelecidos os valores de normalidade das respostas miogênicas vestibulares cervicais em crianças entre 8 e 13 anos sem queixas otoneurológicas.
Subject(s)
Adolescent , Child , Female , Humans , Male , Muscle Contraction/physiology , Neck Muscles/physiology , Vestibular Evoked Myogenic Potentials/physiology , Cross-Sectional Studies , Electromyography , Reference ValuesABSTRACT
INTRODUCTION: Cervical vestibular evoked myogenic potential is a test used in neurotological examination. It verifies the integrity of vestibular function through a muscular response evoked by an acoustic stimulation which activates the saccular macula. Normal standards in adults have been established, however, there are few published data on the normal responses in children. OBJECTIVE: To establish normal standards for vestibular myogenic responses in children without neurotological complaints. METHODS: This study's design is a cohort with cross-sectional analysis. The sample consisted of 30 subjects, 15 females (50%) and 15 males (50%). RESULTS: The age of the subjects ranged between 8 and 13 years, with a mean of 10.2 (± 1.7). P1 peak showed an average latency of 17.26 (± 1.78)ms and a mean amplitude of 49.34 (± 23.07)µV, and the N2 peak showed an average latency of 24.78 (± 2.18)ms and mean amplitude of 66.23 (± 36.18)µV. P1-N2 mean amplitude was 115.6 (± 55.7)µV. There were no statistically significant differences when comparing by gender or by laterality. CONCLUSION: We established normal values of cervical myogenic vestibular responses in children between 8 and 13 years without neurotological complaints.
Subject(s)
Muscle Contraction/physiology , Neck Muscles/physiology , Vestibular Evoked Myogenic Potentials/physiology , Adolescent , Child , Cross-Sectional Studies , Electromyography , Female , Humans , Male , Reference ValuesABSTRACT
Introduction: Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective: To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion: Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR...
Subject(s)
Biomarkers, Pharmacological , Esophageal pH Monitoring , Laryngopharyngeal Reflux , Laryngoscopy , Diagnosis , Epidemiology , TherapeuticsABSTRACT
Introduction Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.
ABSTRACT
São apresentados dois pacientes do sexo masculino com quadro de vertigem aguda e ataxia da marcha. Em ambos os casos o infarto cerebelar foi a etiologia comprovada pelos exames de neuroimagem. Estes pacientes evoluíram para a recuperação completa dos sintomas vestibulares, em um dos casos o paciente permaneceu com disacusia sensório-neural à esquerda. Acreditamos que pacientes com clínica semelhante devam ser submetidos de rotina a exames radiográficos como a tomografia computadorizada e/ou ressonância nuclear magnética.
