ABSTRACT
PURPOSE: The video Head Impulse Test is routinely used to assess semicircular canal function in adults, but to date, pediatric reference values are scarce. This study aimed to explore the vestibulo-ocular reflex (VOR) in healthy children at different development stages and to compare the obtained gain values with reference to those in an adult population. METHODS: This prospective, single-center study recruited 187 children from among patients without otoneurological diseases, healthy relatives of these patients, and staff families from a tertiary hospital. Patients were divided into three groups by age: 3-6 years, 7-10 years, and 11-16 years. The vestibulo-ocular reflex was assessed by video Head Impulse Test, using a device with a high-speed infrared camera and accelerometer (EyeSeeCam®; Interacoustics, Denmark). RESULTS: We found a lower vestibulo-ocular reflex gain of both horizontal canals in the 3-6-year-old group when compared with the other age groups. No increasing trend was found in the horizontal canals from age 7-10 years to age 11-16 years, and no differences were found by sex. CONCLUSION: Gain values in the horizontal canals increased with age until children reached age 7-10 years and matched the normal values for adults.
Subject(s)
Head Impulse Test , Reflex, Vestibulo-Ocular , Adult , Humans , Child , Child, Preschool , Adolescent , Prospective Studies , Semicircular Canals , Reference ValuesABSTRACT
Vestibular Migraine in children can mimic other disorders, especially at presentation. Outcome is hard to predict and management may be challenging due to the fact that many of the patients are too young to describe their symptoms and these are not always accompanied by headache. OBJECTIVE: To assess vestibulo-ocular reflex (VOR) in pediatric patients who meet criteria for defined Vestibular Migraine and to compare results to healthy controls. METHODS: Twenty-one patients aged 11-16 years were included in this prospective multicentric study. VOR was assessed using the video Head Impulse Test by EyeSeeCam®(Interacoustics, Denmark). RESULTS: Patients with Vestibular Migraine (VM) have higher values of gain compared to asymptomatic patients. CONCLUSION: Video Head Impulse Test (vHIT) is a useful and relatively fast-to-perform examination in children compared to other vestibular tests. Patients with VM seem to have higher values of gain at vHIT.
Subject(s)
Head Impulse Test , Migraine Disorders/diagnosis , Migraine Disorders/physiopathology , Reflex, Vestibulo-Ocular , Adolescent , Case-Control Studies , Child , Female , Head Impulse Test/methods , Humans , Male , Prospective StudiesABSTRACT
Los encefaloceles espontáneos son aquellos en los que no se puede determinar un origen. El objetivo del trabajo consiste en describir el tratamiento quirúrgico empleado. Presentamos los 3 últimos casos tratados mediante abordaje combinado transmastoideo y minicraneotomía, y cierre con cartílago y pericondrio conchal. En todos los casos se pudo acometer una correcta localización del encefalocele con un adecuado sellado del defecto óseo. No existieron complicaciones postoperatorias. No existieron recidivas en el periodo de seguimiento. El abordaje transmastoideo tiene la ventaja de permitir la localización del defecto en la base del cráneo sin provocar morbilidad neurológica. Sin embargo, y sobre todo en defectos amplios o de localización más anterior no permite un correcto sellado del defecto óseo y/o un control de todo el volumen de tejido herniado. Debido a estas limitaciones creemos una buena indicación combinar el abordaje transmastoideo con la realización de una minicraneotomía temporal (AU)
Spontaneous encephaloceles are defined as brain herniations with no apparent cause. The aim of this paper is to describe the surgical technique performed in our department. We reviewed the last 3 cases treated with combined approach (transmastoid plus minicraniotomy) with 2-layer closure. In all cases the bone defects were located and successfully sealed. We had no postoperative complications. There were no relapses in our follow-up period. The transmastoid approach has the advantage over the open approach with middle fossa craniotomy in that it locates the bone defect with no brain retraction. Nevertheless, it is not useful in large-sized, multiple or anterior defects. Due to those drawbacks, we think that the combined approach with temporal minicraniotomy is the best choice for this entity (AU)
Subject(s)
Humans , Female , Middle Aged , Aged , Encephalocele/surgery , Mastoid/surgery , Craniotomy/methods , Cerebrospinal Fluid Otorrhea/surgery , Risk Factors , Diagnostic Imaging/methodsABSTRACT
Spontaneous encephaloceles are defined as brain herniations with no apparent cause. The aim of this paper is to describe the surgical technique performed in our department. We reviewed the last 3 cases treated with combined approach (transmastoid plus minicraniotomy) with 2-layer closure. In all cases the bone defects were located and successfully sealed. We had no postoperative complications. There were no relapses in our follow-up period. The transmastoid approach has the advantage over the open approach with middle fossa craniotomy in that it locates the bone defect with no brain retraction. Nevertheless, it is not useful in large-sized, multiple or anterior defects. Due to those drawbacks, we think that the combined approach with temporal minicraniotomy is the best choice for this entity.
