Vestibular rehabilitation with electrotactile vestibular substitution: early effects.

We aimed to determine the early efficacy of vestibular rehabilitation with electrotactile vestibular substitution system (EVSS) as a new treatment modality in patients with bilateral vestibular loss due to aminoglycoside-induced ototoxicity. Six men and four women with bilateral vestibular failure were rehabilitated with EVSS prospectively. Patients were trained with EVSS for ten sessions each lasted 20 min, two sessions per day. Sensory organization test (SOT) protocol and dizziness handicap inventory (DHI) were used to compare pre- and post-training results of the rehabilitative treatment. Post-training tests were done at the first day of post-treatment period. All ten patients in the standardized testing subset demonstrated improved scores in the composite SOT scores and in the functional transfer testing with DHI after 5 days of training with the EVSS. In conclusion, these preliminary results demonstrate efficacy of the EVSS in improving patients symptoms and signs and signify the evidence of sensory substitution in the early post-training period.

Migraine vestibulopathy in three families with idiopathic scoliosis: a case series.

INTRODUCTION: We assessed clinical and etiological association between vestibular pathology and idiopathic scoliosis concerning seven members of three families with idiopathic scoliosis. CASE PRESENTATION: The families were referred to neurotology center for evaluation of balance problems. Patients were evaluated thorough anamnesis to relevant vestibular and audiological studies in addition to idiopathic scoliosis assessment. All evaluated scoliotic patients had clinical manifestations of vestibular dysfunctions and migrainous headache. All of the scoliotic patients (seven patients) in these three families were diagnosed as migraine vestibulopathy. CONCLUSION: With the presentation of these three families, we discussed the probable role of the vestibular dysfunctions including migraine vestibulopathy in the development and progression of idiopathic scoliosis.

Falling sensation in patients who undergo the Epley maneuver: a retrospective study.

The author conducted a retrospective study to determine the prevalence of a falling sensation in patients who underwent the Epley canalith repositioning maneuver for the treatment of benign paroxysmal positional vertigo. The author studied a total of 436 maneuvers performed on 412 patients and observed 58 episodes (13%) of a strong falling sensation, some very severe. In almost every case, the sensation occurred when the patient was moved to the final (sitting) position; in 1 case, the sensation occurred nearly 30 minutes later. The author recommends that physicians who perform the Epley maneuver warn patients of the risk of a falling sensation, take steps to prevent its consequences, and monitor their patients for at least 30 minutes after the completion of the procedure.

Migraine and benign paroxysmal positional vertigo: an outcome study of 476 patients.

To investigate whether migraine is more common in patients with benign paroxysmal positional vertigo (BPPV) than in the general population, the author conducted a retrospective study of 476 patients with BPPV seen over 12 years at a tertiary referral center. Records of patients with a confirmed diagnosis of BPPV followed for 1 to 7 years were reviewed. The typical history of BPPV and the characteristic torsional positional nystagmus were identified in all patients. A modified Epley maneuver was performed for all patients with posterior semicircular canal BPPV, with a 98% success rate. The survey consisted of detailed patient questionnaires and vestibular tests. Migraine and motion sickness were three times more common in patients with BPPV than in the general population. A family history of migraine (58.4%) and vertigo (44.9%) was also more common in patients than in a control group.