Vértigo posicional paroxístico benigno del canal horizontal / Benign paroxysmal positional vertigo of the horizontal semicircular canal

Objetivo: Aportación de 8 nuevos casos de vértigo posicional paroxístico benigno del canal horizontal (VPPBCH), dada la presentación poco común de esta variante de vértigo posicional. Realización del estudio oculográfico de la respuesta nistágmica mediante Electrooculografía (EOG), técnica que permite estudiar con detalle las características de los nistagmos. Material y método: Estudio retrospectivo de 8 pacientes con VPPB-CH y con maniobra diagnóstica de rotación de la cabeza objetivada mediante Electrooculografía (EOG). Se analizó mediante esta técnica las características de la respuesta nistágmica. Se investigó también la existencia de posibles alteraciones en otras pruebas de EOG. Resultados: La respuesta nistágmica observada con mayor frecuencia fue un nistagmo horizontal bilateral de dirección cambiante geotrópico que lo presentaron 7 de los 8 pacientes del estudio. Hubo 1 paciente en el que el nistagmo fue horizontal ageotrópico. Hubo 5/8 pacientes con alteración de la prueba calórica. Conclusiones: Se constata que el VPPB-CH es una entidad poco frecuente. En la mayoría de los casos al realizar la maniobra de provocación se procude un nistagmo horizontal bilateral de dirección cambiante geotrópico que tendría su explicación en la canalitiasis del canal semicircular horizontal. Existe un pequeño número de casos en los cuales la respuesta nistágmica sería horizontal ageotrópica que implicaría cupulolitiasis o localización de las partículas en la parte anterior del canal. La prueba calórica, que aparece alterada en muchos de los casos, puede ayudar a determinar el oído afectado

Objective: Assesment of 8 new cases of benign paroxysmal positional vertigo of the horizontal semicircular canal (BPPV-HC), since this variant of benign positional vertigo occurs rarely. An oculographic study of features in the positional response was carried out. Electrooculograpy (EOG) allows an exhaustive study of positional nystagmus. Material and methods: We have studied retrospectively 8 patients with BPPV-HC and positive head rotation manoeuvre registered by EOG techniques. Possible alterations in other EOG tests in the group of patients were analyzed. Results: Most of the patients (7/8) expressed bilateral horizontal geotropic changing-direction nystagmus. One patient exhibited apogeotropic horizontal nystagmus. 5/8 cases showed caloric hypofunction. Conclusions: We have proven that BPPVHC is an uncommon disorder. In most of the cases, provocative manoeuver generates bilateral horizontal geotropic changing-direction nystagmus that probably is due to canalitiasis of the horizontal semicircular canal. The rest, a few cases, exhibit apogeotropic horizontal response that can be secondary to cupulolitiasis or location particles in the anterior portion of the horizontal canal. A caloric test showed abnormal in many and can help to locatize the affected ear

[Oculographic findings in 145 patients with benign paroxysmal positional vertigo]. / Hallazgos oculográificos en 145 pacientes con vértigo posicional paroxístico benigno.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) can be produced by specific manoeuvres and be studied by electrooculography (EOG). It allows an exhaustive study of features in the positional nystagmus. Although most of the patients with BPPV express typical nystagmus, there exists a group of them that exhibit a non typical form. In this work, a comparative study was carried out between two groups of patients. MATERIAL AND METHODS: We have studied retrospectively 145 patients with BPPV and Dix-Hallpicke (D-H) positive manoeuvre registered by EOG techniques. All patients were explored in a complete EOG tests. Two groups were identified: typical response/atypical response according to the features of nystagmus response. Possible alterations in other EOG tests in each group were investigated and differences between both types of response were analyzed. RESULTS: 83.5% of cases showed typical nystagmus and atypical in the rest. Other EOG alterations observed in these patients, were (group typical response/atypical response): caloric hypofunction (17.3%/23%), positional nystagmus (12.4%/62.5%), alterations in visual-oculomotor function tests (10%/50%). CONCLUSIONS: Frequent alterations were observed in the classic manoeuvres and also in the rest of EOG tests. Probably atypical response in the first is due to or can explain the existence of the second.

Hallazgos oculográficos en 145 pacientes con vértigo posicional paroxístico benigno / Oculographic findings in 145 patients with benign paroxysmal positional vertigo

Objetivo: En los pacientes afectados por vértigo posicional paroxístico benigno (VPPB), el nistagmo provocado por las maniobras posicionales clásicas puede ser recogido mediante electrooculografía (EOG), que permite estudiar con detalle sus características. Aunque la respuesta nistágmica suele tener unas características típicas, existe un grupo de pacientes que presentarán una respuesta atípica. En este trabajo se realizó un estudio comparativo entre ambos grupos de pacientes. Material y método: Estudio retrospectivo de 145 pacientes con VPPB y con maniobra de Dix-Hallpike (D-H) positiva objetivada mediante EOG. Se hizo una clasificación en dos grupos: respuesta típica/respuesta atípica, según la secuencia nistágmica obtenida. Se investigó la existencia de alteraciones en otras pruebas de EOG en uno y otro grupo y se analizaron las diferencias entre ambos tipos de respuesta. Resultados: El nistagmo típico se dio en el 83,4% de casos, apareciendo en el resto de los casos con algún rasgo atípico. Se asociaron alteraciones en otras pruebas de EOG: (grupo de pacientes con respuesta típica/atípica): hipofunción calórica: (17,3%/50%), nistagmo de posición: (12,4%/62,4%), alteración de pruebas de función visuo-oculomotora: (10%/50%). Conclusiones: Existencia de frecuentes alteraciones tanto en las maniobras posicionales clásicas como en el resto de pruebas de EOG practicadas. La respuesta atípica en las primeras es probablemente debida o explica la existencia de las segundas

Objective: Benign paroxysmal positional vertigo (BPPV) can be produced by specific manoeuvres and be studied by electrooculography (EOG). It allows an exhaustive study of features in the positional nystagmus. Although most of the patients with BPPV express typical nystagmus, there exists a group of them that exhibit a non typical form. In this work, a comparative study was carried out between two groups of patients. Material and methods: We have studied retrospectively 145 patients with BPPV and Dix-Hallpicke (D-H) positive manoeuvre registered by EOG techniques. All patients were explored in a complete EOG tests. Two groups were identified: typical response/atypical response according to the features of nystagmus response. Possible alterations in other EOG tests in each group were investigated and differences between both types of response were analyzed. Results: 83.5% of cases showed typical nystagmus and atypical in the rest. Other EOG alterations observed in these patients, were (group typical response/atypical response): caloric hypofunction (17.3%/23%), positional nystagmus (12.4%/62.5%), alterations in visual-oculomotor function tests (10%/50%). Conclusions: Frequent alterations were observed in the classic manoeuvres and also in the rest of EOG tests. Probably atypical response in the first is due to or can explain the existence of the second

[Benign paroxysmal positional vertigo of the horizontal semicircular canal]. / Vértigo posicional paroxístico benigno del canal horizontal.

OBJECTIVE: Assesment of 8 new cases of benign paroxysmal positional vertigo of the horizontal semicircular canal (BPPV-HC), since this variant of benign positional vertigo occurs rarely. An oculographic study of features in the positional response was carried out. Electrooculograpy (EOG) allows an exhaustive study of positional nystagmus. MATERIAL AND METHODS: We have studied retrospectively 8 patients with BPPV-HC and positive head rotation manoeuvre registered by EOG techniques. Possible alterations in other EOG tests in the group of patients were analyzed. RESULTS: Most of the patients (7/8) expressed bilateral horizontal geotropic changing-direction nystagmus. One patient exhibited apogeotropic horizontal nystagmus. 5/8 cases showed caloric hypofunction. CONCLUSIONS: We have proven that BPPV-HC is an uncommon disorder. In most of the cases, provocative manoeuver generates bilateral horizontal geotropic changing-direction nystagmus that probably is due to canalitiasis of the horizontal semicircular canal. The rest, a few cases, exhibit apogeotropic horizontal response that can be secondary to cupulolitiasis or location particles in the anterior portion of the horizontal canal. A caloric test showed abnormal in many and can help to locatize the affected ear.

[Electrooculography. Its value in the diagnosis of the patient with a balance disorder]. / Electrooculografía: aportación al diagnóstico del paciente con alteraciones del equilibrio.

INTRODUCTION: Controversy persists on the value of electrooculography (EOG) in the diagnosis of the unbalanced patient. The aim of this study has been to know the utility of EOG in the diagnosis of patients with equilibrium disorders. MATERIAL AND METHODS: We have examined 1000 patients in whom EOG test has been performed for unbalance symptoms. Results have been classified in peripheric or central pattern. Those patients included in the central pattern group have been compared with the results of imaging techniques. RESULTS: 45.7% of EOG performed showed pathological signs, 29.2% were of peripheral characteristics and 16.5% of central ones, of whom 6% showed different pathologies in the imaging test. DISCUSSIONS AND CONCLUSIONS: EOG in now a days of high value in the diagnosis of unbalanced patient, specially in those cases in which other clinical explorations were normal.

Electrooculografía: aportación al diagnóstico del paciente con alteraciones del equilibrio / Electrooculography. Its value in the diagnosis of the patient with a balance disorder

Introducción: El papel que debe jugar la electrooculografía (EOG) en el diagnóstico del paciente con trastornos del equilibrio sigue siendo controvertido. El objetivo de este estudio ha sido determinar la utilidad de la EOG en el diagnóstico del paciente con trastornos del equilibrio. Material y métodos: Hemos llevado a cabo un estudio retrospectivo de 1.000 pacientes que habían sido estudiados mediante EOG por padecer vértigo o desequilibrio. Se hizo una clasificación topográfica (central/periférico) de los resultados obtenidos. En el grupo de pacientes con resultado de características centrales en la EOG se compararon con los resultados obtenidos en la técnica de imagen. Resultados: En el 45,7% la exploración mostraba alteraciones, 29,2% de características periféricas y 16,5% con algún signo de centralidad, de los que el 6% tenían una prueba de imagen patológica. Discusión y conclusiones: La EOG es en la actualidad útil y rentable en el diagnóstico de los trastornos del equilibrio, sobre todo en aquellos pacientes en los cuales otras exploraciones complementarias son negativas

Introduction: Controversy persists on the value of electrooculography (EOG) in the diagnosis of the unbalanced patient. The aim of this study has been to know the utility of EOG in the diagnosis of patients with equilibrium disorders. Material and methods: We have examined 1000 patients in whom EOG test has been performed for unbalance symptoms. Results have been classified in peripheric or central pattern. Those patients included in the central pattern group have been compared with the results of imaging techniques. Results: 45.7% of EOG performed showed pathological signs, 29.2% were of peripheral characteristics and 16.5% of central ones, of whom 6% showed different pathologies in the imaging test. Discusions and conclusions: EOG in now a days of high value in the diagnosis of unbalanced patient, specially in those cases in which other clinical explorations were normal

[Study of 1,000 patients with disequilibrium]. / Estudio de 1.000 pacientes con desequilibrio.

We present a series of one thousand patients tested with electronystagmography (ENG) for evaluation of complaints of unstability. Personal data and electronystagmographic results are analysed.

[Thyroid actinomycosis: a case report]. / Actinomicosis tiroidea: un nuevo caso.

Actinomycosis is nowadays a not very common festered chronic infection. Cervicofacial actinomycosis is the most frequent clinical form, and it is due in most cases to Actinomyces israelii. Thyroid actinomycosis has been scarcely described in the literature. The lesions, that are characterized to be notably indurated and to contain multiple abscesses that drain to the surface through sinus tracts, frequently simulate other infective clinical entities and often neoplasms, therefore the diagnosis is delayed in the time. From a case of thyroid actinomycosis diagnosed and treated in our service which was initial diagnosed as a thyroid neoplasm, we revise the cases described in the literature and we make a point in the difficulty to arrive to the diagnosis of this entity.

Estudio de 1.000 pacientes con desequilibrio / Study of 1.000 patients with unstability

Presentamos una serie de 1.000 pacientes con desequilibrio que habían sido estudiados mediante pruebas de ENG. Se recogen los datos referentes a los pacientes y a las pruebas . Se trata de un estudio retrospectivo de la serie en el que se analizan los resultados obtenidos en cuando a los datos personales de los pacientes, los resultados globales en la ENG, así como los resultados particulares en cada uno de los tests (AU)

No disponible

Actinomicosis tiroidea: un nuevo caso / Thyroid actinomycosis: a case report

La actinomicosis es una infección crónica supurada poco común en la actualidad. La actinomicosis cervicofacial es la forma clínica más frecuente, producida en la mayoría de las ocasiones por Acti nomyces israelii. La tiroiditis por actinomices ha sido descrita escaso número de veces en la literatura. Las lesiones que se caracterizan por ser notablemente induradas y contener múltiples abscesos que drenan hacia la superficie por fístulas, frecuentemente simulan otras entidades clínicas infecciosas y con frecuencia neoplásicas con lo que el diagnóstico se retrasa en el tiempo. A partir de un caso de actinomicosis tiroidea diagnosticado y tratado en nuestro servicio, cuyo diagnóstico presuntivo inicial fue de neoplasia tiroidea, revisamos los casos descritos en la literatura, y hacemos hincapié en la dificultad para llegar al diagnóstico de esta entidad (AU)

Actinomycosis is nowadays a not very common festered chronic infection. Cervicofacial actinomycosis is the most frequent clinical form, and it is due in most cases to Actinomyces israelii. Thyroid actinomycosis has been scarcely described in the literature. The lesions, that are characterized to be notably indurated and to contain multiple abscesses that drain to the surface through sinus tracts, frequently simulate other infective clinical entities and often neoplasms, therefore the diagnosis is delayed in the time. From a case of thyroid actinomycosis diagnosed and treated in our service which was initial diagnosed as a thyroid neoplasm, we revise the cases described in the literature and we make a point in the difficulty to arrive to the diagnosis of this entity (AU)

[Advanced stage laryngeal chondrosarcoma]. / Condrosarcoma laríngeo de alto grado de agresividad.

Chondrosarcoma is a tumor very seldom encountered in the larynx. In this location chondrosarcomas have typical features: slow growing, metastasis rares and scarce tendency to recur. But recurrences occurs at long-term and often can be controlled. We report a case diagnosed and treated in our Hospital which, on the contrary, recurrences presented in a short-term after first surgical removal. Clinical management and treatment of these neoplasms are reviewed.

[Dermoid cyst of the mouth floor]. / Quiste dermoide del suelo de la boca.

Dermoid cysts are congenital lesions deriving from the ectodermal differentiation of stem cells. They are uncommon in the floor of the mouth. We report a sublingual dermoid cyst in a 24-year-old male and review the literature.