Otoneurological findings in spinocerebellar ataxia.

OBJECTIVE: Describe findings observed in ENG of patients with spinocerebellar ataxias. METHOD: Forty-three patients were studied, and the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation (ENG). RESULTS: The clinical findings in the entire group of patients were: gait disturbances (83.72%), speech difficulties (48.83%), dizziness (41.86%) and dysphagia (39.53%). Vestibular examination disclosed abnormal caloric exam (83.71%) and saccadic movements (69.76%) with the highest rates of abnormality. The overall presence of alterations in vestibular tests was (90.70%), and the most frequent finding was central vestibular disorder in (74.42%) of patients. CONCLUSION: The study showed that alterations in ENG are related to the severity of SCAs or clinical stage of the disease. We emphasize the importance of studying the vestibular system concomitantly to clinical and genetic follow up.

Reabilitação labiríntica na vertigem periférica / Vestibular rehabilitation in peripheral vertigo

Introdução: A reabilitação vestibular (RV) tem sobressaído por agir fisiologicamente sobre o sistema vestibular, estimulando os sistemas visual, proprioceptivo e vestibular, objetivando manter o equilíbrio corporal em indivíduos com sintomas vertiginosos. Objetivo: Avaliar a eficácia do exercício de RV (reabilitação vestibular) de Cawthorne por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI). Material e método: Avaliaram-se seis pacientes com idade médiade 67,5 anos e (±SD) 5,35 com queixa de tontura que foram submetidos aos seguintes procedimentos: anamnese, inspeção otorrinolaringológica, avaliação vestibular e aplicação do DHI pré e pós RV utilizando-se o protocolo de Cawthorne. Resultados: a) observou-se nas queixas otoneurológicas a prevalência da tontura (100,0%), dificuldade para escutar, zumbido e formigamento de extremidades com (30,0%) em cada; b) no exame vestibular, todos os pacientes apresentaram alteração periférica,sendo irritativa (50,0%) e deficitária (50,0%); c) no questionário DHI, houve melhora em 4 pacientes(67,0%) e 2 pacientes (33,0%) mantiveram-se estáveis; d) houve melhora significativa do aspecto físico (p=0,0431) após a realização dos exercícios de RV. Conclusão: O protocolo utilizado mostrou-se eficaz no processo de compensação vestibular, mas o sucesso do tratamento necessita da cooperação do pacientee de sua participação de forma ativa. A RV é uma importante ferramenta terapêutica para o controle da vertigem e melhora na qualidade de vida.

Introduction: Vestibular rehabilitation (RV) has been distinguished because of its physiological effect on the vestibular system, stimulating the visual, proprioceptive and vestibular systems, and thus endeavouring to maintain the corporal balance of individuals with vertiginous symptoms. Objective: To evaluate the effectiveness of the Cawthorne vestibular rehabilitation exercises by means of evaluation before and after the application of the Dizziness Handicap Inventory questionnaire (DHI). Materialand method: Six patients of average age 67.5 years and (±SD) 5.35 with complaints of dizziness were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic inspection, vestibular evaluation and application of the DHI before and after RV using the Cawthorne protocol. Results: a) In the otoneurological complaints a prevalence of dizziness (100.0%), difficulty in hearing, tinnitus and paraesthesia of the extremities (30.0% in each), was observed; b) In the vestibular exam,all the patients presented peripheral irritative (50.0%) and deficient (50.0%) alterations; c) In the DHI questionnaire, there was an improvement in 4 patients (67.0%) and 2 patients (33.0%) remained stable; d)There was a significant improvement of the physical aspect (p=0.0431) after execution of the RV exercises. Conclusion: The protocol utilized was shown to be effective in the process of vestibular compensation, but the success of the treatment requires patient cooperation and active participation. RV is an important therapeutic tool for the control of vertigo and improvement in the quality of life.

Introducción: La rehabilitación vestibular (RV) se ha destacado por actuar fisiológicamente sobre el sistema vestibular, estimulando los sistemas visual, propioceptivo y vestibular, para mantener el equilibrio corporal en individuos con síntomas de vértigo. Objetivo: evaluar la eficacia de los ejercicios de RV (rehabilitación vestibular) de Cawthome por medio de la evaluación pré y pós aplicación del cuestionario Dizziness Handicap Inventory (DHI) Material y Método: se evaluaron seis pacientes con edad media de 67,5 años (±SD) 5,35 con queja de vértigo, sometidos a los siguientes procedimientos: anamnesis, inspección otorrinolaringológica, evaluación vestibular y aplicación del DHI pré y pós RV utilizando el guión de Cawthorne. Resultados: a) se observó en las quejas otoneurológicas la prevalencia de mareo (100%), dificultades para escuchar, zumbido e hormigueo de extremidades con (30%) encada; b) en el exámen vestibular, todos los pacientes presentaron alteración periférica siendo irritativa (50%) y deficitaria (50%); c) en la encuesta DHI, hubo mejoría en 4 pacientes (67%) y 2 pacientes(33%) se mantuvieron estables; d) hubo mejoría significativa del aspecto físico (p=0,0431) después dela realización de los ejercicios de RV. Conclusión: el protocolo utilizado se mostró eficaz en el procesode compensación vestibular, pero, el éxito del tratamiento necesita de la cooperación del paciente y desu participación de modo activo. La RV es una importante herramienta terapéutica para el control del vértigo y mejoría en la calidad de vida.

Reabilitação labiríntica na vertigem periférica / Vestibular rehabilitation in peripheral vertigo

Introdução: A reabilitação vestibular (RV) tem sobressaído por agir fisiologicamente sobre o sistema vestibular, estimulando os sistemas visual, proprioceptivo e vestibular, objetivando manter o equilíbrio corporal em indivíduos com sintomas vertiginosos. Objetivo: Avaliar a eficácia do exercício de RV (reabilitação vestibular) de Cawthorne por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI). Material e método: Avaliaram-se seis pacientes com idade média de 67,5 anos e (±SD) 5,35 com queixa de tontura que foram submetidos aos seguintes procedimentos: anamnese, inspeção otorrinolaringológica, avaliação vestibular e aplicação do DHI pré e pós RV utilizando-se o protocolo de Cawthorne. Resultados: a) observou-se nas queixas otoneurológicas a prevalência da tontura (100,0%), dificuldade para escutar, zumbido e formigamento de extremidades com (30,0%) em cada; b) no exame vestibular, todos os pacientes apresentaram alteração periférica, sendo irritativa (50,0%) e deficitária (50,0%); c) no questionário DHI, houve melhora em 4 pacientes (67,0%) e 2 pacientes (33,0%) mantiveram-se estáveis; d) houve melhora significativa do aspecto físico (p=0,0431) após a realização dos exercícios de RV. Conclusão: O protocolo utilizado mostrou-se eficaz no processo de compensação vestibular, mas o sucesso do tratamento necessita da cooperação do paciente e de sua participação de forma ativa. A RV é uma importante ferramenta terapêutica para o controle da vertigem e melhora na qualidade de vida.(AU)

Introduction: Vestibular rehabilitation (RV) has been distinguished because of its physiological effect on the vestibular system, stimulating the visual, proprioceptive and vestibular systems, and thus endeavouring to maintain the corporal balance of individuals with vertiginous symptoms. Objective: To evaluate the effectiveness of the Cawthorne vestibular rehabilitation exercises by means of evaluation before and after the application of the Dizziness Handicap Inventory questionnaire (DHI). Material and method: Six patients of average age 67.5 years and (±SD) 5.35 with complaints of dizziness were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic inspection, vestibular evaluation and application of the DHI before and after RV using the Cawthorne protocol. Results: a) In the otoneurological complaints a prevalence of dizziness (100.0%), difficulty in hearing, tinnitus and paraesthesia of the extremities (30.0% in each), was observed; b) In the vestibular exam, all the patients presented peripheral irritative (50.0%) and deficient (50.0%) alterations; c) In the DHI questionnaire, there was an improvement in 4 patients (67.0%) and 2 patients (33.0%) remained stable; d) There was a significant improvement of the physical aspect (p=0.0431) after execution of the RV exercises. Conclusion: The protocol utilized was shown to be effective in the process of vestibular compensation, but the success of the treatment requires patient cooperation and active participation. RV is an important therapeutic tool for the control of vertigo and improvement in the quality of life.(AU)

Introducción: La rehabilitación vestibular (RV) se ha destacado por actuar fisiológicamente sobre el sistema vestibular, estimulando los sistemas visual, propioceptivo y vestibular, para mantener el equilibrio corporal en individuos con síntomas de vértigo. Objetivo: evaluar la eficacia de los ejercicios de RV (rehabilitación vestibular) de Cawthome por medio de la evaluación pré y pós aplicación del cuestionario Dizziness Handicap Inventory (DHI) Material y Método: se evaluaron seis pacientes con edad media de 67,5 años (±SD) 5,35 con queja de vértigo, sometidos a los siguientes procedimientos: anamnesis, inspección otorrinolaringológica, evaluación vestibular y aplicación del DHI pré y pós RV utilizando el guión de Cawthorne. Resultados: a) se observó en las quejas otoneurológicas la prevalencia de mareo (100%), dificultades para escuchar, zumbido e hormigueo de extremidades con (30%) en cada; b) en el exámen vestibular, todos los pacientes presentaron alteración periférica siendo irritativa (50%) y deficitaria (50%); c) en la encuesta DHI, hubo mejoría en 4 pacientes (67%) y 2 pacientes (33%) se mantuvieron estables; d) hubo mejoría significativa del aspecto físico (p=0,0431) después de la realización de los ejercicios de RV. Conclusión: el protocolo utilizado se mostró eficaz en el proceso de compensación vestibular, pero, el éxito del tratamiento necesita de la cooperación del paciente y de su participación de modo activo. La RV es una importante herramienta terapéutica para el control del vértigo y mejoría en la calidad de vida.(AU)

Vestibular findings in relapsing, remitting multiple sclerosis: a study of thirty patients.

Our objective was to describe vestibular abnormalities in patients with relapsing and remitting multiple sclerosis. Thirty patients (6 men and 24 women) between 27 and 64 years of age underwent neurological and otolaryngological examinations, complete anamnesis, and electronystagmography. Patients with psychological or oculomotor paresis (or both), internuclear ophthalmoparesis, severe visual disturbances, or locomotion restrictions were excluded. The difference-of-proportion test was used to compare affected patients with controls, with a significance level of 5%. Vestibular alterations were found in 26 (86%) of the evaluated patients, from which 25 presented peripheral etiology and only 1 presented a problem of central origin. There was a prevalence of bilateral peripheral irritative vestibulopathy (20%), followed by bilateral peripheral deficit vestibulopathy (20%) and left peripheral deficit vestibulopathy (17%). The high incidence of vestibular disorders observed in this study indicates that this population might benefit from specific rehabilitation programs. Studies with larger samples are still required and may contribute to the understanding of this pathology.

High-frequency hearing threshold in adult women with multiple sclerosis.

Our objective was to determine the high-frequency hearing thresholds of women with multiple sclerosis (MS) and to investigate the presence of side dominance for high-frequency perception. We submitted 19 affected and 106 nonaffected women (controls) to high-frequency audiometry and classified them in subgroups according to their age (30-40, 40-50, and 50-60 years). We analyzed data through selected statistical tests. We could detect no consistent effect of side dominance and observed a general increase in the hearing sensitivity for high frequencies in MS patients. We concluded that high-frequency sounds seemed to be detected more easily by MS patients than by controls.