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| 2. |
- Karlberg, Mikael, et al.
(författare)
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Impaired postural control in patients with cervico-brachial pain
- 1995
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Ingår i: Acta Oto-Laryngologica. Supplement. - 0365-5237. ; 115:S520, s. 440-442
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Tidskriftsartikel (refereegranskat)abstract
- Dizziness and subjective balance disturbances are common complaints in cervical pain syndromes. We assessed balance function with posturography using vibration-induced and galvanically-induced body sway in consecutive patients (n = 116) with cervico-brachial pain syndrome of more than 3 months' duration. A total of 83% of the patients showed signs of cervical root compression on MRT scans. The incidence of complaints of vertigo was 50%. The patients manifested significantly poorer postural control than sex- and age-matched controls (n = 20). Disorders of the neck should be considered when assessing patients complaining of dizziness, vertigo and balance disturbances.
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| 3. |
- Magnusson, Måns, et al.
(författare)
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Vestibular "PREHAB"
- 2009
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Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923. ; 1164, s. 257-262
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Tidskriftsartikel (refereegranskat)abstract
- A sudden unilateral loss or impairment of vestibular function causes vertigo, dizziness, and impaired postural function. In most occasions, everyday activities supported or not by vestibular rehabilitation programs will promote a compensation and the symptoms subside. As the compensatory process requires sensory input, matching performed motor activity, both motor learning of exercises and matching to sensory input are required. If there is a simultaneous cerebellar lesion caused by the tumor or the surgery of the posterior cranial fossa, there may be a risk of a combined vestibulocerebellar lesion, with reduced compensatory abilities and with prolonged or sometimes permanent disability. On the other hand, a slow gradual loss of unilateral function occurring as the subject continues well-learned everyday activities may go without any prominent symptoms. A pretreatment plan was therefore implemented before planned vestibular lesions, that is, "PREHAB." This was first done in subjects undergoing gentamicin treatment for morbus Meniere. Subjects would perform vestibular exercises for 14 days before the first gentamicin installation, and then continue doing so until free of symptoms. Most subjects would only experience slight dizziness while losing vestibular function. The approach-which is reported here-was then expanded to patients with pontine-angle tumors requiring surgery, but with remaining vestibular function to ease postoperative symptoms and reduce risk of combined cerebellovestibular lesions. Twelve patients were treated with PREHAB and had gentamicin installations transtympanically. In all cases there was a caloric loss, loss of VOR in head impulse tests, and impaired subjective vertical and horizontal. Spontaneous, positional nystagmus, subjective symptoms, and postural function were normalized before surgery and postoperative recovery was swift. Pretreatment training with vestibular exercises continued during the successive loss of vestibular function during gentamicin treatment, and pre-op gentamicin ablation of vestibular function offers a possibility to reduce malaise and speed up recovery.
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| 4. |
- Malmström, Eva-Maj, et al.
(författare)
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Dizziness and localized pain are often concurrent in patients with balance or psychological disorders
- 2020
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 20:2, s. 353-362
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims Symptoms of dizziness and pain are both common complaints and the two symptoms often seem to coincide. When symptoms appear concomitant for sustained periods of time the symptoms might maintain and even exacerbate each other, sometimes leading to psychological distress. In order to evaluate such comorbidity we studied patients referred to a vestibular unit and to a psychiatric outpatient clinic with respectively balance disorders and psychological issues. Methods Consecutive patients referred to a vestibular unit (n = 49) and a psychiatric outpatient clinic (n = 62) answered the Dizziness Handicap Inventory (DHI) questionnaire and a questionnaire detailing occurrence of dizziness and pain. Results The experience of dizziness and pain often coincided within individuals across both clinical populations, especially if the pain was located to the neck/shoulder or the back (p = 0.006). Patients who reported dizziness had significantly more often pain (p = 0.024); in the head (p = 0.002), neck/shoulders (p = 0.003) and feet (p = 0.043). Moreover, patients who reported dizziness stated significantly higher scoring on emotional (p < 0.001) and functional (p < 0.001) DHI sub-scales. Furthermore, patients who reported an accident in their history suffered significantly more often from dizziness (p = 0.039) and pain (p < 0.001); in the head (p < 0.001), neck/shoulders (p < 0.001) and arms (p = 0.045) and they scored higher on the emotional (p = 0.004) and functional (p = 0.002) DHI sub-scales. Conclusions The findings suggest comorbidity to exist between dizziness and neck/shoulder or back pain in patients seeking health care for balance disorders or psychological issues. Patients suffering from dizziness and pain, or with both symptoms, also reported higher emotional and functional strain. Thus, healthcare professionals should consider comorbidity when determining diagnosis and consequent measures. Implications Clinicians need to have a broader "receptive scope" in both history and clinical examinations, and ask for all symptoms. Although the patients in this study visited a vestibular unit respectively a psychological clinic, they commonly reported pain conditions when explicitly asked for this symptom. A multimodal approach is thus to favor, especially when the symptoms persist, for the best clinical management.
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| 5. |
- Karlberg, Mikael, et al.
(författare)
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Acute vestibular neuritis visualized by 3-T magnetic resonance imaging with high-dose gadolinium.
- 2004
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Ingår i: Archives of Otolaryngology - Head and Neck Surgery. - 1538-361X. ; 130:2, s. 229-232
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Tidskriftsartikel (refereegranskat)abstract
- Sudden idiopathic unilateral loss of vestibular function without other signs or symptoms is called acute vestibular neuritis. It has been suggested that reactivation of human herpes simplex virus 1 could cause vestibular neuritis, Bell palsy, and sudden unilateral hearing loss. Enhancement of the facial nerve on gadolinium-enhanced magnetic resonance imaging (MRI) is a common finding in Bell palsy, but enhancement of the vestibular nerve has never been reported in acute vestibular neuritis. We present 2 consecutive cases of acute vestibular neuritis where high-field-strength MRI (3.0 T) with high-dose (0.3 mmol/kg of body weight) gadolinium–pentetic acid showed isolated enhancement of the vestibular nerve on the affected side only. These findings support the hypothesis of a viral and inflammatory cause of acute vestibular neuritis and might have implications for its treatment.
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| 7. |
- Fransson, Per-Anders, et al.
(författare)
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Direction of galvanically-induced vestibulo-postural responses during active and passive neck torsion
- 2000
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 120:4, s. 500-503
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Tidskriftsartikel (refereegranskat)abstract
- The direction of a postural response induced by galvanic vestibular stimulation depends on the head and trunk position. The relative importance of afferent information (proprioception) and efferent motor command/corollary discharge is unknown. We studied the direction of body sway evoked by galvanic vestibular stimulation in 9 healthy subjects during active and passive head positioning at 0 degrees frontal position, 35 degrees to the left, and 75 degrees to the right, using a custom-built collar. At 0 degrees and 75 degrees there were no significant differences in sway direction between active and passive head positioning. The galvanic stimulation invoked sway toward the anode, mainly in the inter-aural direction. The sway direction differed significantly between active and passive positioning at 35 degrees to the side (p < 0.05). When the head was actively kept in this position, the body sway was mainly in an inter-aural direction. The sway shifted to a naso-occipital direction when the head was passively positioned at 35 degrees. Our results indicate that the afferent proprioceptive information has the largest influence on the direction of the galvanically-induced postural response, although some dependence on efferent motor commands and non-linear cervical proprioception cannot be ruled out entirely.
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| 9. |
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| 10. |
- Hafström, Anna, et al.
(författare)
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Visual influence on postural control, with and without visual motion feedback.
- 2002
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 122:4, s. 392-397
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Tidskriftsartikel (refereegranskat)abstract
- Body sway was investigated in 20 healthy subjects to determine whether visual input must contain motion feedback information from the surroundings in order to influence postural control. Posturography was used to record body sway under the following visual conditions: eyes open with or without a restricted visual field; eyes open in ganzfield white light; eyes open in darkness with a head-fixed visual target; eyes open in darkness; and eyes closed in darkness. Stance was perturbed by means of a pseudorandomly applied vibratory stimulation to the calf muscles. Least sway was found with eyes open in an unrestricted visual field but increased in a restricted visual field. Greatest sway was found without visual motion feedback, i.e. under the following conditions: eyes closed; eyes open in darkness; eyes open in ganzfield white light; and with a head-mounted fixation point. Sway was significantly (p < 0.05) greater with eyes open in darkness compared with eyes closed during the initial 50 s with perturbations. After 150 s, sway was almost identical under the four test conditions without visual motion feedback. Standing with eyes open in darkness was initially a disadvantage compared with having the eyes closed. The postural control system may be programmed to expect visual feedback information when the eyes are open, which may delay changes in postural strategy.
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