| 1. |
- Bergenius, J., et al.
(författare)
-
The subjective horizontal at different angles of roll-tilt in patients with unilateral vestibular impairment
- 1996
-
Ingår i: Brain Research Bulletin. - : Elsevier BV. - 0361-9230 .- 1873-2747. ; 40:5-6, s. 385-390
-
Tidskriftsartikel (refereegranskat)abstract
- The subjective visual horizontal is mainly dependent on the otolithic system. A group of 11 patients with sudden unilateral vestibular impairment were asked to set a dimly illuminated bar according to their subjective horizontal when they were seated upright and tilted 10, 20, and 30 degrees to the right and left in a completely darkened room (Bias test). The patients were examined within 1 week, after 3 and 6 weeks, and 9 patients consented to the 11-week follow-up. The results were compared with ENG examinations. In the acute stage of the disease all patients, when they were in upright position, set the light bar tilted towards the affected side. At roll tilt to the affected side, 9 of the 11 patients set the light bar in the same direction as their body tilt (undercorrection). At a tilt to the unaffected side 6 of the 11 patients made an undercorrection. For the group of patients the magnitude of undercorrection was larger at tilt to the affected side than to the unaffected side. The patients' ability to correctly align the light bar with the true horizontal gradually improved but was found normal in both upright and tilted positions in only three of the nine patients at the last follow-up. In four of the six patients who still demonstrated pathologic results, these were met only in tilted positions. No significant correlation was found between the intensity of spontaneous nystagmus or the degree of caloric side difference and the deviation in setting of the light bar in upright or tilted positions. The large asymmetric perceptual responses at tilt found at onset might be explained by the two-directional organisation of the utricle.
|
|
| 2. |
- Brantberg, K., et al.
(författare)
-
Gentamicin treatment in peripheral vestibular disorders other than Ménière's disease
- 1996
-
Ingår i: Journal for Oto-Rhino-Laryngology. - : S. Karger AG. - 0301-1569 .- 1423-0275. ; 58:5, s. 277-279
-
Tidskriftsartikel (refereegranskat)abstract
- Intratympanic instillation of gentamicin may not exclusively be a treatment for Ménière's disease. We present case reports of successful vertigo control in peripheral vestibular disorders other than Ménère's disease. Cases 1 and 2 illustrate treatment of vertigo attacks caused by vestibular dysfunction in deaf ears. Case 3 illustrates treatment of brief sensations of linear acceleration in a patient who had suffered idiopathic sudden hearing loss a few years earlier. Case 4 illustrates treatment of disabling benign paroxysmal positioning vertigo. Case 5 illustrates treatment of severe and frequent attacks of vertigo in an elderly patient with a medium-sized acoustic neuroma who did not want surgical extirpation of the tumor.
|
|
| 3. |
- Brantberg, Krister, et al.
(författare)
-
Skull tap induced vestibular evoked myogenic potentials : an ipsilateral vibration response and a bilateral head acceleration response?
- 2008
-
Ingår i: Clinical Neurophysiology. - : Elsevier BV. - 1388-2457 .- 1872-8952. ; 119:10, s. 2363-2369
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the mechanisms for skull tap induced vestibular evoked myogenic potentials (VEMP). METHODS: An electro-mechanical "skull tapper" (that provided a constant stimulus intensity) was used to test the effects of different midline stimulus sites/directions in healthy subjects (n=10) and in patients with severe unilateral loss of vestibular function (n=8). RESULTS: The standardized midline skull taps caused highly reproducible VEMP. There were highly significant differences in amplitude and latency in both normals and patients depending on site/direction of tapping (suggesting a stimulus direction dependency). Occiput skull taps caused, in comparisons to forehead and vertex taps, larger amplitude VEMP with more pronounced differences between the lesioned and the healthy side in the patients. CONCLUSIONS: The present data, in conjunction with earlier findings, support a theory that skull tap VEMP are mediated by two different mechanisms. It is suggested that skull tapping causes both skull vibration and head acceleration. Further, the VEMP would be the sum of the direction-independent vibration-induced response (from the sound-sensitive part of the saccule) and the direction-dependent head acceleration response (from other parts of the labyrinth). SIGNIFICANCE: Skull tap VEMP, as a diagnostic test, is not equivalent to sound-induced VEMP.
|
|
| 4. |
- Brantberg, K., et al.
(författare)
-
Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal
- 2001
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 121:1, s. 68-75
-
Tidskriftsartikel (refereegranskat)abstract
- Recently Minor and co-workers described patients with sound- and pressure-induced vertigo due to dehiscence of the superior semicircular canal. Identifying patients with this 'new' vestibular entity is important, not only because the symptoms are sometimes very incapacitating, but also because they can be treated. We present symptoms and findings in eight such patients, all of whom reported pressure-induced vertigo that increased during periods of upper respiratory infections. Pulse-synchronous tinnitus and gaze instability during head movements were also common complaints. All patients lateralized Weber's test to the symptomatic ear. In some of the patients the audiogram also revealed a small conductive hearing loss. However, the stapedius reflexes were always normal. A vertical/torsional eye movement related to the superior semicircular canal was seen in most of the patients in response to pressure changes and/or sound stimulation. One patient also had superior canal-related positioning nystagmus. Testing vestibular evoked myogenic potentials revealed in all patients a vestibular hypersensitivity to sounds. In the coronal high-resolution 1-mm section CT scans the dehiscence was visible on 1 to 4 sections. Moreover, the skull base was rather thin in this area and cortical bone separating the middle ear and the antrum from the middle cranial fossa was absent in many of the patients. Two of the patients have undergone plugging of the superior semicircular canal using a transmastoid approach and both patients were relieved of the pressure-induced symptoms.
|
|
| 5. |
- Brantberg, K., et al.
(författare)
-
Tilt suppression, OKAN, and head-shaking nystagmus at long-term follow-up after unilateral vestibular neurectomy
- 1996
-
Ingår i: Journal of Vestibular Research-Equilibrium & Orientation. - 0957-4271 .- 1878-6464. ; 6:4, s. 235-241
-
Tidskriftsartikel (refereegranskat)abstract
- The functional status of the velocity storage mechanism was studied in patients at long-term follow-up (2 to 4 years) after unilateral vestibular neurectomy. The time constant of the vestibulo-ocular reflex (VORtc), the effect of head tilt on postrotatory nystagmus, optokinetic after-nystagmus (OKAN), and nystagmus after rapid head shaking were studied in 10 patients. In agreement with previous findings, VORtc was found to be short and most patients manifested OKAN, suggesting that unilateral peripheral vestibular loss is associated with a complete loss of storage within the the VOR but only a partial loss of velocity storage for visual input. However, at postrotatory head tilt the VOR time constant was further shortened, supposedly due to discharge of functioning velocity storage. Moreover, most patients manifested nystagmus after head shaking. These findings on tilt suppression and head-shaking nystagmus suggest that velocity storage within the VOR may function even in patients with complete unilateral vestibular lesions.
|
|
| 6. |
- Brantberg, K., et al.
(författare)
-
Vestibular-evoked myogenic potentials in patients with dehiscence of the superior semicircular canal
- 1999
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 119:6, s. 633-640
-
Tidskriftsartikel (refereegranskat)abstract
- Recently Minor and co-workers described patients with sound- and pressure-induced vertigo due to dehiscence of bone overlying the superior semicircular canal. Identifying patients with this "new" vestibular entity is important, not only because the symptoms can be very incapacitating, but also because they are surgically treatable. We present symptoms and findings for three such patients. On exposure to sounds, especially in the frequency range 0.5-1 kHz, they showed vertical/torsional eye movements analogous to a stimulation of the superior semicircular canal. They also showed abnormally large sound-induced vestibular-evoked myogenic potentials (VEMP), i.e. the short latency sternomastoid muscle response considered to be of saccular origin. The VEMP also had a low threshold, especially in the frequency range 0.5-1 kHz. However, in response to saccular stimulation by skull taps, i.e. when the middle ear route was bypassed, the VEMP were not enlarged. This suggests that the relation between the sound-induced and the skull tap-induced responses can differentiate a large but normal VEMP from an abnormally large response due to dehiscence of bone overlying the labyrinth, because only the latter would produce large sound-induced VEMP compared to those induced by skull taps.
|
|
| 7. |
- Brantberg, Krister, et al.
(författare)
-
Vestibular evoked myogenic potentials in response to lateral skull taps are dependent on two different mechanisms
- 2009
-
Ingår i: Clinical Neurophysiology. - : Elsevier BV. - 1388-2457 .- 1872-8952. ; 120:5, s. 974-979
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore the mechanisms for skull tap induced vestibular evoked myogenic potentials (VEMP). METHODS: The muscular responses were recorded over both sternocleidomastoid (SCM) muscles using skin electrodes. A skull tapper which provided a constant stimulus intensity was used to test cervical vestibular evoked myogenic potentials (VEMP) in response to lateral skull taps in healthy subjects (n=10) and in patients with severe unilateral loss of vestibular function (n=10). RESULTS: Skull taps applied approximately 2 cm above the outer ear canal caused highly reproducible VEMP. There were differences in VEMP in both normals and patients depending on side of tapping. In normals, there was a positive-negative ("normal") VEMP on the side contra-lateral to the skull tapping, but no significant VEMP ipsi-laterally. In patients, skull taps above the lesioned ear caused a contra-lateral positive-negative VEMP (as it did in the normals), in addition there was an ipsi-lateral negative-positive ("inverted") VEMP. When skull taps were presented above the healthy ear there was only a small contra-lateral positive-negative VEMP but, similar to the normals, no VEMP ipsi-laterally. CONCLUSIONS: The present data, in conjunction with earlier findings, support a theory that skull-tap VEMP responses are mediated by two different mechanisms. It is suggested that skull tapping causes both a purely ipsi-lateral stimulus side independent SCM response and a bilateral and of opposite polarity SCM response that is stimulus side dependent. Possibly, the skull tap induced VEMP responses are the sum of a stimulation of two species of vestibular receptors, one excited by vibration (which is rather stimulus site independent) and one excited by translation (which is more stimulus site dependent). SIGNIFICANCE: Skull-tap VEMP probably have two different mechanisms. Separation of the two components might reveal the status of different labyrinthine functions.
|
|
| 8. |
- Brantberg, Krister, et al.
(författare)
-
Vestibular evoked myogenic potentials in response to laterally directed skull taps
- 2002
-
Ingår i: Journal of Vestibular Research-Equilibrium & Orientation. - 0957-4271 .- 1878-6464. ; 12:1, s. 35-45
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years it has been demonstrated that loud clicks generate short latency vestibular evoked myogenic potentials (VEMP). It has also been demonstrated that midline forehead skull tap stimulation evokes similar VEMP. In the present study, the influence of skull tap direction on VEMP was studied in 13 normal subjects and in five patients with unilateral vestibular loss. Gentle skull taps were delivered manually above each ear on the side of the skull. The muscular responses were recorded over both sternocleidomastoid muscles using skin electrodes. Among the normals, laterally directed skull taps evoked "coordinated contraction-relaxation responses", i.e. skull taps on one side evoked a negative-positive "inverted" VEMP on that side and a positive-negative "normal" VEMP on the other side. Among patients with unilateral vestibular function loss, skull taps above the lesioned ear evoked similar coordinated contraction-relaxation responses. However, skull taps above the healthy ear did not evoke that type of response. These findings suggest that laterally directed skull taps activate mainly the contralateral labyrinth.
|
|
| 9. |
- Brantberg, Krister, et al.
(författare)
-
Vestibular evoked myogenic potentials in response to skull taps for patients with vestibular neuritis
- 2003
-
Ingår i: Journal of Vestibular Research-Equilibrium & Orientation. - 0957-4271 .- 1878-6464. ; 13:2-3, s. 121-130
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years it has been demonstrated that loud clicks generate short latency vestibular evoked myogenic potentials (VEMP). It has also been demonstrated that skull tap stimulation evokes similar VEMP. In the present study, the differences between the click-induced and the skull-tap induced VEMP were studied in 18 patients at onset of vestibular neuritis. Gentle skull taps were delivered manually above each ear on the side of the skull and on the forehead midline. The muscular responses were recorded over both sternocleidomastoid muscles using skin electrodes. Abnormal skull tap VEMP were found in the majority of the patients (10/18, 56%). However, only 4/18 (22%) showed asymmetry in the click-induced VEMP. The high percentage of abnormal skull tap VEMP might suggest that this response is not only dependent on the inferior division of the vestibular nerve, because the inferior division of this nerve is usually spared in vestibular neuritis. Moreover, the patients with abnormal skull tap VEMP differed from those with normal VEMP in their settings of the subjective visual horizontal with static head tilt in the roll plane. This might suggest that skull tap VEMP are (also) related to utricular function.
|
|
| 10. |
- Brink, Andreas, et al.
(författare)
-
Factors of significance for the ability of fighter pilots to visually indicate the magnitude of roll tilt during simulated turns in a centrifuge
- 2024
-
Ingår i: Perception. - : SAGE Publications. - 0301-0066 .- 1468-4233. ; 53:2, s. 75-92
-
Tidskriftsartikel (refereegranskat)abstract
- During coordinated flight and centrifugation, pilots show interindividual variability in perceived roll tilt. The study explored how this variability is related to perceptual and cognitive functions. Twelve pilots underwent three 6-min centrifugations on two occasions (G levels: 1.1G, 1.8G, and 2.5G; gondola tilts: 25°, 56°, and 66°). The subjective visual horizontal (SVH) was measured with an adjustable luminous line and the pilots gave estimates of experienced G level. Afterward, they were interrogated regarding the relationship between G level and roll tilt and adjusted the line to numerically mentioned angles. Generally, the roll tilt during centrifugation was underestimated, and there was a large interindividual variability. Both knowledge on the relationship between G level and bank angle, and ability to adjust the line according to given angles contributed to the prediction of SVH in a multiple regression model. However, in most cases, SVH was substantial smaller than predictions based on specific abilities.
|
|
