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| 3. |
- Brantberg, K., et al.
(författare)
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Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal
- 2001
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 121:1, s. 68-75
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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.
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| 11. |
- Bergenius, J., et al.
(författare)
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The subjective horizontal at different angles of roll-tilt in patients with unilateral vestibular impairment
- 1996
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Ingår i: Brain Research Bulletin. - : Elsevier BV. - 0361-9230 .- 1873-2747. ; 40:5-6, s. 385-390
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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.
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| 13. |
- Bergenius, J, et al.
(författare)
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Vestibular neuritis: a follow-up study
- 1999
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Ingår i: Acta oto-laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 119:8, s. 895-899
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Tidskriftsartikel (refereegranskat)
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| 14. |
- Bergenius, S., et al.
(författare)
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Proton irradiation response of CsI(Tl) crystals for the GLAST calorimeter
- 2003
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Ingår i: 2003 IEEE Nuclear Science Symposium Conference Record. - : IEEE Press. - 0780382579 ; , s. 1096-1099
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Konferensbidrag (refereegranskat)abstract
- The electromagnetic calorimeter of the Gamma-Ray Large Area Space Telescope (GLAST) consists of 16 towers of CsI(Tl) crystals. Each tower contains 8 layers of crystals (each 326.0x26.7x19.9 mm3) arranged in a hodoscopic fashion. The crystals are read out at both ends with photodiodes. Crystals produced by Amcrys-H (Ukraine) are used. A full size crystal was irradiated with a 180 MeV proton beam and the radiation induced attenuation was measured. The induced radioactivity of the crystal was also studied. In this paper we will discuss the damage due to proton irradiation and compare this with the expected in-orbit background flux.
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| 15. |
- Bergenius, S., et al.
(författare)
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Radiation hardness tests of CSI(Tl) crystals for the GLAST electromagnetic calorimeter
- 2003
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Ingår i: Proceedings of 28th International Cosmic Ray Conference. ; , s. 2787-2790
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Konferensbidrag (refereegranskat)abstract
- The electromagnetic calorimeter of the Gamma ray Large Area Space Telescope(GLAST) consists of 16 towers of CsI(Tl) crystals. Each tower contains 8layers of crystals (each 326.0×26.7×19.9 mm3) arranged in a hodoscopic fashion.The crystals are read out at both ends with PIN photodiodes. Crystals producedby Amcrys-H (Ukraine) are used. As a part of the quality control procedureduring crystal production, samples from the uncut boules are systematically irradiatedwith gamma rays from a 60Co source. Studies have also been carried outto verify the correspondence between the post-irradiation properties of the boulesamples and the full size crystals which are subsequently cut from the boule. Thefull size crystals have also been irradiated with a 180 MeV proton beam and theradiation induced attenuation measured.
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| 17. |
- Brantberg, K., et al.
(författare)
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Gentamicin treatment in peripheral vestibular disorders other than Ménière's disease
- 1996
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Ingår i: Journal for Oto-Rhino-Laryngology. - : S. Karger AG. - 0301-1569 .- 1423-0275. ; 58:5, s. 277-279
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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.
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| 18. |
- Brantberg, K., et al.
(författare)
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Tilt suppression, OKAN, and head-shaking nystagmus at long-term follow-up after unilateral vestibular neurectomy
- 1996
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Ingår i: Journal of Vestibular Research-Equilibrium & Orientation. - 0957-4271 .- 1878-6464. ; 6:4, s. 235-241
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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.
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| 20. |
- Brantberg, K., et al.
(författare)
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Vestibular-evoked myogenic potentials in patients with dehiscence of the superior semicircular canal
- 1999
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 119:6, s. 633-640
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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.
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| 21. |
- Faag, Carina, et al.
(författare)
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Symptoms experienced by patients with peripheral vestibular disorders : evaluation of the Vertigo Symptom Scale for clinical application
- 2007
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Ingår i: Clinical Otolaryngology. - : Blackwell Publishing. - 1749-4478 .- 1365-2273. ; 32:6, s. 440-446
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe symptoms during an episode of dizziness in a sample of patients suffering from peripheral vestibular disorders and to compare them with the items in the Vertigo Symptom Scale.Design: A descriptive study from a sample of patients with peripheral vestibular disorders.Setting: Patients visiting a department of audiology at a university hospital.Participants: Twenty patients with peripheral vestibular disorders. The inclusion criteria were that the patient had had at least three spontaneous attacks of vertigo and/or was constantly unsteady during the last 3 months for at least 75% of the time when awake.Main outcome measures: Patients were instructed to complete a diary where they recorded symptoms that arose during an episode of dizziness. These symptoms were compared with the content of the Vertigo Symptom Scale.Results: The most frequent symptoms as mentioned by the patients in their diaries were a feeling that things are spinning or moving around, nausea, feeling unsteady/about to lose one’s balance, fatigue, headache, a feeling as if the ground you walk on is distant and ear-related such as tinnitus and a feeling of pressure in the ear. Pain in the heart or chest region, a heavy feeling in the arms or legs, pain in the lower part of the back and excessive sweating were not mentioned at all or by very few patients. Analysis showed that some of the symptoms included in the Vertigo Symptom Scale occurred less during an episode of dizziness than others in this sample of patients with peripheral vestibular disorders.Conclusion: It was found that the Vertigo Symptom Scale is an adequate base but may need to be developed for use in patients diagnosed with peripheral vestibular symptoms to be able to evaluate care and treatment.
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| 22. |
- Geisler, C, et al.
(författare)
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Nystagmus findings in healthy subjects examined with infrared videonystagmoscopy
- 2000
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Ingår i: ORL. - : S. Karger AG. - 0301-1569 .- 1423-0275. ; 62:5, s. 266-269
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Tidskriftsartikel (refereegranskat)abstract
- The increased use of videosystems for the detection of nystagmus is a new diagnostic tool in the diagnosis of patients with vestibular disorders. Small video cameras mounted in a light sealed mask visualize the eyes which are illuminated with infrared light. Compared to the well-established use of Frenzel glasses the patient has no visual references at all. This new technique requires standards for normal limits. Thirty subjects between 20 and 78 years of age with no history of vestibular disorders were examined with infrared video-oculoscopy with the gaze in primary position, after head-shake and in supine position with head torsion and Dix-Hallpike positions backward and forward according to a standardized procedure at our department. Two subjects had spontaneous nystagmus, but nystagmus after head-shake was not found in any. No subject had torsional nystagmus in the Dix-Hallpike positions. In the elderly subjects horizontal nystagmus in head hanging position was a frequent finding.
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| 24. |
- Mendel, Barbro, et al.
(författare)
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Dizziness symptom severity and impact on daily living as perceived by patients suffering from peripheral vestibular disorder
- 1999
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Ingår i: Clinical Otolaryngology & Allied Sciences. - : Wiley. - 0307-7772 .- 1365-2273. ; 24:4, s. 286-293
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe quality-of-life aspects in a group of patients (n = 99) suffering from peripheral vestibular disorder, using three different self-rated instruments, the Vertigo Symptom Scale (VSS), the Vertigo Handicap Questionnaire (VHQ) and the Sickness Impact Profile (SIP). The results showed that the type of dizziness that most influenced the quality-of-life aspects were: frequent short- or long-term dizziness, nausea, and the feeling that the ground was distant or as though the patient were walking on clouds. However, several of the impairments in daily life were neither related to the disease itself nor the demographic data. This verifies the necessity of investigating other factors such as personality and coping capacity. The results of this study also demonstrate the patients' need of psychosocial support. A comprehensive assessment and evaluation is important in order to identify each patient's needs.
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| 25. |
- Mendel, Barbro, et al.
(författare)
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Living with dizziness : an explorative study
- 1997
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 26:6, s. 1134-1141
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Tidskriftsartikel (refereegranskat)abstract
- A qualitative study was conducted for the purpose of exploring how patients with dizziness manage their daily living. Ten patients with history of dizziness were recruited from the out-patient clinic, Department of Audiology, in a hospital in Stockholm. Collection and analysis of data were inspired by the method of grounded theory. Four themes were developed that described the experience-of living with dizziness: vulnerable reactions, affirmation and non-affirmation, finding ways to carry on daily living, and expressing the need for health care support. These themes seem to conceptualize these patients' difficulties and needs in relationship to living with dizziness and, given the small sample, have implications for nursing practice and provide a framework for a broader study.
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| 26. |
- Mendel, Barbro, et al.
(författare)
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The sense of coherence : a tool for evaluating patients with peripheral vestibular disorders
- 2001
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Ingår i: Clinical Otolaryngology & Allied Sciences. - : Wiley. - 0307-7772 .- 1365-2273. ; 26:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- Peripheral vestibular disorders may result. in physical as well as psychosocial dysfunction. Such a situation demands a capacity to cope which lately has been discussed as an important factor in the health outcome. Antonovsky has described the concept of sense of coherence (SOC) as such a trait and has developed a questionnaire (the SOC Scale) to measure it. The aim of this study was to describe the patients' self-rated degree of SOC and to set this in relation to their perception of the self-rated quality of life. The results showed that patients with a strong SOC scored statistically less self-rated handicap, less emotional distress, less impact on working capacity and sleep and rest and less psychosocial dysfunction than those with weak SOC scores. It is suggested that the SOC Scale may serve as a tool to identify patients who are at risk of poorer quality of life and in need of supportive care.
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| 34. |
- Tribukait, Arne, et al.
(författare)
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Subjective visual horizontal during follow-up after unilateral vestibular deafferentation with gentamicin
- 1998
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 118:4, s. 479-487
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Tidskriftsartikel (refereegranskat)abstract
- The subjective visual horizontal (SVH) was measured by means of a small, rotatable, luminous line in darkness in the upright head and body position and at 10, 20 and 30 degrees of tilt to the right and left before, and repeatedly during a follow-up period of 1 year after intratympanic gentamicin instillations in 12 patients with recurrent vertigo attacks. This treatment caused a loss of the bithermal caloric responses on the diseased side. Shortly after treatment there was a significant tilt of SVH towards the treated side (group mean = 10.6 degrees). Repeated testing made it possible to characterize mathematically the changes with time for SVH. For the group of patients as a whole this otolithic component of vestibular compensation was best described by a power function, SVH = 8.65t(-0.16) degrees, where t is time in days after maximum tilt of SVH. After 1 year, SVH was still significantly tilted towards the treated side (group mean = 3.16 degrees). Gentamicin treatment also caused a significant reduction in the perception of head and body tilt towards the deafferented side, while the perception of tilt towards the healthy side did not show any significant changes. During follow-up there was a gradual improvement in the perception of tilt towards the treated side. However, a significant asymmetry in roll-tilt perception was still present 1 year after deafferentation. There was no correlation between SVH in the upright position and roll-tilt perception, suggesting that these parameters are to some extent dependent on different afferent input from the vestibular organ. They were also found to be complementary for the detection of vestibular disturbance.
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| 35. |
- Tribukait, Arne, et al.
(författare)
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The subjective visual horizontal after stapedotomy : evidence for an increased resting activity in otolithic afferents
- 1998
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 118:3, s. 299-306
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Tidskriftsartikel (refereegranskat)abstract
- The subjective visual horizontal (SVH) was measured by means of a small rotatable luminous line in darkness in the upright body position and at 10, 20 and 30 degrees of body tilt to the right and left prior to, and during a follow-up period after, stapedotomy in 12 patients with otosclerosis. In the acute stage after surgery, SVH in the upright body position was significantly tilted away from the operated side. In addition, the perception of roll tilt towards the operated side (Kop) was significantly increased after stapedotomy, while the perception of roll tilt towards the healthy side (Khe) showed a slight but not significant reduction. After exclusion of two outliers, a statistically significant correlation was found between changes in Kop and in Khe. The slope of the regression line was 1.8:1, probably corresponding to a preference of the utricle for ipsilateral as opposed to contralateral head tilt. In four patients there was a weak ( < 1 degrees/s) spontaneous nystagmus, not systematically related to the side of surgery, while in most cases there were no nystagmus or subjective vertigo symptoms. These specific changes in the subjective horizontal show that the otolithic effects on perception can be dissociated from canal effects. Further, the results are opposite to those for patients with unilateral loss of vestibular function. The tilt of SVH after stapedotomy indicates an increase in resting activity of utricular afferents. In addition, based on recent theories on otolith function, we suggest that an increased activity in saccular afferents is of major importance for the changes in roll-tilt perception because of its interaction with the utricle on the central nervous level.
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| 36. |
- Tribukait, Arne, et al.
(författare)
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The subjective visual horizontal for different body tilts in the roll plane : characterization of normal subjects
- 1996
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Ingår i: Brain Research Bulletin. - 0361-9230 .- 1873-2747. ; 40:5-6, s. 375-383
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Tidskriftsartikel (refereegranskat)abstract
- In order to establish a method for estimation of the perceptual horizontal as a test of otolith function in diagnosis of atypical vertigo, in a first study we have standardized a test procedure and characterized a body of normal material consisting of 72 healthy subjects, 24 of them examined with tests followed by retests. The perceptual visual horizontal in darkness was estimated in the upright body position and at body tilts of 10, 20, and 30 degrees to the right and to the left by means of a narrow luminous bar. The deviation of the perceptual horizontal relative to the gravitational horizontal is expressed as a function of body tilt. In the upright body position, 95% had a perceptual horizontal within the range of +/- 2.5 degrees. In the tilted positions, there was a tendency to set the light bar tilted oppositely with respect to the body tilt. The results suggest that roll tilt to the right and to the left is sensed by two independent functional units. Furthermore, the results imply that some other factor might be of importance and that the perceptual horizontal in the upright position and tilt perception are complementary in reflecting vestibular function. Differences between individuals were great in comparison with intraindividual variability and the test-retest variability. The results are discussed against the background of the extensive literature.
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| 37. |
- Ödkvist, L. M., et al.
(författare)
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When and how to use Gentamicin in the treatment of Meniere's disease
- 1997
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Ingår i: Acta oto-laryngologica. Supplementum. - : Informa UK Limited. - 0365-5237 .- 1651-2464 .- 0001-6489 .- 1651-2251. ; 117:S526, s. 54-57
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Tidskriftsartikel (refereegranskat)abstract
- Gentamicin given as local therapy for severe Meniere's disease is of considerable value in the control of vertigo. The ototoxic antibiotic is instilled through the tympanic membrane causing a peripheral vestibular loss and possibly also diminished endolymph production. In order to achieve the best results with gentamicin treatment it is of utmost importance that the diagnosis is correct. Given to a patient with vertigo of other than peripheral origin, the outcome would be worsening of the existing symptoms and addition of new ones. The method should be used only by physicians who are very familiar with vertigo and otology, and only in patients with such a disturbing degree of vertigo that they are well motivated to receive treatment. Thorough information regarding the disease, the treatment procedure and the symptoms caused by a unilateral peripheral vestibular loss should be given to the patient. Vestibular rehabilitation, including movement therapy, should be given by the physician or, preferably, a well trained physiotherapist on an individual basis or in patient groups together with written practice programmes for use at home. Vertigo attacks are usually relieved in 95% of patients. Twenty percent of patients experience an added hearing loss in the treated ear, although this number is reduced if the treatment is given as a single installment on consecutive days with extra installments given one month later if the vertigo remains.
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