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Sample records for vestibular semiology hysteria

  1. Semiologi Komunikasi

    Directory of Open Access Journals (Sweden)

    Andrik Purwasito

    2006-06-01

    Full Text Available There’s no easy way to understand semiology, or semiotics. For sure, semiology is focusing itself to study sign, text, and representation. By employing semiology, scholars try to interpret signs and addressing the politics of representation as reflected on the text. In the field of communication, semiology occupied itself to interpret the meaning which lies behind various means of communication. In order to reveal the hidden meanings behind the text, scholars must equipped themselves with a clear statement of the problem, corpus, scope of problems, and text substance. There are three kind of corpus:  (1  primary corpus, e.g. text; (2 comparative  orpus; and  (3 referent corpus.

  2. Hysteria and its metamorphoses

    Directory of Open Access Journals (Sweden)

    Lazslo Antônio Ávila

    2012-03-01

    Full Text Available OBJECTIVE: To investigate the historical evolution of hysteria and its possible psychopathological ramifications in today’s diagnostic classifications. Method: Clinical and historical problematization contrasting classical and contemporary references on the subject. Conclusion: Higher incidence of certain conditions and decline in the use of the construct of hysteria should be seen as different moments in a continuum.

  3. [Babinski and hysteria].

    Science.gov (United States)

    Allilaire, Jean-François

    2007-10-01

    Babinski made important contributions to both psychiatry and neurology. He disagreed with Charcot's theatrical interpretation of hysteria and made a subtle distinction between Suggestion and Persuasion, thereby differentiating Hysteria from Pithiatism. This paper examines Charcot's concepts and the way in which Babinski refined and honed his master's theories.

  4. The Discourse of "Environmentalist Hysteria."

    Science.gov (United States)

    Killingsworth, M. Jimmie; Palmer, Jacqueline S.

    1995-01-01

    Fleshes out a model of hysterical discourse, and applies it to an analysis of the charges and countercharges of "environmentalist hysteria." Gives special attention to the book that drew the earliest accusations of hysteria, Rachel Carson's "Silent Spring." (SR)

  5. [Hippocratic concept of hysteria].

    Science.gov (United States)

    Catonné, J P

    1992-12-01

    The Greek physicians of the fourth century B.C. painstakingly described a number of symptoms that they thought were caused by migrations of a restless uterus, said "wandering womb". According to this concept, we can use the term "hysteria", despite the fact that the noun itself never appears in any of the Hippocratic texts. We can determine its origin as being in ancient Egypt from the medical writings of the Egyptian papyri. In the same way, the therapy is mainly of Egyptian origin, using a combination of recipes to make the moving womb return to its proper place in the body cavity. However, we can also identify the rationality of the Greeks, in particular as regards mechanical physiopathology. Hippocratic authors are closely connected with presocratical physics, and manifest a distinct break with magic and religion. Furthermore, they claim that hysteria may result from prolonged sexual continence, an opinion which was to influence medical history for over two thousand years.

  6. Temporal Lobe Epilepsy Semiology

    National Research Council Canada - National Science Library

    Blair, Robert D. G

    2012-01-01

    .... The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies...

  7. Temporal lobe epilepsy semiology

    National Research Council Canada - National Science Library

    Blair, Robert D G

    2012-01-01

    .... The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies...

  8. Traces of hysteria in novels.

    Science.gov (United States)

    Haan, Joost; Koehler, Peter J

    2014-01-01

    There have been many descriptions of presumed 'hysterics' in fiction, many appearing in French literature, but also in a number of other languages. It is clear that contemporary medical ideas and insights about hysteria had a major influence on its depiction in novels. This is particularly true for naturalistic literature, which has been the subject of previous reviews. Here, we focus on a more recent novel: Human Traces by Sebastian Faulks (2005). What is special about the depiction of hysteria in this work is that the presumed 'hysteric' turns out not to be hysteric at all. In the novel, as well as in this chapter, the diagnosis of hysteria is discussed in the light of theories about hysteria of around 1900. For comparison, we present some examples of true 'hysterics' as they occur in fiction. Since it has become clear that severe nonpsychiatric diseases such as an ovarian teratoma can lead to bizarre phenotypes, the association of 'hysteria' with the womb has to be seen in another light.

  9. Semiology and the Producer.

    Science.gov (United States)

    Jacquinot, Genevieve

    1979-01-01

    A semiological analysis of films and television broadcasts permits better mastery of the way in which filmic matter can realize didactic intentions, improved understanding of the process of acquisition of knowledge, and a better means of relating the processes of communication and learning to interindividual and intercultural differences.…

  10. Reliability of semiology description.

    Science.gov (United States)

    Heo, Jae-Hyeok; Kim, Dong Wook; Lee, Seo-Young; Cho, Jinwhan; Lee, Sang-Kun; Nam, Hyunwoo

    2008-01-01

    Seizure semiology is important for classifying patients' epilepsy. Physicians usually get most of the seizure information from observers though there have been few reports on the reliability of the observers' description. This study aims at determining the reliability of observers' description of the semiology. We included 92 patients who had their habitual seizures recorded during video-EEG monitoring. We compared the semiology described by the observers with that recorded on the videotape, and reviewed which characteristics of the observers affected the reliability of their reported data. The classification of seizures and the individual components of the semiology based only on the observer-description was somewhat discordant compared with the findings from the videotape (correct classification, 85%). The descriptions of some ictal behaviors such as oroalimentary automatism, tonic/dystonic limb posturing, and head versions were relatively accurate, but those of motionless staring and hand automatism were less accurate. The specified directions by the observers were relatively correct. The accuracy of the description was related to the educational level of the observers. Much of the information described by well-educated observers is reliable. However, every physician should keep in mind the limitations of this information and use this information cautiously.

  11. Freud's hysteria and its legacy.

    Science.gov (United States)

    Kanaan, R A A

    2016-01-01

    Though Freud was himself interested in neurologic disorders, the model of hysteria he developed - of the repression of painful experiences, and their conversion into physical symptoms - made the disorder psychiatric, as the increasingly complex explanations came to rely on the "meaning" of events, which could not easily be understood neurologically. This evolved to become a prototype for psychiatric illness more broadly, a model which, though challenged by the First World War, enjoyed great success, notably in the USA, dominating psychiatric thinking for most of the 20th century. Concerns about the empiric basis for his ideas latterly led to a rapid decline in their importance, however, exemplified by 1980's "etiologically neutral" DSM-III. Hysteria, now renamed conversion disorder, retained its Freudian explanation for another 30 years, but as psychiatry lost its faith in Freud, so psychiatrists stopped seeing the disorder he had made theirs, and returned it once more to neurology. © 2016 Elsevier B.V. All rights reserved.

  12. Seizure semiology and aging.

    Science.gov (United States)

    Silveira, Diosely C; Jehi, Lara; Chapin, Jessica; Krishnaiengar, Suparna; Novak, Eric; Foldvary-Schaefer, Nancy; Najm, Imad

    2011-02-01

    The incidence of epilepsy is high in older individuals. However, epilepsy in the elderly may be underdiagnosed and undertreated because of diagnostic difficulties. The main goal of this study was to determine whether seizure semiology differs between older and younger adults with epilepsy in the outpatient setting. Fifty patients with focal epilepsy aged 55 years and older and 50 patients aged between 18 and 45 years were included. Review of medical records contained detailed seizure description. There were no differences in seizure semiology between groups, except that subtle perceptions of transient confusion were seen in older patients but not in younger patients (P=0.0028). Older patients had less generalized motor seizures, but the differences between groups did not reach significance (P=0.01). Older patients may present with subtle symptoms of seizures characterized by brief periods of confusion, which may contribute to greater difficulty diagnosing seizures in the elderly. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Temporal lobe epilepsy semiology.

    Science.gov (United States)

    Blair, Robert D G

    2012-01-01

    Epilepsy represents a multifaceted group of disorders divided into two broad categories, partial and generalized, based on the seizure onset zone. The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies such as MRI, fMRI, FDG-PET, MEG, or invasive intracranial EEG recording. Temporal lobe epilepsy (TLE) is the commonest form of focal epilepsy and represents almost 2/3 of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone.

  14. Semiology and a Semiological Reading of Power Myths in Education

    Science.gov (United States)

    Kükürt, Remzi Onur

    2016-01-01

    By referring to the theory of semiology, this study aims to present how certain phrases, applications, images, and objects, which are assumed to be unnoticed in the educational process as if they were natural, could be read as signs encrypted with certain ideologically-loaded cultural codes, and to propose semiology as a method for educational…

  15. Insular Epilepsy: Semiology and Noninvasive Investigations.

    Science.gov (United States)

    Obaid, Sami; Zerouali, Younes; Nguyen, Dang Khoa

    2017-07-01

    In this review, authors discuss the semiology and noninvasive investigations of insular epilepsy, an underrecognized type of epilepsy, which may mimic other focal epilepsies. In line with the various functions of the insula and its widespread network of connections, insular epilepsy may feature a variety of early ictal manifestations from somatosensory, visceral, olfactory, gustatory, or vestibular manifestations. Depending on propagation pathways, insular seizures may also include altered consciousness, dystonic posturing, complex motor behaviors, and even autonomic features. Considering the variability in seizure semiology, recognition of insular epilepsy may be challenging and confirmation by noninvasive tests is warranted although few studies have assessed their value. Detection of an insular lesion on MRI greatly facilitates the diagnosis. Scalp EEG findings in frontocentral and/or temporal derivations will generally allow lateralization of the seizure focus. Ictal single-photon computed tomography has moderate sensitivity, whereas positron emission tomography has lower sensitivity. Among newer techniques, magnetoencephalography is highly beneficial, whereas proton magnetic resonance spectroscopy currently has limited value.

  16. Pain Disorder, Hysteria or Somatization?

    Directory of Open Access Journals (Sweden)

    Harold Merskey

    2004-01-01

    Full Text Available Pain used to be a simple issue. It was caused by physical injury or disease and the sufferer had to rest and take opium. That was about two hundred years ago. A few scattered commentators from Jeremiah (Lamentations I:12-13 to Montaigne (1 had the idea that emotion could cause pain or influence it. The development of anatomical knowledge, closely followed by physiology and then pathology, produced a dilemma. There were many pains that could not be explained by the most modern physical methods of the nineteenth century. Hodgkiss (2 has tersely labelled the problem as "pain without lesion". The nineteenth century solution lay in a diagnosis of hysteria.

  17. Hysteria to conversion disorders: Babinski's contributions

    Directory of Open Access Journals (Sweden)

    Marleide da Mota Gomes

    2014-04-01

    Full Text Available The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.

  18. Hysteria to conversion disorders: Babinski's contributions

    OpenAIRE

    Marleide da Mota Gomes; Eliasz Engelhardt

    2014-01-01

    The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hyster...

  19. Relationship between semiology of psychogenic nonepileptic seizures and Minnesota Multiphasic Personality Inventory profile.

    Science.gov (United States)

    Griffith, Nathan M; Szaflarski, Jerzy P; Schefft, Bruce K; Isaradisaikul, David; Meckler, Jason M; McNally, Kelly A; Privitera, Michael D

    2007-08-01

    Subtypes of psychogenic nonepileptic seizures (PNES) have emerged via classification of seizure semiology, psychological variables, or both. PNES subtypes that differ with respect to etiology may be amenable to targeted treatment strategies. The aim of the present study was to investigate the relationship between semiology type and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profile among patients with PNES. We did so by modifying a classification scheme proposed by Selwa et al. Our main hypothesis was that there would be significant associations of semiology-based subtypes with psychological profiles among patients with PNES. We found significant differences in mean scores on MMPI-2 clinical scales 1 (Hypochondriasis) and 3 (Hysteria) and Harris-Lingoes subscales D5 (Brooding) and Sc5 (Lack of Ego Mastery, Defective Inhibition) across PNES subtypes (catatonic, minor motor, major motor). The results of the present study enhance understanding of the nosology of PNES by identifying psychopathological correlates of semiology-based subtypes of PNES. Our study also may inform the methodology of future investigations of psychopathology among patients with PNES by providing support for content-based interpretation of the MMPI.

  20. [New Forms of Hysteria: Globalization, Market and the Comeback of Hysteria].

    Science.gov (United States)

    Ortega, Lucio González

    2012-09-01

    Hysterical disorder has had different interpretations and therapeutic approaches according to the different cultural contexts. In the Middle Ages, hysteria was conceived as devilish possessions whose symptoms became a sort of veracity certificate for the era's cultural pillar: the Bible. During Renaissance, hysteria obeys a new master: Science, dramatizing the neurological degenerative injuries to give reputation to physicians of the time. There is a kind of consensus: hysteria is an ever less observable disorder in consultation. It has practically disappeared in the North American Diagnosis Manual, DSM-IV. We wonder, has hysteria as such disappeared? Has it gotten new expressions? Psychoanalytic review of hysteria, followed by a qualitative, historical and hermeneutic study. In these days of globalization, science is not the master anymore; instead, science is at the service of computing and market. The market biggest sellers are: depressive and anxious disorders, bulimia, anorexia, fibromyalgia, sexual drawbacks, somatoform disorders and extreme exhaustion disorder. Hysteria, raising bewilderment in modern medicine, comes back, cut up into pieces, in the form of these multiple disorders. Not only hysteria has not disappeared, but it has increased in consultation, almost perfect simulation of the disorders most promoted by capitalistic markets, granting power to the new master. Subsequently, its powerlessness is denounced, nothing alleviates said disorders. As Freud stated, the problem lies in the fact that this word does not have a receiver to decipher it. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Localization of pediatric seizure semiology.

    Science.gov (United States)

    Vendrame, Martina; Zarowski, Marcin; Alexopoulos, Andreas V; Wyllie, Elaine; Kothare, Sanjeev V; Loddenkemper, Tobias

    2011-10-01

    The aim of this study was to evaluate the relationship between semiology of seizures in children and adolescents to the corresponding EEG localization. Charts of 225 consecutive pediatric epilepsy patients undergoing Video-EEG monitoring (VEM) over 2 years were reviewed. Seizure semiology recorded during VEM was classified according to ILAE seizure semiology terminology and EEG localization, and analyzed based on onset as defined by the EEG data (generalized, frontal, temporal, parietal, occipital or multilobar). A total of 1008 seizures were analyzed in 225 children (mean age 8.5 years, range 0-20), with 50% boys. Auras and seizures with automatisms arose predominantly from the temporal lobes (psemiologies relate to specific brain regions, with overlap between focal and generalized semiological seizure types, as identified electrographically. Semiology of seizures can provide important information for epilepsy localization, and should not be overlooked, especially in patients undergoing pre-surgical evaluation. Separation of clinical seizure description and EEG findings may be useful, in particular when only incomplete information is available. i.e. during the first office visit. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Semiology Put to Data Mining.

    Science.gov (United States)

    Tunbridge, Nat

    1999-01-01

    Describes Semio, a company founded in 1996 that uses semiology to provide straightforward access to information. Discusses the text-mining engine at the core of the company's software; products; focus on the intranet market; competitors; partnership with corporate portals. (AEF)

  3. Semiology of hypermotor (hyperkinetic) seizures.

    Science.gov (United States)

    Alqadi, Khalid; Sankaraneni, Ram; Thome, Ursula; Kotagal, Prakash

    2016-01-01

    Hypermotor seizures (HMSs) consist of complex movements involving proximal segments of the limbs and trunk that appear violent and inappropriate for the situation. We analyzed hypermotor seizure videos in seizure-free patients (Engel class I) following resective epilepsy surgery. After completion of video analysis, we reviewed EEG and neuroimaging data. Search of our epilepsy surgery database yielded 116 patients classified as having hypermotor seizures between 1996 and 2013. From this subset, 17/31 (55%) patients had been seizure-free for >6months (mean follow-up: 3.3years). Mean seizure duration was 35s (range: 6-91s), of which the HM phase lasted a mean of 22s (range: 3-53s). In 16 patients (95%), hypermotor activity was seen at or within 10s of clinical seizure onset. Type I semiology occurred in 6 patients, type II semiology in 10 patients, and 1 patient exhibited features of both. Type I and type II semiologies were noted in patients who had frontal lobe as well as extrafrontal resections. Nonversive head and body turning occurred in 10 patients (ranging from 90° to 270°) which was ipsilateral to the side of resection in all patients and seen both in frontal and extrafrontal resections. Six out of eleven patients with abnormal MRI and 4/6 patients with nonlesional MRI underwent invasive EEG evaluation. Eight patients (47%) had frontal lobe resection, 4/17 (23%) patients had temporal lobe resection, and one patient each had parietal lobe, insular, temporoparietooccipital, or motor sparing resection; 1 patient had functional hemispherectomy. Hypermotor semiology typically occurs at or within 10s after seizure onset. Ipsilateral head/body turning appears to be of lateralizing value whereas asymmetry of limb movement was not lateralizing. Hypermotor semiology is most often seen in frontal lobe epilepsy but may occur in seizures arising from other locations. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. [Living hysteria--hysteria in every day life and asyum psychiatry around 1900].

    Science.gov (United States)

    Nolte, Karen

    2005-01-01

    Hysteria has been mostly analysed with reference to the medical and intellectual discourse. The patient's view (Porter) has been solely included on the basis of published case histories. Historians have focussed particularly on the relation between famous psychiatrists or neurologists and "their" hysterics. The social circumstances of a maid's mental illness in 1913 are reconstructed. The servant Grete K. was admitted to the Landesheilanstalt Marburg (asylum of Marburg) with the diagnosis of "depressive hysteria". Her hysterical malady was traced back to her reading of the novel 'Ich lasse dich nicht' ('I won't let you go') written by the popular novelist Hedwig Courths-Mahler in 1912. Physicians and pedagogues at that time uniformly claimed the reading of pulp fiction to be dangerous for the nerves in general. Elaine Showalter has pointed out that in the 19th century hysteria was spread by "media infection". This historical analysis of Grete K.s medical record will seize and improve Showalters suggestion. The analysis of the maid's medical record is a part of a dissertation project on hysteria in every day life and psychiatric practice around 1900. The study has turned the attention on the process of negotiation between psychiatrists and hysterical women.

  5. Vestibular migraine

    DEFF Research Database (Denmark)

    Lempert, Thomas; Olesen, Jes; Furman, Joseph

    2012-01-01

    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

  6. [Semiology and propagation of epileptic seizures].

    Science.gov (United States)

    Gellner, A-K; Fritsch, B

    2013-06-01

    The evaluation of episodic seizure-like symptoms is a common challenge in the neurologist's daily routine. The clinical signs (semiology) are the most important puzzle pieces to distinguish epileptic seizures from other episodic entities. Due to the often far-reaching health and social consequences of the diagnosis of epilepsy, the early and rigorous assessment of episodic symptoms by means of the patient history is important. This assessment is based on knowledge of the association of certain semiologies with epileptic syndromes and brain regions; however, certain limitations and pitfalls have to be considered. Typical propagation pathways of seizure activity determine the serial occurrence of semiological features and provide supplementary information.

  7. [Interactive tools to standardize semiology teaching].

    Science.gov (United States)

    González, Alejandro; Vargas, Bryan; González, Vicente; Reyes, Ignacio; Sarfatis, Alberto

    2016-12-01

    The learning process for medical semiology depends on multidisciplinary teaching activities, including simulation tools. These tools should achieve a standardization level aiming at a same level of basic knowledge in each student. To evaluate an interactive online semiology learning tool. An interactive online learning method for medical semiology was developed. It focused mainly on physical examination and incorporated audiovisual and self-explanatory elements, to strengthen the acquisition of skills and basic knowledge for each standardized clinical learning simulation session. Subsequently, a satisfaction survey was conducted. Also the performance of students in a clinical examination was compared with that of students of the previous year. Student satisfaction was outstanding, and there was a significant improvement in the performance on the final exam. The use of interactive self-learning online content for medical semiology provides an effective tool to improve student learning.

  8. Disguised hysteria in a child psychosis?

    Science.gov (United States)

    Pualuan de Gomberoff, L; Gomberoff, M

    1998-01-01

    In this paper the stages are presented in the psychoanalysis of an eight-and-a-half-year-old boy consulting with a worsening symptomatology that has been evolving for more than one year. The trigger element seems to have been the birth of a brother. During the analysis the relation was clear between this brother's birth, the mother's abortions, and the previous death of a brother. The interpretation of the homicidal omnipotent fantasies and the analyst's reception of projective identifications, destructive anxieties, and castrating anxieties of the patient produced, apparently, an unimagined fast improvement of the psychotic symptoms. This took the authors retrospectively to raise the hypothesis that this patient's psychosis could be a disguised child hysteria.

  9. Mass hysteria among South African primary school learners in Kwa ...

    African Journals Online (AJOL)

    2009-08-03

    Natal, 27 children who had been well when they left their ... to the stress and the anxiety that the children faced when they returned to school. Mass hysteria can ... then difficulty in breathing and palpitations, followed by abdominal ...

  10. Sigmund Freud and hysteria: the etiology of psychoanalysis?

    Science.gov (United States)

    Bogousslavsky, Julien; Dieguez, Sebastian

    2014-01-01

    Sigmund Freud developed a specific interest in hysteria after his stay with Professor Jean-Martin Charcot during the winter of 1885-1886, although his previous activity mainly consisted of neuropathology and general medical practice. Most of his initial studies on hysteria (hysteria in men, influence of subconscious ideas, role of traumas, and psychological and sexual factors) were indeed 'borrowed' from Charcot and his immediate followers, such as Pierre Janet and Paul Richer. Subsequently, Freud developed with Breuer a theory of hysteria which encompassed a mixture of Janet's 'fixed subconscious ideas' with the 'pathological secret' concept of Moriz Benedikt. After their book Studies on Hysteria (1895), Freud interrupted his collaboration with Breuer and developed the concept of conversion of psychological problems into somatic manifestations, with a strong 'sexualization' of hysteria. Firstly, he believed that actual abuses had occurred in these patients (the 'seduction' theory), but then blamed them for having deceived him on that issue, so that he subsequently launched a 'fantasy' theory to explain the development of hysterical symptoms without the necessity of actual abuses. Like many of his contemporaries, and contrary to his claims, Freud did not follow a scientific process of verified experiments, but rather adapted his theories to the evolution of his own beliefs on psychological conditions, selectively emphasizing the aspects of his 'therapies' with patients which supported his emerging ideas, with often abrupt changes in theoretical interpretations. While it remains difficult to get a clear, synthetic vision of what was Freud's definite theory of hysteria, it is obvious that hysteria really was the origin of what would become Freud's psychoanalytical theory. Indeed, psychoanalysis appears to have been initially developed by him largely in order to absorb and explain his many changes in the interpretation of hysterical manifestations.

  11. The history of hysteria and what’s next…

    Directory of Open Access Journals (Sweden)

    Hłodzik Klemens

    2016-03-01

    Full Text Available From the ancient times up till now hysteria has been a mysterious and intriguing issue. The authors of this article using mainly the work of Etienne Trillat of the same title, present the most important facts from the history of hysteria. Our work shows how notions of hysteria known initially as uterine dyspnoea, which was the term used by Hippocrates in the seventh tome of his “Collected Works” evolved step by step. At the end of 1st century AD a newcomer to Rome, Soranus of Ephesus, as an experienced anatomist in his “Treatise on midwifery and the diseases of women” moved away from the old ideas of Plato and Hippocrates equating uterus to an animal. How did views on hysteria develop throughout Middle Ages, Renaissance or World Wars period? In this article the authors are trying to determine the nature of hysteria as well as what remained from hysteria in the contemporary times, depicting hysteria’s elusiveness as a disease, many difficulties with its definition and connection with many shocking events in history of mankind. From the ancient sages, through Kramer, Sprenger, Wier, Harvey, Willis, Sydenham, Blackmore up until Mesmer, Freud and many others. From hysteric witches, beings suffering from vapors, through sensitive, fragile and musing women up until mythomaniacs, nymphomaniacs and what we define today as histrionic personality disorder. In the words of French neurologist and a creator of psychiatry – Charcot – hysteria existed forever, everywhere and all-time. Why did it vanish though? Authors of this article will address this problem in the final part, trying to determine the cause.

  12. Pretreatment seizure semiology in childhood absence epilepsy.

    Science.gov (United States)

    Kessler, Sudha Kilaru; Shinnar, Shlomo; Cnaan, Avital; Dlugos, Dennis; Conry, Joan; Hirtz, Deborah G; Hu, Fengming; Liu, Chunyan; Mizrahi, Eli M; Moshé, Solomon L; Clark, Peggy; Glauser, Tracy A

    2017-08-15

    To determine seizure semiology in children with newly diagnosed childhood absence epilepsy and to evaluate associations with short-term treatment outcomes. For participants enrolled in a multicenter, randomized, double-blind, comparative-effectiveness trial, semiologic features of pretreatment seizures were analyzed as predictors of treatment outcome at the week 16 to 20 visit. Video of 1,932 electrographic absence seizures from 416 participants was evaluated. Median seizure duration was 10.2 seconds; median time between electrographic seizure onset and clinical manifestation onset was 1.5 seconds. For individual seizures and by participant, the most common semiology features were pause/stare (seizure 95.5%, participant 99.3%), motor automatisms (60.6%, 86.1%), and eye involvement (54.9%, 76.5%). The interrater agreement for motor automatisms and eye involvement was good (72%-84%). Variability of semiology features between seizures even within participants was high. Clustering analyses revealed 4 patterns (involving the presence/absence of eye involvement and motor automatisms superimposed on the nearly ubiquitous pause/stare). Most participants experienced more than one seizure cluster pattern. No individual semiologic feature was individually predictive of short-term outcome. Seizure freedom was half as likely in participants with one or more seizure having the pattern of eye involvement without motor automatisms than in participants without this pattern. Almost all absence seizures are characterized by a pause in activity or staring, but rarely is this the only feature. Semiologic features tend to cluster, resulting in identifiable absence seizure subtypes with significant intraparticipant seizure phenomenologic heterogeneity. One seizure subtype, pause/stare and eye involvement but no motor automatisms, is specifically associated with a worse treatment outcome. © 2017 American Academy of Neurology.

  13. The hysteria in The Flesh, of Julio Ribeiro

    Directory of Open Access Journals (Sweden)

    André Luis Masiero

    2012-11-01

    Full Text Available This paper analyzes the novel The flesh of Julio Ribeiro, from the perspective of freudian psychoanalysis. The book, a naturalistic novel published in 1888, criticizes the formation of gender roles in nineteenth-century culture and anticipates psychoanalytic ideas about sexuality and hysteria, which allows an interesting approach between literature and psychoanalysis. The analysis is focused on the development of the two central characters, Lenita and Manduca. We observed in Lenita a transformation of hysteria, first it appears like a illness, after to transgression and thence like a critique of sexuality and gender roles. The male anxieties and conflicts are marked by silence, a discursive failure which does not allow psychopathological ratings. At the end the hysteric Lenita interrupts a long cycle of compulsive repetition and Manduca linearly stay mute and succumbs. Returning to the beginning of psychoanalysis observe the same phenomenon: the difficulty, admitted by Freud, in exposing male hysteria.

  14. Alleviation of hysteria in laying hens with dietary tryptophan.

    Science.gov (United States)

    Laycock, S R; Ball, R O

    1990-01-01

    A commercial layer breeder flock that was suffering from hysteria was fed a diet containing 5 grams tryptophan/kg for six days. The incidence of episodes of hysteria declined from five times/hour on day 0 to once/hour on day 6 and none on day 8. Feed consumption increased from 107 g to 145 g/hen/day and egg production increased 23% during the six day feeding period. The tryptophan concentration in plasma doubled (from 95.6 to 188.2 mumol/mL). Plasma phenylalanine and tyrosine also increased. Birds that were not in lay, by postmortem examination, had significantly higher plasma valine concentrations (476.4 vs 372.7 mumol/mL). Tryptophan, serotonin and related metabolites increased in both the hypothalamic region and the remainder of the brain following tryptophan feeding, and subsequently declined. High levels of dietary tryptophan may be useful in alleviating hysteria in poultry. PMID:2357668

  15. View Point: Episodes of mass hysteria in African schools: A study of ...

    African Journals Online (AJOL)

    African schools. South Africa. South Africa is one of the countries in Africa with a number of episodes of Mass hysteria among students being reported. In 1999 mass hysteria occurred at a high school in Umtata,. Eastern Cape of South ..... Mampunza M. (1999) Coexistence of mass hysteria, konzo and HTLV-1 virus in the ...

  16. The Structural Linguistic Foundation of Film Semiology.

    Science.gov (United States)

    Buckland, Warren

    1991-01-01

    Epistemological breaks in several of the humanities disciplines in the twentieth century (existentialism, phenomenology, and traditional film theory) are traced. The breaks are attributed to each discipline's attempt to become scientific. In this process is seen the emergence of the discipline of film semiology in France in the 1960s. (34…

  17. Elementary lesions in dermatological semiology: literature review.

    Science.gov (United States)

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology.

  18. Early modern green sickness and pre-Freudian hysteria.

    Science.gov (United States)

    Schleiner, Winfried

    2009-01-01

    In early modern medicine, both green sickness (or chlorosis) and hysteria were understood to be gendered diseases, diseases of women. Green sickness, a disease of young women, was considered so serious that John Graunt, the father of English statistics, thought that in his time dozens of women died of it in London every year. One of the symptoms of hysteria was that women fell unconscious. The force of etymology and medical tradition was so strong that in one instance the gender of the patient seems to have been changed by the recorder to make the case fit medical theory.

  19. Dissociation in hysteria and hypnosis: evidence from cognitive neuroscience.

    Science.gov (United States)

    Bell, Vaughan; Oakley, David A; Halligan, Peter W; Deeley, Quinton

    2011-03-01

    Jean-Martin Charcot proposed the radical hypothesis that similar brain processes were responsible for the unexplained neurological symptoms of 'hysteria', now typically diagnosed as 'conversion disorder' or 'dissociative (conversion) disorder', and the temporary effects of hypnosis. While this idea has been largely ignored, recent cognitive neuroscience studies indicate that (i) hypnotisability traits are associated with a tendency to develop dissociative symptoms in the sensorimotor domain; (ii) dissociative symptoms can be modelled with suggestions in highly hypnotisable subjects; and (iii) hypnotic phenomena engage brain processes similar to those seen in patients with symptoms of hysteria. One clear theme to emerge from the findings is that 'symptom' presentation, whether clinically diagnosed or simulated using hypnosis, is associated with increases in prefrontal cortex activity suggesting that intervention by the executive system in both automatic and voluntary cognitive processing is common to both hysteria and hypnosis. Nevertheless, while the recent literature provides some compelling leads into the understanding of these phenomena, the field still lacks well controlled systematically designed studies to give a clear insight into the neurocognitive processes underlying dissociation in both hysteria and hypnosis. The aim of this review is to provide an agenda for future research.

  20. Emergence of semiology in epileptic seizures.

    Science.gov (United States)

    Chauvel, Patrick; McGonigal, Aileen

    2014-09-01

    Semiology, the manifestation of epilepsy, is dependent upon electrical activity produced by epileptic seizures that are organized within existing neural pathways. Clinical signs evolve as the epileptic discharge spreads in both time and space. Studying the relation between these, of which the temporal component is at least as important as the spatial one, is possible using anatomo-electro-clinical correlations of stereoelectroencephalography (SEEG) data. The period of semiology production occurs with variable time lag after seizure onset and signs then emerge more or less rapidly depending on seizure type (temporal seizures generally propagating more slowly and frontal seizures more quickly). The subset of structures involved in semiological production, the "early spread network", is tightly linked to those constituting the epileptogenic zone. The level of complexity of semiological features varies according to the degree of involvement of the primary or associative cortex, with the former having a direct relation to peripheral sensory and motor systems with production of hallucinations (visual and auditory) or elementary sensorimotor signs. Depending on propagation pattern, these signs can occur in a "march" fashion as described by Jackson. On the other hand, seizures involving the associative cortex, having a less direct relation with the peripheral nervous system, and necessarily involving more widely distributed networks manifest with altered cognitive and/or behavioral signs whose neural substrate involves a network of cortical structures, as has been observed for normal cognitive processes. Other than the anatomical localization of these structures, the frequency of the discharge is a crucial determinant of semiological effect since a fast (gamma) discharge will tend to deactivate normal function, whereas a slower theta discharge can mimic physiological function. In terms of interaction between structures, the degree of synchronization plays a key role in

  1. Method in the Madness: Hysteria and the Will to Power

    Directory of Open Access Journals (Sweden)

    Matthew Gildersleeve

    2016-07-01

    Full Text Available At the very start of a chapter on hysteria in her book From Mastery to Analysis: Theories of Gender in Psychoanalytic Feminism, Patricia Elliot cites Nietzsche’s “truths are illusions of which one has forgotten that they are illusions”. This paper follows this connection between hysteria and the work of Nietzsche. This paper will highlight how a Lacanian interpretation of hysteria can elucidate Heidegger’s reading of Nietzsche’s Will to Power and how this interpretation of the Will to Power can better explain the value and importance of hysteria for psychoanalysis and philosophy. I will show that the hysteric’s discourse has a “higher value” than the master’s discourse because it meets Nietzsche’s definition of art, which aims at life’s enhancement rather than the master’s knowledge or truth which aims at the preservation of life. My work will explain how the hysteric’s discourse can transform the master’s discourse into the analyst’s discourse through the Will to Power. This is important, as this is the ultimate aim of psychoanalysis where “At the end of analysis the subject passes to the position of analyst”. This is the ultimate aim of psychoanalysis because “For Lacan, the Discourse of the Analyst is revolutionary because it articulates the truth of the (unconscious subject”. Fundamentally, the objective of this article is to demonstrate that “hysteria is to be understood not as an ‘abnormal’ condition but as one possible manifestation of the subject’s uncanny relationship to itself”.

  2. Vestibular mechanisms.

    Science.gov (United States)

    Precht, W

    1979-01-01

    It is apparent from this and other reviews of the subject that our knowledge of vestibular function is most complete for the primary canal and otolithic afferents. Relatively little progress has been made in the understanding of receptor mechanisms and the functional importance of the efferent vestibular system. Since most of it has been summarized previously the latter were not considered here. Considerably more knowledge has accumulated in the field of central vestibular mechanisms, particularly those related to eye movements. Recent advances in functional synaptology of direct and indirect vestibuloocular pathways are described. It appears that the indirect pathways are essential for the central integration of the peripheral head velocity into a central eye position signal. Candidates for the neural integrator are presented and discussed and their connectivity described both for the horizontal and the relatively poorly studied vertical eye movement system. This field will certainly be studied extensively during the next years. Another interesting field is the role of the cerebellum in the control the vestibuloocular reflex. Recent data and hypotheses, including the problem of cerebellar plasticity, are summarized and evaluated. That the vestibular nuclei are by no means a simple relay system for specific vestibular signals destined for other sensory or motor centers is evidenced in this review by the description of multiple canal-canal, canalotolith, and visual-vestibular convergence at the nuclear level. Canal-otolith and polysensory convergence in vestibular neurons enables them to correct for the inherent inadequacies of the peripheral canal system in the low frequency range. The mechanisms of polysensory interaction in the central vestibular system will undoubtedly be an important and interesting field for future research.

  3. Semiological analysis of Polish theater posters

    Directory of Open Access Journals (Sweden)

    Jelena Nikolić

    2016-02-01

    Full Text Available Through the application of semiological analysis to theater posters made by two Polish authors, the paper uncovers signs, meanings, codes and specifics of the „Polish school of poster-making“ and contemporary Polish posters. Aside from this, I suggest a methodological framework for studying the issue of coding and shaping a theater poster as a culturally specific form of visual communication. The aesthetic and semiotic outlook of the Polish theater posters which were chosen is analyzed using the semiological method which highlights their differences and similarities. By pointing out the system of codes through the examples given here, a graphic designer is informed about the existence and the possibilities of a more systematic approach to shaping a theater poster.

  4. Semiological analysis of Polish theater posters

    OpenAIRE

    Jelena Nikolić; Uroš Nedeljković

    2016-01-01

    Through the application of semiological analysis to theater posters made by two Polish authors, the paper uncovers signs, meanings, codes and specifics of the „Polish school of poster-making“ and contemporary Polish posters. Aside from this, I suggest a methodological framework for studying the issue of coding and shaping a theater poster as a culturally specific form of visual communication. The aesthetic and semiotic outlook of the Polish theater posters which were chosen is analyzed using ...

  5. Elementary lesions in dermatological semiology: literature review*

    Science.gov (United States)

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology. PMID:27828637

  6. [Semiology for gluteal remodeling by lipofilling].

    Science.gov (United States)

    Ho Quoc, C; Mojallal, A

    2012-12-01

    Gluteal augmentation is a consultation request for many patients. The most common surgical techniques performed for gluteal augmentation employ gluteal implants. However, the results can be frustrating. Liposuction is one of the most common surgical procedures in aesthetic surgery. This surgical procedure can provide some complications. Fat grafting is an effective and predictable way to remodel the buttocks. To get better results, it's important to understand gluteal compartments with a descriptive study. The aim of this study is to describe gluteal semiology for buttocks remodeling with fat grafting. We have described gluteal semiology with our review of literature. We have analyzed fat compartments of gluteal region: volume, links between every compartments, connections with major gluteal muscle and with the skin. We have also analyzed shape and volume of the buttocks. We have described 11 aesthetic subunits, the volume and the shape of the buttocks, and the skin laxity. We did an important literature review to understand the most important gluteal zones to improve for patients' satisfaction. Our gluteal semiology description is very useful to understand liposuction/lipoinjection of gluteal areas. Fat grafting may be a reliable technique, simple and safe procedure. Surgery for correction of the buttocks may involve more than projection and volume. However, these must be in a balanced proportion with the rest of the body. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. [Another seizure classification--Semiological Seizure Classification].

    Science.gov (United States)

    Lin, Ji-Ho; Kwan, Shang-Yeong; Wu, Dean; Su, Min-Shin; Yiu, Chun-Hing

    2004-09-01

    The International League Against Epilepsy (ILAE) introduced in 1981 a seizure classification based on clinical semiology, interictal EEG findings, and ictal EEG patterns. Such classification depends heavily on detailed electroclinical correlation. After 20 years' progress in epileptology, many clinicians have found it difficult to make a "definite" seizure diagnosis clinically without a series of electrophysiological examinations, particularly in the infants, and further advancement in epileptology has findings have made the previous classification inefficient. Lüders and colleagues have proposed a classification, Semiological Seizure Classification (SSC), based exclusively on ictal semiology, which was published in the official journal of ILAE-EPILEPSIA in 1998. The EEG, neuroimaging and other laboratory results should be analyzed separately and then integrated to define the epileptic syndromes. The seizure diagnosis is thus made through a "what-you-see-is-what-you-get" way. It has also provoked an extensive discussion about the necessity of this new classification. In this review, we present the original guideline, which has been used at The Cleveland Clinic Foundation for years, to introduce another method of epileptic seizure classification.

  8. Vestibular compensation following vestibular neurotomy.

    Science.gov (United States)

    Devèze, A; Montava, M; Lopez, C; Lacour, M; Magnan, J; Borel, L

    2015-09-01

    Four studies assessing vestibular compensation in Menière's disease patients undergoing unilateral vestibular neurotomy, using different analysis methods, are reviewed, with a focus on the different strategies used by patients according to their preoperative sensory preference. Four prospective studies performed in a university tertiary referral center were reviewed, measuring the pattern of vestibular compensation in Menière's disease patients before and after unilateral vestibular neurotomy on various assessment protocols: postural syndrome assessed on static posturography and gait analysis; perceptual syndrome assessed on subjective visual vertical perception; and oculomotor syndrome assessed on ocular cyclotorsion. Vestibular compensation occurred at variable intervals depending on the parameter investigated. Open-eye postural control and gait/walking returned to normal one month after neurotomy. Fine balance analysis found that visual perception of the vertical and ocular cyclotorsion impairment persisted at long-term follow-up. Clinical postural disturbance persisted only when visual afferents were cut off (eyes closed). These impairments were the expression of a postoperative change in postural strategy related to the new use of visual and non-visual references. Understanding pre-operative interindividual variation in balance strategy is critical to screening for postural instability and tailoring vestibular rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Value and limitations of seizure semiology in localizing seizure onset.

    Science.gov (United States)

    So, Elson L

    2006-08-01

    Seizure semiology has been the foundation of clinical diagnosis of seizure disorders. This article discusses the value and the limitations of behavioral features of seizure episodes in localizing seizure onset. Studies have shown that some semiologic features of seizures are highly accurate in the hemispheric lateralization and lobar localization of seizures. There is good agreement between blinded reviewers in lateralizing video-recorded seizures in temporal lobe and extratemporal lobe epilepsies. However, seizure semiology alone should not be used to determine the site of seizure onset. Each semiologic feature may falsely localize seizure onset. Seizure semiology in some patients may signify the site of seizure propagation rather than origination. Moreover, seizure semiology may not be as reliable in multifocal epilepsies as it is in unifocal epilepsies. Many semiologic features of seizures of adults are often missing in seizures of children. Seizure semiology should be analyzed and integrated with EEG and neuroimaging data to localize the seizure focus. A sample of the recorded seizures should be shown to the patient's relatives or friends to verify that it is representative of habitual seizures.

  10. Teatro y Semiología

    Directory of Open Access Journals (Sweden)

    Bobes Naves, María del Carmen

    2004-04-01

    Full Text Available Se detiene este trabajo en el inicio de la Semiología del Teatro desde los años treinta del siglo XX, delimitando su campo de estudio -el estudio de los signos, de todos los signos-. Después de señalar la importancia de algunos autores (Veltruski, Honzl, Bogatyrev..., se estudia la diferencia entre texto literario y texto espectacular, para detenerse luego en las teorías semánticas sobre el Teatro, los sistemas de signos en la escena y el proceso de comunicación dramática.…

  11. 'The Move', an innovative simulation-based medical education program using roleplay to teach neurological semiology: Students' and teachers' perceptions.

    Science.gov (United States)

    Roze, E; Flamand-Roze, C; Méneret, A; Ruiz, M; Le Liepvre, H; Duguet, A; Renaud, M-C; Alamowitch, S; Steichen, O

    2016-01-01

    Neurological disorders are frequently being managed by general practitioners. It is therefore critical that future physicians become comfortable with neurological examination and physical diagnosis. Graduating medical students often consider neurological examination as one of the clinical skills they are least comfortable with, and they even tend to be neurophobic. One way to improve the learning of neurological semiology is to design innovative learner-friendly educational methods, including simulation training. The feasibility of mime-based roleplaying was tested by a simulation training program in neurological semiology called 'The Move'. The program was proposed to third-year medical students at Pierre and Marie Curie University in Paris during their neurology rotation. Students were trained to roleplay patients by miming various neurological syndromes (pyramidal, vestibular, cerebellar, parkinsonian) as well as distal axonopathy, chorea and tonic-clonic seizures. Using an anonymous self-administered questionnaire, the students' and teachers' emotional experience and views on the impact of the program were then investigated. A total of 223/365 students (61%) chose to participate in the study. Both students and teachers felt their participation was pleasant. Students stated that The Move increased their motivation to learn neurological semiology (78%), and improved both their understanding of the subject (77%) and their long-term memorization of the teaching content (86%). Although only a minority thought The Move was likely to improve their performance on their final medical examination (32%), a clear majority (77%) thought it would be useful for their future clinical practice. Both students (87%) and teachers (95%) thought The Move should be included in the medical curriculum. Mime-based roleplaying simulation may be a valuable tool for training medical students in neurological semiology, and may also help them to overcome neurophobia. Copyright © 2016

  12. Varying seizure semiology according to age.

    Science.gov (United States)

    Nordli, Douglas R

    2013-01-01

    The clinical manifestations of seizures change in a predictable fashion with advancing age. For focal seizures these changes can be summarized into domains similar to those used in developmental models. These include fine motor, communication, and gross motor manifestations. Instead of socialization the fourth domain for seizure semiology concerns synchronization. Focal seizures in the very young tend to be simpler with fewer fine motor manifestations. Auras are uncommon, even in young children with some linguistic skill and it is often difficult to discern alteration of consciousness. Infantile focal seizures can present with spasms or even diffuse tonic seizures. In terms of synchronization, orderly secondary generalization is rarely seen so that primary generalized clonic seizures are rarely recorded in infants. Amongst so-called "generalized" seizures spasms are most often seen in the first year of life. Absence seizures, myoclonic-astatic and generalized tonic-clonic seizures are all usually not seen until after age 2 years. A full description of the clinical details of seizures is probably the most important part of the epilepsy history. A detailed knowledge of seizure semiology can make the history more effective and also in the identification of the correct seizure classification. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Seizure semiology identifies patients with bilateral temporal lobe epilepsy.

    Science.gov (United States)

    Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

    2015-01-01

    Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; psemiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Hysteria in fin de siècle French novels.

    Science.gov (United States)

    Walusinski, Olivier

    2013-01-01

    During the second half of the 19th century, sociopolitical conditions and society's interest in psychological questions transformed the millennial concept of hysteria into a sociocultural representation of the female condition and sexuality. Influenced by the public demonstrations of Jean-Martin Charcot at La Salpêtrière, many writers attempted to magnify this neurologist's work in their novels. In this chapter, we will analyze several representative passages written by Jules Clarétie, Camille Lemonnier, Jules Lermina, Octave Mirbeau, Joris-Karl Huysmans, and Gustave Flaubert, bearing in mind the scientific, progressive, and anticlerical ideas of the time. Copyright © 2013 S. Karger AG, Basel.

  15. Restaging Hysteria: Mary Wigman as Writer and Dancer

    Directory of Open Access Journals (Sweden)

    Laura A. McLary

    2003-06-01

    Full Text Available Mary Wigman was not only a leading proponent of the early twentieth-century Expressionist dance movement, but also a writer of poetry and short poetic prose. Despite her assertion that dance was beyond language, she wrote often about dance in an attempt to articulate the kinesthetic experience of dance through languages. This interdisciplinary study explores the intersection of dance and writing for Wigman, focusing on gender coding in writing and dance within the context of early twentieth-century dialogues. Despite the pervasive equation of (feminine hysteria with dance and (masculine subjectivity with authorship, Wigman engaged in both activities. I argue that Wigman is able to reclaim and redefine the "hysteria" of the dance experience through writing about dance. In her dance poetry, the act of looking at herself in a mirror as she dances allows Wigman to circumvent the traditional objectification through the male gaze experienced by the female dancer. Through the act of writing, Wigman asserts her subjectivity, taking control of the out-of-body experience of dance creation.

  16. Reliability of seizure semiology in patients with 2 seizure foci.

    Science.gov (United States)

    Rathke, Kevin M; Schäuble, Barbara; Fessler, A James; So, Elson L

    2011-06-01

    To determine whether seizure semiology is reliable in localizing and distinguishing seizures at 2 independent brain foci in the same patient. Two masked reviewers localized seizures from 2 foci by their clinical semiology and intracranial electroencephalograms (EEGs). Epilepsy monitoring unit of referral comprehensive epilepsy program. Seventeen consecutive patients (51 seizures) with sufficient video and intracranial EEG data were identified by reviewing medical records of 366 patients older than 10 years. The primary outcome measures were interobserver agreement between the 2 masked reviewers; the proportion of seizures localized by semiology; the proportion of localized seizures concordant with intracranial EEG localization; and comparison between concordant and nonconcordant seizures in latency of intracranial EEG seizure spread. Interobserver agreement was 41% (κ score, 0.16). Only 30 of 51 seizures (59%) were localized by seizure semiology. The focus localized by semiology was concordant with the location of intracranial EEG seizure onset in 16 of 30 seizures (53%). No significant difference was observed between concordant and nonconcordant seizures in relation to the speed with which the EEG discharge spread from the location of seizure onset to another lobar region (P = .09, Wilcoxon rank sum test). Clinical seizure semiology is not as useful as intracranial EEG in localizing seizure onset in patients with dual seizure foci.

  17. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Hansen, Søren; Caye-Thomasen, Per

    2015-01-01

    that this may be caused by both cochlear and retrocochlear mechanisms. Multiple mechanisms may also be at play in the case of dizziness, which may broaden perspectives of therapeutic approach. This study presents a systematic and detailed assessment of vestibular histopathology in temporal bones from patients...... with VS. METHODS: Retrospective analysis of vestibular system histopathology in temporal bones from 17 patients with unilateral VS. The material was obtained from The Copenhagen Temporal Bone Collection. RESULTS: Vestibular schwannomas were associated with atrophy of the vestibular ganglion, loss of fiber...... density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas...

  18. On the early history of male hysteria and psychic trauma. Charcot's influence on Freudian thought.

    Science.gov (United States)

    Libbrecht, K; Quackelbeen, J

    1995-10-01

    This paper discusses the influence of Jean-Martin Charcot's views on Sigmund Freud's early theory of hysteria and the notion of psychical trauma. We consider the early history of both psychical trauma and male hysteria, for in Charcot's view traumatic hysteria and male hysteria are identical. Freud's two 1886 lectures on male hysteria, delivered after his return from Paris, are crucial to the subject because they present Freud's first impressions of Charcot and his teaching. Some of the ideas presented in the two lectures foreshadow Freud's later generalization of the etiological role of trauma and his theory of the role of psychical trauma in the genesis of hysteria; that is, each hysterical symptom is due to a psychical trauma reviving an earlier traumatic event--the so-called principle of deferred action (Nachträglichkeit). Several arguments substantiate the thesis that Freud's notion of psychical (sexual) trauma was developed in reference to Charcot's notion of traumatic hysteria, and that the early psychoanalytic theory of psychical trauma is clearly indebted to Freud's encounter with Charcot's male traumatic hysterical patients. The discussed Freudian development points out the major role of (physical) traumata in eliciting psychopathological pictures and in this way is of definite historical relevance for the present-day discussion on the traumatic nature of the so-called multiple personality syndrome and other dissociative disorders, and post-traumatic stress disorders.

  19. Frontal lobe seizures: from clinical semiology to localization.

    Science.gov (United States)

    Bonini, Francesca; McGonigal, Aileen; Trébuchon, Agnès; Gavaret, Martine; Bartolomei, Fabrice; Giusiano, Bernard; Chauvel, Patrick

    2014-02-01

    Frontal lobe seizures are difficult to characterize according to semiologic and electrical features. We wished to establish whether different semiologic subgroups can be identified and whether these relate to anatomic organization. We assessed all seizures from 54 patients with frontal lobe epilepsy that were explored with stereoelectroencephalography (SEEG) during presurgical evaluation. Semiologic features and concomitant intracerebral EEG changes were documented and quantified. These variables were examined using Principal Component Analysis and Cluster Analysis, and semiologic features correlated with anatomic localization. Four main groups of patients were identified according to semiologic features, and correlated with specific patterns of anatomic seizure localization. Group 1 was characterized clinically by elementary motor signs and involved precentral and premotor regions. Group 2 was characterized by a combination of elementary motor signs and nonintegrated gestural motor behavior, and involved both premotor and prefrontal regions. Group 3 was characterized by integrated gestural motor behavior with distal stereotypies and involved anterior lateral and medial prefrontal regions. Group 4 was characterized by seizures with fearful behavior and involved the paralimbic system (ventromedial prefrontal cortex ± anterior temporal structures). The groups were organized along a rostrocaudal axis, representing bands within a spectrum rather than rigid categories. The more anterior the seizure organization, the more likely was the occurrence of integrated behavior during seizures. Distal stereotypies were associated with the most anterior prefrontal localizations, whereas proximal stereotypies occurred in more posterior prefrontal regions. Meaningful categorization of frontal seizures in terms of semiology is possible and correlates with anatomic organization along a rostrocaudal axis, in keeping with current hypotheses of frontal lobe hierarchical organization

  20. Modern faces of hysteria, or some of the dissociative disorders

    Directory of Open Access Journals (Sweden)

    Stefańska Alena

    2016-09-01

    Full Text Available The concept of “hysteria” comes from the Greek word “hystera” (uterus and dates back to the time of Hippocrates, at least. Modern classifications differ regarding the area encompassed by the concepts of dissociation and conversion differ. Mental health professionals in the United States (DSM-5 use a standard classification of mental disorders codifying dissociative disorders as a distinct class of disorders, but subsumes conversion disorders under “somatoform disorders”. The history of hysteria is as long as the history of mankind. Apparently, both the essence and mechanisms of dissociative disorders remain unchanged despite the fact that many years have passed. According to Owczarek et al., dissociative symptoms are caused by the malfunctioning of defence mechanisms and anxiety. This article provides an overview of the available literature on the etiology and pathogenesis of dissociative disorders as well as disorders such as amnesia, dissociative fugue, trance and possession.

  1. [Handwriting expression of 2 major neuroses: hysteria and obsessive disorder].

    Science.gov (United States)

    Volmat, R; Belin, C J

    1983-01-01

    In psychopathology, an interesting approach consists of observing the essential characteristics of already recorded entities. Very few works have been devoted to the rapport existing between graphological productions, personality structure and mental illness. This work concerns the handwritings observed in hysteric patients, diagnosed as such after taking into account case history and clinical interview. Our aim is to show the essential points which characterize this particular pathological structure. The stable features of hysteria are verified in graphic items. From, movement and ordonnance of such handwritings serve as useful aides in identifying the stages of maturation of the Ego. The graphological expressions observed in patients presenting with obsessional neurosis significantly contrast, however, with those encountered in the preceding personality structure (Hy). A comparison of these two different series demonstrate the utility of this work in clinical psychiatry.

  2. Seizure semiology of occipital lobe epilepsy in children.

    Science.gov (United States)

    Van den Hout, B M; Van der Meij, W; Wieneke, G H; Van Huffelen, A C; Van Nieuwenhuizen, O

    1997-11-01

    Occipital lobe epilepsy in children occurs as an idiopathic form, i.e., Benign Epilepsy with Occipital Paroxysms (BEOP), and a symptomatic form. This study attempted to determine whether seizure semiology could distinguish between the two forms. Fifty children (34 boys, 16 girls) with clinical seizures and interictal EEGs presenting occipital spikes were included consecutively in the study. Seizure onset was between the ages of 2 months and 15 years. Epilepsy was considered symptomatic when psychomotor retardation and/or abnormalities at neurological and/or neuroradiological examination were found: 17 children were classified as idiopathic, and the remaining 33 children were classified as symptomatic. Seizure semiology was assessed by means of a structured interview of the children and their parents, using a detailed questionnaire. Seizure semiology was determined to comprise motor (versive or other movements of the eyes, versive movements of the head, (hemiconvulsions), visual, other signs (e.g. vomiting and headache), and impairment of consciousness. There were no statistically significant differences in seizure semiology between the two groups. Seizure semiology cannot distinguish between different forms of occipital lobe epilepsy: Further clinical examination, clinical neurophysiological investigations, and neuroimaging studies are needed for a correct classification.

  3. Seizure semiology of lesional frontal lobe epilepsies in children.

    Science.gov (United States)

    Battaglia, D; Lettori, D; Contaldo, I; Veredice, C; Sacco, A; Vasco, J; Martinelli, D; Chieffo, D; Tartaglione, T; Colosimo, C; Di Rocco, C; Guzzetta, F

    2007-12-01

    The aim of the study was to analyse the semiology of seizures in children with frontal lobe epilepsy (FLE) and to compare them with other paediatric cohorts described in the literature as well as with adult counterparts. We analysed 174 registered seizures of 18 cases under 12 years with lesional epilepsy whose frontal origin was defined by the concordance of neuroimaging and ictal electrographic findings, and confirmed by surgery in the six cases operated on. Seizures were generally short, with a high daily frequency and usually related to sleep. The most characteristic semiological pattern consisted of complex motor seizures, particularly hypermotor. Often seizures corresponded to a mixture of different semiological patterns (tonic, gelastic, automotor, hypermotor, versive) presenting in the same seizure, often as a unique type in the same patient. With regard to several aspects the semiology of FLE in our cohort looks like that reported in adult series, in particular as to the frequency of complex motor seizures. However, our cohort was also characterised by a more protean array of seizure semiology, stressing the occurrence of seizures typically present in adults (versive and complex motor) and of some seizure patterns more characteristic in children such as epileptic spasms; moreover, the rare occurrence of secondarily generalised tonic clonic seizures (SGTCS) was confirmed.

  4. Age-dependent seizure semiology in temporal lobe epilepsy.

    Science.gov (United States)

    Fogarasi, András; Tuxhorn, Ingrid; Janszky, József; Janszky, Imre; Rásonyi, György; Kelemen, Anna; Halász, Péter

    2007-09-01

    To examine the effects of age on different aspects of temporal lobe seizure semiology. We performed a video analysis of 605 archived seizures from 155 consecutive patients (age 10 months to 49 years) selected by seizure freedom after temporal lobectomy. Eighty patients had hippocampal sclerosis (HS). Beside semiological seizure classification, we assessed age dependency of several axes of seizure semiology: (1) aura, (2) number of different lateralizing signs, occurrence of ictal (3) emotional signs, (4) autonomic symptoms, (5) automatisms, and (6) secondary generalization as well as (7) the ratio of motor seizure components. From the 155 patients, 117 reported aura, 39 had ictal emotional signs, 51 had autonomic symptoms, 130 presented automatisms, while 18 patients showed secondary generalization at least once during their seizures. Altogether 369 (median: 2/patient) different lateralizing signs were recorded. Frequency of HS (p semiology. Conversely, other aspects (aura, emotional, and autonomic signs) are independent of the maturation process. This is the first report investigating age dependency of epileptic seizure semiology comparing all age groups.

  5. Misunderstanding psychopathology as medical semiology: an epistemological enquiry.

    Science.gov (United States)

    Gorostiza, Pablo Ramos; Manes, Jaime Adan

    2011-01-01

    In our everyday clinical experience we encounter significant problems directly related to the instability of psychopathological concepts. In order to trace the origin of this inconsistency, the nature of these concepts will be explored in their historical development. They will be compared to those pertaining to medical semiology, paying special attention to the specific nature of the 'object' each of them refers to. While concepts belonging to medical semiology refer to natural objects and retain their meaning independently of the patient's context, psychopathological concepts refer to fragments of experience, which lose their significance if detached from their contextual horizon. The instability of psychopathological concepts is a consequence of the misunderstanding of psychopathology as medical semiology. As an alternative to this view, it will be argued that psychopathology represents an active and never-ending process aimed at the creation of intelligibility. Copyright © 2011 S. Karger AG, Basel.

  6. [HOW TO EXPLORE BIPOLARITY IN CHILD PSYCHIATRY: A DIMENSIONAL SEMIOLOGY].

    Science.gov (United States)

    Scholl, J-M

    2016-02-01

    Despite its high frequency, bipolarity in childhood is little understood and is often diagnosed only after several years of development, and this during a time when the child's psychosocial future is at stake. A proper diagnosis requires recognition of accurate clinical signs. It is therefore essential to furnish clinicians with precise semiological markers. This paper presents a dimensional semiology for use in anamnesis and in clinical observation of the child. These clinical signs enable the identification of a bipolar manic temperament in the child and/or the identification of various different forms of childhood bipolar and depressive disorder. The relevant differential diagnoses and comorbidities are also presented.

  7. Electrical Stimulations of the Human Insula: Their Contribution to the Ictal Semiology of Insular Seizures.

    Science.gov (United States)

    Mazzola, Laure; Mauguière, François; Isnard, Jean

    2017-07-01

    Stereotactic stimulations of the insular cortex through intracranial electrodes aim at characterizing the semiology of insular seizures. These stimulations, carried out in the context of Stereo-Electro-Encephalography (SEEG) during presurgical monitoring of epilepsy, reproduce the ictal symptoms observed during the development of insular seizures. The authors reviewed the results of insular stimulations performed in 222 patients admitted between 1997 and 2015 for presurgical SEEG exploration of atypical temporal or perisylvian epilepsy. Stimulations (50 Hz, trains of 5 seconds, pulses of 0.5 ms, intensity 0.2-3.5 mA) were carried out using transopercular electrodes implanted orthogonal to midsagittal plane. Out of a total of 669 stimulations, 550 were clinically eloquent in the absence of any postdischarge (237 and 313, respectively, in the right and left insulae). Somatosensory responses (61% of evoked sensations) including pain and visceral sensations (14.9%) were the most frequent, followed by auditory sensations (8%), vestibular illusions (7.5%), speech impairment (5%), gustatory, (2.7%), and olfactory (1%) sensations. Although these responses showed some functional segregation (in particular a privileged pain representation in the postero-superior quadrant), there was a clear spatial overlap between representations of the different modalities. Symptoms evoked by insular stimulations are multiple. None of them can be considered as absolutely specific to the insular cortex, but the occurrence in given seizure of a somatosensory symptom such as pain or of a laryngeal spasm associated with vestibular, auditory, aphasic, or olfacto-gustatory symptoms points to a discharge development in the insular cortex, which is the only cortical region where stimulations demonstrate such a multimodal representation.

  8. Semiology of subtle motor phenomena in critically ill patients.

    Science.gov (United States)

    Florea, Bogdan; Beniczky, Simona Alexandra; Demény, Helga; Beniczky, Sándor

    2017-05-01

    to investigate the semiology of subtle motor phenomena in critically ill patients, with- versus without nonconvulsive status epilepticus (NCSE). 60 consecutive comatose patients, in whom subtle motor phenomena were observed in the intensive care unit (ICU), were analysed prospectively. The semiology of the subtle phenomena was described from video-recordings, blinded to all other data. For each patient, the type, location and occurrence-pattern/duration were described. EEGs recorded in the ICU were classified using the Salzburg criteria for NCSE. only 23% (14/60) of the patients had NCSE confirmed by EEG. None of the semiological features could distinguish between patients with NCSE and those without. In both groups, the following phenomena were most common: discrete myoclonic muscle twitching and discrete tonic muscle activation. Besides these, automatisms and eye deviation were observed in both groups. subtle motor phenomena in critically ill patients can raise the suspicion of NCSE. Nevertheless, EEG is needed to confirm the diagnosis, since none of the semiological features are specific. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  9. Adult absence semiology misinterpreted as mesial temporal lobe epilepsy.

    Science.gov (United States)

    Hurst, Rebecca; Chiota-McCollum, Nicole; Tatum, William

    2014-12-01

    Correct diagnosis of seizure type and epilepsy syndrome is the foundation for appropriate antiepileptic drug selection. Inappropriate medication choices occur in the treatment of generalized epilepsy and may aggravate some seizure types, including absence seizures, potentially leading to pseudo-drug resistance. Fortunately, a correct diagnosis of absence seizures is usually not difficult, though rarely demonstrates electroclinical overlap with focal seizures. EEG can be especially misleading when secondary bilateral synchronous discharges occur in patients with focal seizures. However, the semiology of focal seizures associated with mesial temporal lobe epilepsy has a characteristic and consistent semiology that is the mark of this common epilepsy syndrome in adulthood. We recently encountered a 53-year-old female with refractory seizures and a semiology strongly suggesting mesial temporal lobe epilepsy. Instead of focal seizures, prolonged absence seizures were validated by video-EEG monitoring and she became seizure-free after a change to broad-spectrum antiepileptic drugs. This case further expands our understanding of the complexity of semiology in electroclinical classification and the spectrum that may occur in adult absence seizures. It serves to underscore the need for ictal EEG recordings and the importance of concordance with the clinical course during the pre-surgical evaluation of patients with lesions and drug-resistant epilepsy. [Published with video sequences].

  10. Le Point de Vue Semiologique (The Semiological Point of View)

    Science.gov (United States)

    Nattiez, Jean Jacques

    1975-01-01

    After discussing the nature and application of the word "semiology" (or semiotics) and briefly reviewing research in semiotics, this article examines the issue of whether or not semiotics can be considered an independent discipline. Available from Les Presses de l'Universite du Quebec, C.P. 250, Succursale N, Montreal, Canada H2X 3M4. (Text is in…

  11. Can semiology predict psychogenic nonepileptic seizures? A prospective study.

    Science.gov (United States)

    Syed, Tanvir U; LaFrance, W Curt; Kahriman, Emine S; Hasan, Saba N; Rajasekaran, Vijayalakshmi; Gulati, Deepak; Borad, Samip; Shahid, Asim; Fernandez-Baca, Guadalupe; Garcia, Naiara; Pawlowski, Matthias; Loddenkemper, Tobias; Amina, Shahram; Koubeissi, Mohamad Z

    2011-06-01

    Reducing health and economic burdens from diagnostic delay of psychogenic nonepileptic seizures (PNES) requires prompt referral for video electroencephalography (VEEG) monitoring, the diagnostic gold standard. Practitioners make VEEG referrals when semiology suggests PNES, although few semiological signs are supported by well-designed studies, and most VEEG studies neglect to concurrently measure how accurately seizure witnesses can ascertain semiology. In this study, we estimate the value of eyewitness-reported and video-documented semiology for predicting PNES, and we measure accuracy of eyewitness reports. We prospectively interviewed eyewitnesses of seizures in patients referred for VEEG monitoring, to inquire about 48 putative PNES and ES signs. Multiple, EEG-blinded, epileptologists independently evaluated seizure videos and documented the presence/absence of signs. We used generalized estimating equations to identify reliable video-documented PNES and ES signs, and we compared eyewitness reports with video findings to assess how accurately signs are reported. We used logistic regression to determine whether eyewitness reports could predict VEEG-ascertained seizure type. We analyzed 120 seizures (36 PNES, 84 ES) from 35 consecutive subjects. Of 45 video-documented signs, only 3 PNES signs ("preserved awareness," "eye flutter," and "bystanders can intensify or alleviate") and 3 ES signs ("abrupt onset," "eye-opening/widening," and postictal "confusion/sleep") were significant and reliable indicators of seizure type. Eyewitness reports of these 6 signs were inaccurate and not statistically different from guessing. Consequentially, eyewitness reports of signs did not predict VEEG-ascertained diagnosis. We validated our findings in a second, prospective cohort of 36 consecutive subjects. We identified 6 semiological signs that reliably distinguish PNES and ES, and found that eyewitness reports of these signs are unreliable. We offer suggestions to improve the

  12. Emma Bovary, Hedda Gabler, and Harold Brodkey would not have lived without Charcot: hysteria in novels.

    Science.gov (United States)

    Kaptein, A A

    2014-01-01

    Medical humanities is the interdisciplinary field of humanities (literature, philosophy, ethics, history, and religion), social science (anthropology, cultural studies, psychology, and sociology), and the arts (literature, theater, film, and visual arts), and their application to medical education and practice. In this chapter, the concept of 'hysteria' is put into a medical humanities perspective. We review the concept of hysteria concisely. Two novels and one autobiographical story are used as material in order to study how 'hysteria' is represented in literary work. Madame Bovary (Gustave Flaubert), Hedda Gabler (Henrik Ibsen), and A Story in an Almost Classical Mode (Harold Brodkey) were searched for elements that are characteristic of hysteria. Excessive emotion, dramatics, attention-seeking behavior, physical symptoms of unknown and unidentifiable organic causes, self-centered behavior, and flirtatious behavior are the six elements used to operationalize hysteria. It was found that these elements were present in both a quantitative and qualitative manner in the literary works examined. Acknowledging some limitations and suggesting some research areas and clinical implications, we conclude that literary works are useful in analyzing concepts in medicine. Also, more generally, using literary works seems to have a positive impact on readers, healthcare providers, and researchers in the healthcare domain. Studying novels and related literary work contributes to the body of knowledge of medical humanities.

  13. Common Vestibular Disorders

    OpenAIRE

    Balatsouras, Dimitrios G

    2017-01-01

    The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD) and vestibular neuritis (VN), are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the ...

  14. A neurological bias in the history of hysteria: from the womb to the nervous system and Charcot

    Directory of Open Access Journals (Sweden)

    Marleide da Mota Gomes

    2014-12-01

    Full Text Available Hysteria conceptions, from ancient Egypt until the 19th century Parisian hospital based studies, are presented from gynaecological and demonological theories to neurological ones. The hysteria protean behavioral disorders based on nervous origin was proposed at the beginning, mainly in Great Britain, by the “enlightenment nerve doctors”. The following personages are highlighted: Galen, William, Sydenham, Cullen, Briquet, and Charcot with his School. Charcot who had hysteria and hypnotism probably as his most important long term work, developed his conceptions, initially, based on the same methodology he applied to studies of other neurological disorder. Some of his associates followed him in his hysteria theories, mainly Paul Richer and Gilles de La Tourette who produced, with the master's support, expressive books on Salpêtrière School view on hysteria.

  15. A neurological bias in the history of hysteria: from the womb to the nervous system and Charcot.

    Science.gov (United States)

    Mota Gomes, Marleide da; Engelhardt, Eliasz

    2014-12-01

    Hysteria conceptions, from ancient Egypt until the 19th century Parisian hospital based studies, are presented from gynaecological and demonological theories to neurological ones. The hysteria protean behavioral disorders based on nervous origin was proposed at the beginning, mainly in Great Britain, by the "enlightenment nerve doctors". The following personages are highlighted: Galen, William, Sydenham, Cullen, Briquet, and Charcot with his School. Charcot who had hysteria and hypnotism probably as his most important long term work, developed his conceptions, initially, based on the same methodology he applied to studies of other neurological disorder. Some of his associates followed him in his hysteria theories, mainly Paul Richer and Gilles de La Tourette who produced, with the master's support, expressive books on Salpêtrière School view on hysteria.

  16. A brief history of hysteria: From the ancient to the modern.

    Science.gov (United States)

    Trimble, M; Reynolds, E H

    2016-01-01

    In this paper we discuss the history of hysteria from the Babylonian and Assyrian texts through to the situation as it appears to us at the end of the 19th century. We note the shifting emphasis on causation, earlier ideas being linked to uterine theories, later speculations moving to the brain, and then the mind. We note the persistence of the condition referred to as hysteria over the millennia and the fascination that the condition has held for physicians, neurologists, and psychiatrists since the origins of known medical texts. © 2016 Elsevier B.V. All rights reserved.

  17. Vestibular perception following acute unilateral vestibular lesions.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  18. The semiology of tilt-induced psychogenic pseudosyncope.

    Science.gov (United States)

    Tannemaat, Martijn R; van Niekerk, Julius; Reijntjes, Robert H; Thijs, Roland D; Sutton, Richard; van Dijk, J Gert

    2013-08-20

    To provide a detailed semiology to aid the clinical recognition of psychogenic pseudosyncope (PPS), which concerns episodes of apparent transient loss of consciousness (TLOC) that mimic syncope. We analyzed all consecutive tilt-table tests from 2006 to 2012 showing proven PPS, i.e., apparent TLOC had occurred without EEG changes or a decrease in heart rate (HR) or blood pressure (BP). We analyzed baseline characteristics, video data, EEG, ECG, and continuous BP measurements on a 1-second time scale. Data were compared with those of 69 cases of tilt-induced vasovagal syncope (VVS). Of 800 tilt-table tests, 43 (5.4%) resulted in PPS. The majority (74%) were women. The median duration of apparent TLOC was longer in PPS (44 seconds) than in VVS (20 seconds, p semiology of PPS as a clinical entity is vital to ensure accurate diagnosis.

  19. Psychopathology beyond semiology. An essay on the inner workings of psychopathology.

    Science.gov (United States)

    Rejón Altable, Carlos; Dening, Tom

    2013-03-01

    This text develops three interwoven issues: first, a succinct comparative analysis of medical and psychiatric semiology, which proposes that the lack of referring relations between psychiatric symptoms and brain/psychic dysfunction is a fundamental distinction between medical and psychiatric semiology. Second, the multiple features of psychiatric semiology are reviewed. Third, a new approach to psychopathology is introduced, proposing three different ways to shape symptoms (perception, linguistic structure, praxis); highlighting its role as a cognitive activity that creates intelligibility from undifferentiated experiences; and distinguishing psychopathology and semiology on an activity/product relation basis.

  20. Cluster analysis of clinical seizure semiology of psychogenic nonepileptic seizures.

    Science.gov (United States)

    Gröppel, G; Kapitany, T; Baumgartner, C

    2000-05-01

    To develop an objective classification of psychogenic nonepileptic seizures (NES) based on cluster analysis of clinical seizure semiology. We studied the clinical seizure semiology in 27 patients with psychogenic NES documented by prolonged video-EEG monitoring. We analyzed the following clinical symptoms: clonic and hypermotor movements as well as trembling of the upper and/or lower extremities, pelvic thrusting, head movements, tonic posturing backward of the head, and falling. We used cluster analysis to identify symptoms occurring together in a systematic way and thus tried to achieve a clinical classification of psychogenic NES. We could identify three symptom clusters. Cluster 1 was characterized by clonic and hypermotor movements of the extremities, pelvic thrusting, head movements, and tonic posturing of the head, and therefore was named "psychogenic motor seizures." Cluster 2 comprised trembling of the upper and lower extremities and was termed "psychogenic minor motor or trembling seizures." Cluster 3 consisted of falling to the floor as the only symptom and was referred to as "psychogenic atonic seizures." Our study represents the first study to analyze the clinical semiology of psychogenic NES by cluster analysis, which should be useful for an objective classification of psychogenic NES. This classification should allow both a better characterization of psychogenic NES and an easier differential diagnosis against specific epileptic seizures.

  1. Vestibular evoked myogenic potential

    Directory of Open Access Journals (Sweden)

    Felipe, Lilian

    2012-01-01

    Full Text Available Introduction: The Vestibular Evoked Myogenic Potential (VEMP is a promising test for the evaluation of the cholic descending vestibular system. This reflex depends of the integrity from the saccular macula, from the inferior vestibular nerve, the vestibular nuclei, the vestibule-spinal tract and effectors muscles. Objective: Perform a systematic review of the pertinent literature by means of database (COCHRANE, MEDLINE, LILACS, CAPES. Conclusion: The clinical application of the VEMP has expanded in the last years, as goal that this exam is used as complementary in the otoneurological evaluation currently used. But, methodological issues must be clarified. This way, this method when combined with the standard protocol, can provide a more widely evaluation from the vestibular system. The standardization of the methodology is fundamental criterion for the replicability and sensibility of the exam.

  2. History of Neurology and Psychiatry: Sewing Machine, Tabes Dorsalis, and Ovarian Hysteria

    Directory of Open Access Journals (Sweden)

    Detlef Claus

    2014-06-01

    Full Text Available Hysteria was the Sphinx of nervous disorders. In ancient times the cause of hysteria was supposed to be sited in the womb. However the French Neurologist Jean-Martin Charcot favoured the ovaries as the site of the origin of hysteria, and he recommended the therapeutic compression of the ovaries in order to terminate hysterical fits. To this end, the treatment of hysteria in women was carried out by the surgical removal of one ovary. This surgical intervention was not without risk in the 19th century, but more to the point it did not help the patients. Most German Neurologists doubted this “hysteric ovary” theory, but it was not until after 1901 that Steinhausen was able to prove by statistical analysis, that the “hysteric” ovary did not exist at all. Statistical data analysis also helped to support the connection between Syphilis and Tabes dorsalis, which usually became clinically manifest several years after infection. In those days neither cerebrospinal fluid analysis nor serology were available. Apart from several nonspecific suspected causes of Tabes - it was the use of the newly invented sewing machine that came under suspicion as the trigger of Tabes dorsalis.

  3. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric

    2010-01-01

    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  4. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction.

    Science.gov (United States)

    Hillier, Susan L; McDonnell, Michelle

    2011-02-16

    This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2007.Unilateral peripheral vestibular dysfunction (UPVD) can occur as a result of disease, trauma or postoperatively. The dysfunction is characterised by complaints of dizziness, visual or gaze disturbances and balance impairment. Current management includes medication, physical manoeuvres and exercise regimes, the latter known collectively as vestibular rehabilitation (VR). To assess the effectiveness of vestibular rehabilitation in the adult, community-dwelling population of people with symptomatic unilateral peripheral vestibular dysfunction. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The most recent search was 1 July 2010, following a previous search in March 2007. Randomised trials of adults living in the community, diagnosed with symptomatic unilateral peripheral vestibular dysfunction. We sought comparisons of VR versus control (placebo etc.), other treatment (non-VR, e.g. pharmacological) or another form of VR. We considered the outcome measures of frequency and severity of dizziness or visual disturbance; changes in balance impairment, function or quality of life; and measure/s of physiological status with known functional correlation. Both authors independently extracted data and assessed trials for risk of bias. We included 27 trials, involving 1668 participants, in the review. Trials addressed the effectiveness of VR against control/sham interventions, medical interventions or other forms of VR. Individual and pooled data showed a statistically significant effect in favour of VR over control or no intervention. The exception to this was when movement-based VR was compared to physical manoeuvres for benign

  5. Central vestibular system: vestibular nuclei and posterior cerebellum.

    Science.gov (United States)

    Barmack, Neal H

    2003-06-15

    The vestibular nuclei and posterior cerebellum are the destination of vestibular primary afferents and the subject of this review. The vestibular nuclei include four major nuclei (medial, descending, superior and lateral). In addition, smaller vestibular nuclei include: Y-group, parasolitary nucleus, and nucleus intercalatus. Each of the major nuclei can be subdivided further based primarily on cytological and immunohistochemical histological criteria or differences in afferent and/or efferent projections. The primary afferent projections of vestibular end organs are distributed to several ipsilateral vestibular nuclei. Vestibular nuclei communicate bilaterally through a commissural system that is predominantly inhibitory. Secondary vestibular neurons also receive convergent sensory information from optokinetic circuitry, central visual system and neck proprioceptive systems. Secondary vestibular neurons cannot distinguish between sources of afferent activity. However, the discharge of secondary vestibular neurons can distinguish between "active" and "passive" movements. The posterior cerebellum has extensive afferent and efferent connections with vestibular nuclei. Vestibular primary afferents are distributed to the ipsilateral uvula-nodulus as mossy fibers. Vestibular secondary afferents are distributed bilaterally. Climbing fibers to the cerebellum originate from two subnuclei of the contralateral inferior olive; the dorsomedial cell column and beta-nucleus. Vestibular climbing fibers carry information only from the vertical semicircular canals and otoliths. They establish a coordinate map, arrayed in sagittal zones on the surface of the uvula-nodulus. Purkinje cells respond to vestibular stimulation with antiphasic modulation of climbing fiber responses (CFRs) and simple spikes (SSs). The modulation of SSs is out of phase with the modulation of vestibular primary afferents. Modulation of SSs persists, even after vestibular primary afferents are destroyed by a

  6. Enlarged Vestibular Aqueducts and Childhood Hearing Loss

    Science.gov (United States)

    ... Infections, and Deafness Enlarged Vestibular Aqueducts and Childhood Hearing Loss On this page: What are vestibular aqueducts? How ... How are enlarged vestibular aqueducts related to childhood hearing loss? Research suggests that most children with enlarged vestibular ...

  7. Semiological seizure classification of epileptic seizures in children admitted to video-EEG monitoring unit.

    Science.gov (United States)

    Alan, Serdar; Yalnızoğlu, Dilek; Turanlı, Güzide; Karlı-Oğuz, Kader; Lay-Ergun, Eser; Söylemezoğlu, Figen; Akalan, Nejat; Topçu, Meral

    2015-01-01

    We aimed to determine seizure characteristics of pediatric patients with epilepsy, and evaluate if Semiological Seizure Classification (SSC) system is applicable in this cohort. We retrospectively studied 183 patients, aged between 3 months-18 years, admitted to the video-EEG monitoring unit (VEMU). Most patients suffered from intractable epilepsy with comorbidities, and had structural lesions. Seizures were classified based on ictal video-EEG recordings by using SSC system; 157 patients had only one seizure type, 26 had more than one seizure types. Overall 211 seizures and 373 semiologies were analyzed; 114 seizures (54%) had more than one semiological subtype. The most frequent semiology was motor seizures (78%), followed by dialeptic seizures (12%). The most common subtypes were simple motor seizures (49%); tonic seizures constituted (28.4%) of all semiologies. We conclude that SSC system is applicable for children with epilepsy admitted to VEMU; complementary EEG and imaging data are required for evaluation of patients with epilepsy.

  8. [Therapy of vestibular vertigo].

    Science.gov (United States)

    Hamann, K F

    1993-05-01

    The non-surgical treatment of vestibular disorders must be based on current knowledge of vestibular pathophysiology. It is generally accepted that after vestibular lesions a self-repair mechanism exists that allows a more or less complete recovery. In cases of persisting vestibular complaints the physician's duty consists in stimulation of these pre-existing mechanisms. This can be done by physical exercises, as has been recommended since the work of Cawthorne and Cooksey in 1946. This concept is meanwhile supported by modern neurophysiological research. This article describes a short training program consisting of exercises for fixation during rotations, smooth pursuit, optokinetic nystagmus and motor learning mechanisms. Physical exercises can be reinforced by nootropic drugs.

  9. Angiogenesis in vestibular schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Werther, Kim; Nalla, Amarnadh

    2010-01-01

    Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are potent mediators of tumor angiogenesis. It has been demonstrated that vestibular schwannoma VEGF expression correlates with tumor growth pattern, whereas knowledge on the expression of MMPs is lacking. This study...

  10. Vestibular function testing.

    LENUS (Irish Health Repository)

    Lang, E E

    2010-06-01

    Vestibular symptoms of vertigo, dizziness and dysequilibrium are common complaints which can be disabling both physically and psychologically. Routine examination of the ear nose and throat and neurological system are often normal in these patients. An accurate history and thorough clinical examination can provide a diagnosis in the majority of patients. However, in a subgroup of patients, vestibular function testing may be invaluable in arriving at a correct diagnosis and ultimately in the optimal treatment of these patients.

  11. Common Vestibular Disorders

    Directory of Open Access Journals (Sweden)

    Dimitrios G. Balatsouras

    2017-01-01

    Full Text Available The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV, Meniere's disease (MD and vestibular neuritis (VN, are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the development of appropriate therapeutic maneuvers resulted in its effective treatment. However, involvement of the horizontal or the anterior canal has been found in a significant rate and the recognition and treatment of these variants completed the clinical picture of the disease. MD is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Presence of endolymphatic hydrops on postmortem examination is its pathologic correlate. MD continues to be a diagnostic and therapeutic challenge. Patients with the disease range from minimally symptomatic, highly functional individuals to severely affected, disabled patients. Current management strategies are designed to control the acute and recurrent vestibulopathy but offer minimal remedy for the progressive cochlear dysfunction. VN is the most common cause of acute spontaneous vertigo, attributed to acute unilateral loss of vestibular function. Key signs and symptoms are an acute onset of spinning vertigo, postural imbalance and nausea as well as a horizontal rotatory nystagmus beating towards the non-affected side, a pathological headimpulse test and no evidence for central vestibular or ocular motor dysfunction. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea

  12. Deregulated genes in sporadic vestibular schwannomas

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Helweg-Larsen, Rehannah Holga Andrea; Stangerup, Sven-Eric

    2010-01-01

    In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology.......In search of genes associated with vestibular schwannoma tumorigenesis, this study examines the gene expression in human vestibular nerve versus vestibular schwannoma tissue samples using microarray technology....

  13. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    OpenAIRE

    Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

    2016-01-01

    ABSTRACT INTRODUCTION: Visual stimuli can induce vestibular adaptation and recovery of body balance. OBJECTIVE: To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. METHODS: Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD) (experimental...

  14. Versiones psicoanalíticas de la histeria Psycoanalitical Versions Of Hysteria

    Directory of Open Access Journals (Sweden)

    Roberto Mazzuca

    2008-12-01

    Full Text Available Tomando como punto de partida las diferencias entre las diversas conceptualizaciones psicoanalíticas de la histeria, el trabajo delimita lo esencial de la elaboración freudiana en relación con esta categoría clínica, para destacar a continuación las diferencias con el modo en que la define Lacan. Si bien éste retoma muchos de los conceptos formulados por Freud sobre la histeria, su perspectiva difiere sensiblemente en este tema respecto de la del padre del psicoanálisis.Taking as a starting point the distinctions between diverse psychoanalytical conceptions of hysteria, this paper develops the essence of Freudian elaboration on this clinical category; in order to highlight the differences with the way Lacan defines it. Despite Lacan recuperates lots of Freudian concepts around hysteria; his point of view sensibly differs on this matter from psychoanalysis father's.

  15. Semiological differences between late-life schizophrenia and senile dementia.

    Science.gov (United States)

    Song, Min-Ho; Hamada, Hidemichi; Mimura, Masaru

    2014-01-01

    It is sometimes difficult to distinguish late-life schizophrenia from senile dementia because elderly patients with schizophrenia can present in chronic remission and show gradual cognitive decline with aging. We aimed to elucidate the semiological characteristics of late-life chronic schizophrenia. Three patients aged between 60 and 66 years who were admitted to our hospital were included in this study. Detailed history taking and psychiatric interviews were performed and reviewed in the light of psychopathological semiology. Although the three patients with late-life schizophrenia showed significant cognitive decline on the Hasegawa dementia rating scale and their negative symptoms mimicked dementia, the following psychopathological characteristics clearly differentiated them from patients with senile dementia: (1) a shift of temporal organization toward the future with intact memory, (2) hypersensitivity, (3) ambivalent personal relationships, (4) systematic bodily delusions, and (5) an ante festum mindset. Identifying such clinical features of patients with late-life schizophrenia could be important for developing more effective pharmacotherapy and for providing appropriate psychotherapy.

  16. Semiologi, Strukturalisme, Post-Strukturalisme, dan Kajian Desain Komunikasi Visual?

    Directory of Open Access Journals (Sweden)

    Dominique Rio Adiwijaya

    2011-04-01

    Full Text Available Some concepts from theoretical schools such as semiology, structuralism and post-structuralism are referenced in today’s discussions of design. Its language-ladeness which makes it appeals initially as pertinent to visual communication. Yet under the alleged reason of cross-disciplinary, design study often just wants to pick up one or two concepts without sufficient willingness to grasp their primer. It is very much contradictory since sheer picking up is an anti-intellectual attitude, whereas all forms of study are intellectual in character. Great scholar Alfred North Whitehead once complained those who quoted him in bits and pieces, as did not understand what is meant by his theory. It is true that design has a cross-disciplinary character. But since design is neither philosophy nor social science, it demands a study of their primer with respect (not oversimplifying, within the spirit of liberal arts. Hence this article does not intend to give 'structuralist' account of design; instead it is a brief study into primer of semiology, structuralism and post-structuralism. Its significance for design would be reflected afterwards. 

  17. Analyzing reliability of seizure diagnosis based on semiology.

    Science.gov (United States)

    Jin, Bo; Wu, Han; Xu, Jiahui; Yan, Jianwei; Ding, Yao; Wang, Z Irene; Guo, Yi; Wang, Zhongjin; Shen, Chunhong; Chen, Zhong; Ding, Meiping; Wang, Shuang

    2014-12-01

    This study aimed to determine the accuracy of seizure diagnosis by semiological analysis and to assess the factors that affect diagnostic reliability. A total of 150 video clips of seizures from 50 patients (each with three seizures of the same type) were observed by eight epileptologists, 12 neurologists, and 20 physicians (internists). The videos included 37 series of epileptic seizures, eight series of physiologic nonepileptic events (PNEEs), and five series of psychogenic nonepileptic seizures (PNESs). After observing each video, the doctors chose the diagnosis of epileptic seizures or nonepileptic events for the patient; if the latter was chosen, they further chose the diagnosis of PNESs or PNEEs. The overall diagnostic accuracy rate for epileptic seizures and nonepileptic events increased from 0.614 to 0.660 after observations of all three seizures (p semiological diagnosis of seizures is greatly affected by the seizure type as well as the doctor's experience. Although the overall reliability is limited, it can be improved by observing more seizures. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. The semiology of febrile seizures: Focal features are frequent.

    Science.gov (United States)

    Takasu, Michihiko; Kubota, Tetsuo; Tsuji, Takeshi; Kurahashi, Hirokazu; Numoto, Shingo; Watanabe, Kazuyoshi; Okumura, Akihisa

    2017-08-01

    To clarify the semiology of febrile seizures (FS) and to determine the frequency of FS with symptoms suggestive of focal onset. FS symptoms in children were reported within 24h of seizure onset by the parents using a structured questionnaire consisting principally of closed-ended questions. We focused on events at seizure commencement, including changes in behavior and facial expression, and ocular and oral symptoms. We also investigated the autonomic and motor symptoms developing during seizures. The presence or absence of focal and limbic features was determined for each patient. The associations of certain focal and limbic features with patient characteristics were assessed. Information was obtained on FS in 106 children. Various events were recorded at seizure commencement. Behavioral changes were observed in 35 children, changes in facial expression in 53, ocular symptoms in 78, and oral symptoms in 90. In terms of events during seizures, autonomic symptoms were recognized in 78, and convulsive motor symptoms were recognized in 68 children. Focal features were evident in 81 children; 38 children had two or more such features. Limbic features were observed in 44 children, 9 of whom had two or more such features. There was no significant relationship between any patient characteristic and the numbers of focal or limbic features. The semiology of FS varied widely among children, and symptoms suggestive of focal onset were frequent. FS of focal onset may be more common than is generally thought. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The semiology of benign focal epilepsy with affective symptoms.

    Science.gov (United States)

    Nascimento, Fábio A; Sotero de Menezes, Márcio A; Simão, Cristiane A; Takeshita, Bruno T; Blattes da Rocha, Samanta F; Kowacs, Pedro A

    2017-06-01

    Benign focal epilepsy with affective symptoms (BFEAS) is a rare childhood epilepsy syndrome essentially characterized by "epileptic attacks with affective symptoms of a terrifying type". Since the original description, approximately 50 cases have been reported. To our knowledge, however, none of the studies included video-EEG data. Herein, we detail the electroclinical features of a neurodevelopmentally normal 9-year-old boy with epilepsy since the age of 2 years. His seizure semiology essentially consisted of nocturnal focal seizures featuring abrupt fear and autonomic phenomena (such as excessive sweating, repeated swallowing, and coughing), associated with impaired consciousness. These seizures were often secondary generalized, and he had multiple episodes of convulsive status epilepticus. He has been seizure-free for the past year and a half on dual antiepileptic therapy with sulthiamine and valproate. His intellectual and social abilities are excellent (IQ of 116), although he does have difficulties particularly in language learning, and was recently diagnosed with phonological dyslexia with dysorthography. By presenting our patient's history and video-EEG, we intend to further detail the semiology of seizures with affective symptomatology. [Published with video sequence on www.epilepticdisorders.com].

  20. Perspectives on Aging Vestibular Function

    National Research Council Canada - National Science Library

    Anson, Eric; Jeka, John

    2016-01-01

    Much is known about age related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing...

  1. Neurotransmitters in the vestibular system.

    Science.gov (United States)

    Balaban, C D

    2016-01-01

    Neuronal networks that are linked to the peripheral vestibular system contribute to gravitoinertial sensation, balance control, eye movement control, and autonomic function. Ascending connections to the limbic system and cerebral cortex are also important for motion perception and threat recognition, and play a role in comorbid balance and anxiety disorders. The vestibular system also shows remarkable plasticity, termed vestibular compensation. Activity in these networks is regulated by an interaction between: (1) intrinsic neurotransmitters of the inner ear, vestibular nerve, and vestibular nuclei; (2) neurotransmitters associated with thalamocortical and limbic pathways that receive projections originating in the vestibular nuclei; and (3) locus coeruleus and raphe (serotonergic and nonserotonergic) projections that influence the latter components. Because the ascending vestibular interoceptive and thalamocortical pathways include networks that influence a broad range of stress responses (endocrine and autonomic), memory consolidation, and cognitive functions, common transmitter substrates provide a basis for understanding features of acute and chronic vestibular disorders. © 2016 Elsevier B.V. All rights reserved.

  2. Localization value of seizure semiology analyzed by the conditional inference tree method.

    Science.gov (United States)

    Kim, Dong Wook; Jung, Ki-Young; Chu, Kon; Park, So-Hee; Lee, Seo-Young; Lee, Sang Kun

    2015-09-01

    Although accurate interpretation of seizures is important for the management of patients with epilepsy, studies on the localizing value of seizure semiology and the reliability of the semiology descriptions are scarce. The objective of our study is to investigate the accuracy of video-recorded seizure semiology in the classification and localization of epileptic seizures. We also evaluated the reliability of the semiology descriptions provided by the patients or their caregivers. Video-recorded clinical seizures from 831 consecutive patients (391 females; 31.7 ± 11.6 years) were analyzed retrospectively. Epileptic seizures were classified as generalized and partial seizures, and patients with partial seizures were further divided into five ictal onset areas. In order to analyze the diagnostic value of individual semiologic features for clinical diagnosis, we used the conditional inference tree method. Generalized and partial seizures were differentiated with high accuracy (97.1%), but the accuracy of localization among the five ictal onset areas was relatively low (56.1%), which was largely attributed to the difficulty in the discrimination between mesial and lateral temporal onset seizures. Lateralization of the ictal onset area in partial seizures was possible in 427 (55.1%) patients based on video analysis, nevertheless it was possible in only 158 (20.4%) patients based on historical semiology descriptions. The results of our study suggest that careful observation of seizure semiology may be useful for the differentiation of ictal onset areas. However, the semiologic differentiation between mesial and lateral temporal onset seizures is difficult, and historical semiologic descriptions should be interpreted carefully because of their low reliability. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Semiology: witness to a seizure--what to note and how to report.

    Science.gov (United States)

    Jordan, James W

    2007-12-01

    This article reviews the Cleveland Epilepsy Classification (CEC) of seizure semiology. It defines the concept of semiology, and reviews its importance in epilepsy in defining the Symptomatogenic Zone, one of the five zones that make up the Epileptogenic Zone. It details the four broader spheres that contain all of the possible patient signs and symptoms (cognitive, autonomic, consciousness, and motor spheres), and reviews the specific seizure types that are classified within those spheres. Evidence-based information on usefulness of semiology for localization and lateralization is reviewed. A "user-friendly" reference table is provided.

  4. Vestibular tributaries to the vein of the vestibular aqueduct

    DEFF Research Database (Denmark)

    Hansen, Jesper Marsner; Qvortrup, Klaus; Friis, Morten

    2010-01-01

    CONCLUSION: The vein of the vestibular aqueduct drains blood from areas extensively lined by vestibular dark cells (VDCs). A possible involvement in the pathogenesis of an impaired endolymphatic homeostasis can be envisioned at the level of the dark cells area. OBJECTIVES: The aim of this study...... was to investigate the vascular relationship between the vein of the vestibular aqueduct and the vestibular apparatus, with focus on the VDCs. METHODS: Sixteen male Wistar rats were divided into groups of 6 and 10. In the first group, 2 µm thick sections including the vein of the vestibular aqueduct, utricle...... relation to the VDCs in the utricle and the crista ampullaris of the lateral semicircular canal in the vestibular apparatus. One major vein emanated from these networks, which emptied into the vein of the vestibular aqueduct. Veins draining the saccule and the common crus of the superior and posterior...

  5. Dyscalculia and vestibular function.

    Science.gov (United States)

    Smith, P F

    2012-10-01

    A few studies in humans suggest that changes in stimulation of the balance organs of the inner ear (the 'vestibular system') can disrupt numerical cognition, resulting in 'dyscalculia', the inability to manipulate numbers. Many studies have also demonstrated that patients with vestibular dysfunction exhibit deficits in spatial memory. It is suggested that there may be a connection between spatial memory deficits resulting from vestibular dysfunction and the occurrence of dyscalculia, given the evidence that numerosity is coupled to the processing of spatial information (e.g., the 'spatial numerical association of response codes ('SNARC') effect'). The evidence supporting this hypothesis is summarised and potential experiments to test it are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. The challenge of vestibular migraine.

    Science.gov (United States)

    Sargent, Eric W

    2013-10-01

    Migraine is a common illness and migraine-related dizziness occurs in up to 3% of the population. Because the diagnosis is controversial and may be difficult, many patients go undiagnosed and untreated. This review summarizes current understanding of the taxonomy and diagnosis of vestibular migraine, the relation of vestibular migraine to labyrinthine disease, and the treatment of the condition in adults and children. The categories of migraine accepted by the International Headache Society do not reflect the complex presentations of patients suspected of having vestibular migraine. In clinical practice and research, criteria are increasingly accepted that divide patients suspected of vestibular migraine into 'definite vestibular migraine' and 'probable vestibular migraine.' Because vertigo itself may trigger migraine, patients with vestibular migraine should be suspected of having vestibular end-organ disease until proven otherwise. Treatment remains controversial because of a notable lack of randomized controlled studies of vestibular migraine treatment. For now, the best strategy for the treatment of suspected vestibular migraine patients is dietary/lifestyle modification, antinausea/antiemetics for acute vertigo, and preventive medication for patients who have continued disruptive symptoms. Patients with vestibular migraine should be monitored regularly for the development of latent audiovestibular end-organ disease.

  7. Perfusion defects in pulmonary perfusion iodine maps: causes and semiology.

    Science.gov (United States)

    Bustos Fiore, A; González Vázquez, M; Trinidad López, C; Mera Fernández, D; Costas Álvarez, M

    2017-12-14

    to describe the usefulness of dual-energy CT for obtaining pulmonary perfusion maps to provide morphological and functional information in patients with pulmonary embolisms. To review the semiology of perfusion defects due to pulmonary embolism so they can be differentiated from perfusion defects due to other causes: alterations outside the range used in the iodine map caused by other diseases of the lung parenchyma or artifacts. CT angiography of the pulmonary arteries is the technique of choice for the diagnosis of pulmonary embolisms. New dual-energy CT scanners are useful for detecting perfusion defects secondary to complete or partial obstruction of pulmonary arteries and is most useful for detecting pulmonary embolisms in subsegmental branches. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Seizure semiology of anti-LGI1 antibody encephalitis.

    Science.gov (United States)

    Beimer, Nicholas J; Selwa, Linda M

    2017-11-24

    Limbic encephalitis associated with anti-LGI1 antibody (LGI1 encephalitis) presents with a variety of features, the most prominent of which include seizures and progressive disturbance of memory and behaviour. Although varied in semiology, recognition of the pattern of seizures in LGI1 encephalitis is important, as early diagnosis and definitive treatment may prevent subsequent development of cognitive impairment. We present a patient with LGI1 encephalitis and "faciobrachial dystonic seizures-plus", which began as classic faciobrachial dystonic seizures and progressed to focal seizures with impaired awareness, dacrystic/gelastic-like outbursts, ictal speech, manual automatisms, and autonomic signs (tachycardia). Recognition of the broad range of seizure types associated with LGI1 encephalitis is crucial for early diagnosis and definitive treatment. [Published with video sequence on www.epilepticdisorders.com].

  9. Renal Failure: A Modern Semiology for an Old Disease.

    Science.gov (United States)

    Nasuto, Michelangelo; Pansini, Vittorio; Cortet, Bernard; Guglielmi, Giuseppe; Cotten, Anne

    2016-09-01

    Chronic kidney disease (CKD) is a complex systemic disease that induces mineral metabolic dysfunction leading to bone fragility and tissue calcifications. Bone abnormalities in CKD can include increased bone turnover and resorption due to secondary hyperparathyroidism, decreased bone turnover and bone formation, defective bone mineralization, or a mixed pattern of these abnormalities. Other features of musculoskeletal involvement include synovial, tendon, and ligament thickening due to β2-microglobulin amyloidosis, soft tissue masses, or axial and peripheral arthropathies. The accurate assessment of bone involvement in early-stage CKD is crucial for the success of therapeutic interventions. We summarize the key semiologic features of bone abnormalities in CKD and review musculoskeletal complications as depicted by conventional radiography, computed tomography, magnetic resonance, and ultrasound imaging. We also discuss different experimental diagnostic approaches developed for the purpose of identifying changes in bone quality and structure in early-stage CKD. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  10. Logic structure of clinical judgment and its relation to medical and psychiatric semiology.

    Science.gov (United States)

    Rejón Altable, Carlos

    2012-01-01

    The logical nature of clinical judgment has been conceptualized in different ways, but a clear connection between the features of clinical judgment and those of semiology is still lacking. The characteristics of clinical judgment, medical semiology, and psychiatric semiology are described. Connections between them are drawn. Clinical judgment is described as an abductive inference. Abductive inferences are especially useful to balance universal and singular information. In psychiatric semiology, due to some specific features, a careful balance between the information present in descriptive definitions and the information absent from the definition but present in singular symptoms is needed. The main types of out-of-definition information are reviewed. The implications of the results for diagnosis and research are drawn. Copyright © 2012 S. Karger AG, Basel.

  11. Linguistics, Structuralism, and Semiology Approaches to the Cinema With a Bibliography

    Science.gov (United States)

    Harpole, Charles H.; Hanhardt, John G.

    1973-01-01

    An introduction to linguistics, structuralism, and semiology, with special emphasis on how these fields affect and can be applied in the study of cinema. The extensive bibliography includes books and articles in five languages. (CH)

  12. Pilomotor seizures: an autonomic semiology of limbic encephalitis?

    Science.gov (United States)

    Rocamora, Rodrigo; Becerra, Juan L; Fossas, Pilar; Gomez, María; Vivanco-Hidalgo, Rosa M; Mauri, José A; Molins, Albert

    2014-09-01

    Ictal piloerection is an infrequent seizure semiology that is commonly overlooked as an ictal epileptic manifestation. Piloerection is considered to be principally caused by temporal lobe activity although frontal and hypothalamic seizure origins have been reported. The described etiology has shown a wide variety of structural causes such as mesial temporal sclerosis, tumors, posttraumatic, cavernomas and cryptogenic epilepsies. We retrospectively reviewed the incidence of ictal piloerection in the clinical records of patients who underwent video-EEG monitoring (VEEGM) between 2007 and 2013 in a multicenter cooperative study. All patients presented refractory epilepsies and were evaluated with a protocol that included brain MRI, neuropsychology and VEEGM. A total of 766 patients were evaluated in four tertiary centers in Spain. Five patients showed piloerection as principal seizure semiology (prevalence 0.65%). The mean age at seizure onset was 39.6 years and the average epilepsy duration was 5.2 years (range 2-14) before diagnosis. Four patients were additionally examined with FDG-PET and/or SPECT-SISCOM. All presented temporal lobe epilepsy (TLE), three right-sided and two left-sided. A typical unilateral hippocampal sclerosis was described in 3 cases. The etiology detected in all cases was limbic encephalitis. Three had LGI1, one anti-Hu, and another Ma2 antibodies. Our series describes a so far not well-recognized autoimmune association of pilomotor seizures to limbic encephalitis. This etiology should be ruled out through a comprehensive diagnostic work-up even in cases of long-lasting TLE with typical hippocampal atrophy on MRI. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  13. Political Semiology and Interpretation of Laws: Some Reflections on the Political Semiology and Normativesemiologic Function of Theoretical Common Sense of Jurists

    Directory of Open Access Journals (Sweden)

    Gilmar Antonio Bedin

    2016-06-01

    Full Text Available This text aims to rescue the contributions of Political Semiology proposed by Luis Alberto Warat. This text was structured in six parts. The text begins with the presentation of the linguistic turn of philosophy. Then it analyzes the main concepts of this philosophical perspective and verifies their incorporation into legal theory. In a fourth part it presents the Political Semiology, as a result, it highlights the concept of theoretical common sense of lawyers . The method used in the preparation of this text was the hypothetical-deductive one and the applied technique was bibliography research.

  14. The vestibular body: Vestibular contributions to bodily representations.

    Science.gov (United States)

    Ferrè, Elisa Raffaella; Haggard, Patrick

    2016-01-01

    Vestibular signals are integrated with signals from other sensory modalities. This convergence could reflect an important mechanism for maintaining the perception of the body. Here we review the current literature in order to develop a framework for understanding how the vestibular system contributes to body representation. According to recent models, we distinguish between three processes for body representation, and we look at whether vestibular signals might influence each process. These are (i) somatosensation, the primary sensory processing of somatic stimuli, (ii) somatoperception, the processes of constructing percepts and experiences of somatic objects and events and (iii) somatorepresentation, the knowledge about the body as a physical object in the world. Vestibular signals appear to contribute to all three levels in this model of body processing. Thus, the traditional view of the vestibular system as a low-level, dedicated orienting module tends to underestimate the pervasive role of vestibular input in bodily self-awareness.

  15. Vestibular Schwannoma (Acoustic Neuroma) and Neurofibromatosis

    Science.gov (United States)

    ... vestibular schwannoma is key to preventing its serious consequences. There are three options for managing a vestibular ... Disorders Balance Problems and Disorders - National Institute on Aging Enlarged Vestibular Aqueducts and Childhood Hearing Loss Genetics ...

  16. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    Directory of Open Access Journals (Sweden)

    A. Greco

    2014-01-01

    Full Text Available Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

  17. Neuropharmacology of Vestibular System Disorders

    OpenAIRE

    Soto, Enrique; Vega, Rosario

    2010-01-01

    This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Otolaryngologists are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in...

  18. Prophylactic treatment of vestibular migraine

    OpenAIRE

    Salmito, Márcio Cavalcante; Duarte, Juliana Antoniolli; Morganti, Lígia Oliveira Golçalves; Brandão, Priscila Valéria Caus; Nakao, Bruno Higa; Villa, Thais Rodrigues; Ganança,Fernando Freitas

    2017-01-01

    Abstract Introduction: Vestibular migraine (VM) is now accepted as a common cause of episodic vertigo. Treatment of VM involves two situations: the vestibular symptom attacks and the period between attacks. For the latter, some prophylaxis methods can be used. The current recommendation is to use the same prophylactic drugs used for migraines, including β-blockers, antidepressants and anticonvulsants. The recent diagnostic definition of vestibular migraine makes the number of studies on its ...

  19. Drug therapy for peripheral vestibular vertigo

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko

    2017-01-01

    Full Text Available The choice of effective treatments for vestibular vertigo is one of the important problems, by taking into account the high prevalence of peripheral vestibular diseases. Different drugs, such as vestibular suppressants for the relief of acute vertigo attacks and vestibular compensation stimulants for rehabilitation treatment, are used to treat vestibular vertigo. Drug therapy in combination with vestibular exercises is effective in patients with vestibular neuronitis, Meniere's disease, so is that with therapeutic maneuvers in patients with benign paroxysmal positional vertigo. The high therapeutic efficacy and safety of betahistines permit their extensive use for the treatment of various vestibular disorders.

  20. Mitchell's case of "pendulum spasms": psychogenic movement disorder considered as male hysteria.

    Science.gov (United States)

    Lanska, Douglas J

    2015-01-27

    In the late 19th century, a man with a psychogenic movement disorder was evaluated by many of the Philadelphia neurologists associated with Silas Weir Mitchell. In 1885, prior to the development of movie cameras or projectors, the patient was photographed by pioneering photographer Eadweard Muybridge, in collaboration with neurologist Francis Dercum, using arrays of sequentially triggered single-image cameras. The photographic sequences are among the first motion picture sequences of patients with neurologic disorders. Examination of extant primary source documents concerning this patient, including published writings and photographic sequences by Muybridge and Dercum, the original clinical descriptions, Mitchell's documentation of the patient's later clinical course, and results of the autopsy. Mitchell and his colleagues concluded that this was a "case of undoubted hysteria" in a man. Support for this contention includes the following: protracted course, spanning decades with temporary remissions; inconsistent character of the movement and features incongruous with typical "organic" tremors; complex, bizarre movements that are difficult to classify; increase in movements with attention; alteration in frequency of the movements with movement of the opposite arm; ability to trigger or temporarily stop the movements with unusual or nonphysiologic interventions; involvement of the opposite arm in a synchronous abnormal movement later in the course; remission with hypnotic suggestion; absence of other neurologic signs; and normal brain autopsy. The clinical history, serial examinations, photographic documentation, and autopsy results support Mitchell's contention that this was a case of male hysteria, or, in modern terminology, a psychogenic movement disorder. © 2015 American Academy of Neurology.

  1. Charcot, la salpêtrière, and hysteria as represented in European literature.

    Science.gov (United States)

    Koehler, Peter J

    2013-01-01

    In this chapter, I describe the influence of Jean-Martin Charcot (1825-1893), his neurological school at the Salpêtrière (Paris), and his teaching of hysteria on European literature. Many references to Charcot and descriptions of hysterical attacks are found not only in French naturalistic literature but also subsequently in naturalistic novels from other European countries (the Netherlands, Russia, Scandinavian countries, Spain, Italy, and Germany) and furthermore in novels written in new literary movements that followed naturalism. At first, objective descriptions were presented, but in the periods that followed, in particular during the past decades, criticism, rather than objective descriptions, became the motivation for continuing to use Charcot and his teaching of hysteria as inspiration for novels and plays, although Charcot as an admired founder of neurology did not quite disappear, even in recent novels. It is quite impressive to observe how Charcot and his demonstrations of hysterical attacks still resound throughout European literature, even after more than a century. © 2013 Elsevier B.V. All rights reserved.

  2. Interobserver variability of seizure semiology between two neurologist and caregivers.

    Science.gov (United States)

    Benbir, Gulcin; Demiray, Derya Yavuz; Delil, Sakir; Yeni, Naz

    2013-09-01

    We aimed to compare the extent of inter-observer variability in the description of seizure semiology between both neurologists and caregivers. We prospectively investigated 93 consecutive patients monitored over the past 5 years in our video-EEG unit. The videotaped seizures of the patients were reviewed independently by two neurologists who were blind to the clinical data. The questionnaires were completed by neurologists and caregivers. Interobserver rate of agreement between neurologists and caregivers was analyzed by using the kappa analysis and intraclass correlation coefficients. There was excellent agreement for questions regarding whether the patient's eyes remained open, laterality of head deviation, arm movements, and ictal period. On the other hand, interobserver rate of agreement was fair to moderate for the laterality of hand automatisms, the presence of nose-wiping, and oral clonic jerks. Besides variability in interobserver agreement among clinicians, the variability or concordance between physicians and caregivers are also of great importance, especially in case of epilepsy, where the accurate description of the attacks is the major determinant of an accurate diagnosis. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Classification of clinical semiology in epileptic seizures in neonates.

    Science.gov (United States)

    Nagarajan, Lakshmi; Palumbo, Linda; Ghosh, Soumya

    2012-03-01

    The clinical semiology of 61 neonatal seizures with EEG correlates, in 24 babies was analysed. Most seizures (89%) had multiple features during the EEG discharge. The seizures were classified using the prominent clinical feature at onset, and all features seen during the seizure, using an extended classification scheme. Orolingual features occurred most frequently at onset (30%), whereas ocular phenomena occurred most often during the seizure (70%). Orolingual, ocular and autonomic features were seen at onset in 55% of the seizures. Seizure onsets with clonic, tonic and hypomotor features were seen in 20%, 8% and 18% respectively. Clinico-electrical correlations were as follows. The EEG discharge involved both hemispheres in 54% of all seizures, in clonic seizures this was 93%. Focal clonic seizures were associated with EEG seizure onset from the contralateral hemisphere. Majority of the clonic and hypomotor seizures had a left hemisphere ictal EEG onset. Orolingual seizures frequently started from the right hemisphere, whereas ocular and autonomic seizures arose from either hemisphere. There was no significant difference in mortality, morbidity, abnormal neuroimaging and EEG background abnormalities in babies with or without clonic seizures. This study provides insights into neuronal networks that underpin electroclinical seizures, by analysing and classifying the obvious initial clinical features and those during the seizure. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. Semiology of psychogenic nonepileptic seizures: age-related differences.

    Science.gov (United States)

    Alessi, Rudá; Vincentiis, Silvia; Rzezak, Patricia; Valente, Kette D

    2013-05-01

    The few studies addressing semiology of psychogenic nonepileptic seizures (PNES) in children showed that this group differs from adults, considering the classical signs described. Our study with systematic assessment provides a direct comparison of the classical signs of psychogenic nonepileptic seizures (PNESs) in children and adults in order to establish the usefulness of the most important signs described for adults in children. Video-EEG recordings of patients with PNESs from 2006 to 2011 were analyzed. Twenty-five signs were selected as the most prevalent in literature, and their presence was evaluated. Events were categorized as either of the following: catatonic, major motor, minor motor, and subjective (Griffith et al., 2007 [11]). One hundred and fifteen patients were included; 63.5% were adults, 73.2% were females, and 14.4% had epilepsy. Adults presented more ictal eye closure (p=0.006), convulsions lasting >2 min (psemiological categories, major motor activity was the main feature in adults, and minor motor activity was more prevalent among children (52.9% and 38.1%, respectively; p=0.01). Our data showed that research about the distinct ictal features of PNESs, such as minor motor events that are more typical in children, is likely to be useful in promoting earlier recognition of PNESs in this population. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. The correlation between ictal semiology and magnetoencephalographic localization in frontal lobe epilepsy.

    Science.gov (United States)

    Wu, Xintong; Rampp, Stefan; Weigel, Daniel; Kasper, Burkhard; Zhou, Dong; Stefan, Hermann

    2011-11-01

    The aim of this study was to investigate the correlation of ictal semiology with localization and/or lateralization by magnetoencephalography (MEG). Seven patients from the Neurology Department of the University Hospital Erlangen who underwent resective surgery for frontal lobe epilepsy (FLE) with an Engel 1a outcome were investigated retrospectively. MEG localizations were classified according to five compartments (separate or combined) of the frontal lobe: frontal basal (FB), frontal lateral (FL), frontal polar (FP), frontal mesial (FM), and frontal precentral (FPr). On the basis of previous studies that investigated the value of ictal semiology in localization and lateralization, we compared the experiential localization and/or lateralization of the epileptogenic region deduced from ictal semiology, that is, both seizure history and ictal video/EEG monitoring, with MEG localization. It is easier to determine lateralization than localization from ictal semiology because of the variety of signs and fast propagation in FLE. All of the patients had specific MEG localizations according to favorable postoperative outcome. Three patients had MEG foci associated with ictal semiology; in another four, the MEG localization was adjacent to the estimated area suggested by ictal semiology. Head version signs could be observed in all compartments of the frontal lobe: clonic in FB and FP areas; postural in FPr, FL, and FM areas; hypermotor in FB, FP, FPr, and FM areas; sensation aura in FB, FL, and FM areas; and automatisms in FP, FPr, and FL areas. All patients had concordant lateralizing and limited valuable locating information from ictal semiology, but no complete correlation with MEG foci. Ictal semiology may indicate the involvement of a symptomatogenic brain region during a seizure, but extent of seizure onset in central motor or sensorimotor area is not reliable enough to indicate the seizure onset zone and favorable postoperative outcome in FLE. MEG provided specific

  6. Vestibular pathways involved in cognition

    Directory of Open Access Journals (Sweden)

    Martin eHitier

    2014-07-01

    Full Text Available Recent discoveries have emphasized the role of the vestibular system in cognitive processes such as memory, spatial navigation and bodily self-consciousness. A precise understanding of the vestibular pathways involved is essential to understand the consequences of vestibular diseases for cognition, as well as develop therapeutic strategies to facilitate recovery. The knowledge of the vestibular cortical projections areas, defined as the cortical areas activated by vestibular stimulation, has dramatically increased over the last several years from both anatomical and functional points of view. Four major pathways have been hypothesized to transmit vestibular information to the vestibular cortex: 1 the vestibulo-thalamo-cortical pathway, which probably transmits spatial information about the environment via the parietal, entorhinal and perirhinal cortices to the hippocampus and is associated with spatial representation and self-versus object motion distinctions; 2 the pathway from the dorsal tegmental nucleus via the lateral mammillary nucleus, the anterodorsal nucleus of the thalamus to the entorhinal cortex, which transmits information for estimations of the head direction; 3 the pathway via the nucleus reticularis pontis oralis, the supramammillary nucleus and the medial septum to the hippocampus, which transmits information supporting hippocampal theta rhythm and memory; and 4 a possible pathway via the cerebellum, and the ventral lateral nucleus of the thalamus (perhaps to the parietal cortex, which transmits information for spatial learning. Finally a new pathway is hypothesized via the basal ganglia, potentially involved in spatial learning and spatial memory. From these pathways, progressively emerges the anatomical network of vestibular cognition.

  7. The vestibular implant: Quo vadis?

    Directory of Open Access Journals (Sweden)

    Raymond eVan De Berg

    2011-08-01

    Full Text Available AbstractObjective: to assess the progress of the development of the vestibular implant and its feasibility short-term. Data sources: a search was performed in Pubmed, Medline and Embase. Key words used were vestibular prosth* and vestibular implant. The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation.Study selection: all studies about the vestibular implant and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the vestibular implant. Data extraction and synthesis: data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: to use a basic vestibular implant in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation, complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt.

  8. True incidence of vestibular schwannoma?

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Tos, Mirko; Thomsen, Jens

    2010-01-01

    The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.......The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging....

  9. Hermeneutic and Cultural Codes of S/Z: A Semiological Reading of James Joyce's "The Boarding House"

    Science.gov (United States)

    Booryazadeh, Seyed Ali; Faghfori, Sohila; Shamsi, Habibe

    2014-01-01

    Roland Barthes as a fervent proponent of semiology believes that semiology is a branch of a comprehensive linguistics: it is the study of how language articulates the world. Semiotic codes, the paths of this articulation, accordingly underlie his attention. Barthes in a structural analysis of Balzac's "Sarrasine" in S/Z expounds five…

  10. Hypervascular vestibular Schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ja Young; Yu, In Kyu [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

    2014-11-15

    Most vestibular schwannoma is hypovascular with well known poor tumor staining in cerebral angiography. However, hypervascular vestibular schwannoma might be observed as a rare subtype with increased risk of bleeding during surgery. Multimodal imaging features which represent hypervascularity of the tumor can be observed in hypervascular vestibular schwannoma. Here we report a case of hypervascular vestibular schwannoma with brief literature review.

  11. [Ataxic instable Alajouanine-Akerman's hand: recovery of a semiologic sign].

    Science.gov (United States)

    Levy, G

    1999-06-01

    It is aimed to recover, considering its historical value, a semiological sign described in 1931 by an eminent neurologist of Rio de Janeiro, together with a master of the French neurology. In the article by Alajouanine and Akerman, named "Attitude of the hand in an astereognostic monobrachial crisis of multiple esclerosis", a semiologic alteration was described which was characterized by "an instability in the attitude of the fingers, which is observed mainly with the hand extended in the attitude of swearing". This attitude of hand worsened a lot with the eyes closed and was accompanied by sensory ataxia, astereognosis, and impaired deep sensation in the affected member. From the original article, it is possible to consider at the present time the described semiologic alteration as a form of pseudoathetosis localized in the hand.

  12. Febrile seizures - semiology in humans and animal models: evidence of focality and heterogeneity.

    Science.gov (United States)

    Neville, Brian G R; Gindner, Diane

    2010-01-01

    The relationship between febrile seizures and hippocampal sclerosis has been the subject of longstanding discussion. Animal models for prolonged seizures have shown a clear causal relationship with focal limbic features at low dose and hippocampal damage at high dose. Careful history taking of febrile seizure semiology has shown focal early features often with clear temporal lobe elements. This would suggest that many febrile seizures are secondarily generalised hippocampal seizures. There is evidence of varying levels of epileptogenicity in specific infective causes of febrile seizures. Seizure semiology also suggests that a proportion of such seizures may be non-epileptic reflex asystolic attacks. Seizure semiology in febrile seizures deserves closer scrutiny. Copyright 2009 Elsevier B.V. All rights reserved.

  13. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction.

    Science.gov (United States)

    Bayat, Arash; Pourbakht, Akram; Saki, Nader; Zainun, Zuraida; Nikakhlagh, Soheila; Mirmomeni, Golshan

    2012-11-01

    Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

  14. Lateralizing value of semiology in medial temporal lobe epilepsy.

    Science.gov (United States)

    Dupont, S; Samson, Y; Nguyen-Michel, V-H; Zavanone, C; Navarro, V; Baulac, M; Adam, C

    2015-12-01

    Analysing the clinical characteristics of seizures constitutes a fundamental aspect of the presurgical evaluation of patients with medial temporal lobe epilepsy and unilateral hippocampal sclerosis (MTLE-HS), the most frequent form of focal epilepsy accessible to surgery. We sought to retrospectively determine whether objective manifestations could have a reliable lateralizing value in a large population of MTLE-HS patients and if their presence could help to identify those patients who would be seizure free after surgery. We analysed the frequency and predictive lateralizing value of objective ictal and postictal signs in 391 patients with MTLE-HS (183 left/208 right). Data were derived from chart review and not from blinded videoEEG analysis. Correlation between the presence of reliable lateralizing signs and postoperative outcome was performed in a subgroup of 302 patients who underwent surgery. Contralateral dystonic posturing was the most frequent and reliable lateralizing sign that correctly lateralized the focus in 96% of patients. Unilateral head/eye deviation was noted in 42% of the patients and predicted unilateral focus in 67%. Ipsilateral postictal nose wiping, contralateral clonus and hypokinesia correctly lateralized the focus in 75%, 81%, respectively, and 100 of patients but were less frequently depicted. Postictal aphasia was a strong lateralizing sign for left MLE-HS. The presence of reliable lateralizing signs was not a predictor of seizure freedom. Seizure semiology is a simple tool that may permit reliable lateralization of the seizure focus in MTLE-HS. The presence of reliable lateralizing signs is not associated with a better postoperative outcome. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Seizure semiology and EEG findings in mitochondrial diseases.

    Science.gov (United States)

    Chevallier, Justyna A; Von Allmen, Gretchen K; Koenig, Mary Kay

    2014-05-01

    Seizures constitute a frequent yet under-described manifestation of mitochondrial disorders (MDs). The aim of this study was to describe electroencephalography (EEG) findings and clinical seizure types in a population of children and adults with mitochondrial disease. Retrospective chart review of 165 records of children and adults with mitochondrial disease seen in the University of Texas Houston Mitochondrial Center between 2007 and 2012 was performed; all subjects were diagnosed with confirmed mitochondrial disease. EEG findings and clinical data, including seizure semiology and response to antiepileptic drugs (AEDs), were analyzed and categorized. Sixty-six percent (109/165) of subjects had a routine EEG performed. Sixty-one percent (67/109) of EEG studies were abnormal and 85% (56/67) had epileptiform discharges. The most common EEG finding was generalized slowing (40/67, 60%). The most frequent category of epileptiform activity seen was multifocal discharges (41%), followed by focal (39%) and generalized (39%) discharges. Clinical seizures were seen in 55% of subjects and the most common types of seizures observed were complex partial (37%) and generalized tonic-clonic (GTC; 37%). The most common seizure type in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) was GTC (33%), with generalized or focal discharges seen on EEG. In Leigh syndrome GTC (11%) and complex partial (11%) seizures were the most frequent types. Of 60 subjects with clinical seizures, 28% were intractable to medical treatment. Mitochondrial disorder should be included in the list of differential diagnosis in any child that presents with encephalopathy, seizures, and a fluctuating clinical course. Given the relatively high prevalence of EEG abnormalities in patients with MD, EEG should be performed during initial evaluation in all patients with MD, not only upon clinical suspicion of epilepsy. Wiley Periodicals, Inc. © 2014 International

  16. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    OpenAIRE

    Esther Bernal Valls; Víctor Faus Cuñat; Raquel Bernal Valls

    2006-01-01

    El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a represent...

  17. Hyperkinetic motor seizures: a common semiology generated by two different cortical seizure origins.

    Science.gov (United States)

    Vaugier, Lisa; McGonigal, Aileen; Lagarde, Stanislas; Trébuchon, Agnes; Szurhaj, William; Derambure, Philippe; Bartolomei, Fabrice

    2017-09-01

    We report a 37-year-old, right-handed patient with drug-resistant focal epilepsy whose seizures were characterized by explosive hyperkinetic behaviour. Video-SEEG revealed bifocal organization of epilepsy with two distinct cortical origins of seizures: the right temporal pole and left temporal lateral and perisylvian cortex. Irrespective of the cortical pattern of seizure onset, the hyperkinetic semiology was extremely similar. This supports a major role for "final common pathway" subcortical circuits in the genesis of the hyperkinetic semiology in this patient.

  18. The Head, the Heart, and Hysteria in Jeanne Flore's Tales and Trials of Love (c. 1542).

    Science.gov (United States)

    Peebles, Kelly Digby

    2018-03-01

    This essay examines a challenge to common literary representations of female mental illness in the Early Modern period-the hysterical woman-in a collection of French short stories contemporary to Vesalius's De Fabrica: Jeanne Flore's Tales and Trials of Love (1542). Jeanne Flore's tales depict several mentally disturbed female protagonists, young women prone to paroxysms of madness and self-mutilation. This study maintains that while Tales and Trials of Love superficially participates in the literary tradition that grew out of those accepted social and medical beliefs, it also questions the long-accepted paradigm of female hysteria and points to a shift in the socio-medical climate. Jeanne Flore's fictional narratives suggest that mental illness no longer consists in the realignment of a uterine imbalance, but rather in the telling of personal stories, a precursor to psychoanalysis and narrative medicine.

  19. The vestibular system and cognition.

    Science.gov (United States)

    Smith, Paul F

    2017-02-01

    The last year has seen a great deal of new information published relating vestibular dysfunction to cognitive impairment in humans, especially in the elderly. The objective of this review is to summarize and critically evaluate this new evidence in the context of the previous literature. This review will address the recent epidemiological/survey studies that link vestibular dysfunction with cognitive impairment in the elderly; recent clinical investigations into cognitive impairment in the context of vestibular dysfunction, both in the elderly and in the cases of otic capsule dehiscence and partial bilateral vestibulopathy; recent evidence that vestibular impairment is associated with hippocampal atrophy; and finally recent evidence relating to the hypothesis that vestibular dysfunction could be a risk factor for dementia. The main implication of these recent studies is that vestibular dysfunction, possibly of any type, may result in cognitive impairment, and this could be especially so for the elderly. Such symptoms will need to be considered in the treatment of patients with vestibular disorders.

  20. Pharmacology of the vestibular system.

    Science.gov (United States)

    Smith, P F

    2000-02-01

    In the past year significant advances have been made in our understanding of the neurochemistry and neuropharmacology of the peripheral and central vestibular systems. The recognition of the central importance of excitatory amino acids and their receptors at the level of the hair cells, vestibular nerve and vestibular nucleus has progressed further, and the role of nitric oxide in relation to activation of the N-methyl-D-aspartate receptor subtype is becoming increasingly clear. Increasing evidence suggests that excessive N-methyl-D-aspartate receptor activation and nitric oxide production after exposure to aminoglycoside antibiotics is a critical part of hair cell death, and new pharmacological strategies for preventing aminoglycoside ototoxicity are emerging as a result. Conversely, the use of aminoglycosides to lesion the peripheral vestibular system in the treatment of Meniere's disease has been studied intensively. In the vestibular nucleus, new studies suggest the importance of opioid, nociceptin and glucocorticoid receptors in the control of vestibular reflex function. Finally, the mechanisms of action and optimal use of antihistamines in the treatment of vestibular disorders has also received a great deal of attention.

  1. Is the Headache in Patients with Vestibular Migraine Attenuated by Vestibular Rehabilitation?

    OpenAIRE

    Sugaya, Nagisa; ARAI, Miki; Goto, Fumiyuki

    2017-01-01

    Background Vestibular rehabilitation is the most effective treatment for dizziness due to vestibular dysfunction. Given the biological relationship between vestibular symptoms and headache, headache in patients with vestibular migraine (VM) could be improved by vestibular rehabilitation that leads to the improvement of dizziness. This study aimed to compare the effects of vestibular rehabilitation on headache and other outcomes relating to dizziness, and the psychological factors in patien...

  2. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    Directory of Open Access Journals (Sweden)

    Esther Bernal Valls

    2006-12-01

    Full Text Available El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a representative way, what evidences this is a profitable process for this kind of patients. The good results suggest that vestibular exercises permit a postural stability and a decrease in the perception of disequilibrium.

  3. Task, muscle and frequency dependent vestibular control of posture

    NARCIS (Netherlands)

    Forbes, P.A.; Siegmund, G.P.; Schouten, A.C.; Blouin, J.S.

    2015-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular

  4. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders.

    Science.gov (United States)

    Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

    2016-01-01

    Visual stimuli can induce vestibular adaptation and recovery of body balance. To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD) (experimental group) or Cawthorne-Cooksey exercises (control group). The Dizziness Handicap Inventory (DHI), dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention. Before and after the intervention, there was no difference between the experimental and control groups (p>0.005) regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p<0.05) in the DHI and the dizziness analog scale, and higher values (p<0.05) in the static balance tests in some of the assessed conditions. The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  5. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    Directory of Open Access Journals (Sweden)

    Andréa Manso

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Visual stimuli can induce vestibular adaptation and recovery of body balance. OBJECTIVE: To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. METHODS: Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD (experimental group or Cawthorne-Cooksey exercises (control group. The Dizziness Handicap Inventory (DHI, dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention. RESULTS: Before and after the intervention, there was no difference between the experimental and control groups (p > 0.005 regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p < 0.05 in the DHI and the dizziness analog scale, and higher values (p < 0.05 in the static balance tests in some of the assessed conditions. CONCLUSION: The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders.

  6. Seizure semiology inferred from clinical descriptions and from video recordings. How accurate are they?

    DEFF Research Database (Denmark)

    Beniczky, Simona Alexandra; Fogarasi, András; Neufeld, Miri

    2012-01-01

    To assess how accurate the interpretation of seizure semiology is when inferred from witnessed seizure descriptions and from video recordings, five epileptologists analyzed 41 seizures from 30 consecutive patients who had clinical episodes in the epilepsy monitoring unit. For each clinical episode...

  7. The emergence of psychiatric semiology during the Age of Revolution: evolving concepts of 'normal' and 'pathological'.

    Science.gov (United States)

    Londoño, Diego Enrique; Dening, Tom

    2016-06-01

    This article addresses some important questions in psychiatric semiology. The concept of a sign is crucial in psychiatry. How do signs emerge, and what gives them validity and legitimacy? What are the boundaries of 'normal' and 'pathological' behaviour and mental experiences? To address these issues, we analyse the characteristics and rules that govern semiological signs and clinical elements. We examine 'normality' from the perspective of Georges Canguilehm and compare the differences of 'normal' in physiology and psychiatry. We then examine the history and the philosophical, linguistic and medical-psychiatric origins of semiology during the eighteenth and nineteenth centuries (the Age of Revolution). The field of rhetoric and oratory has emphasized the importance of passions, emotions and language as applied to signs of madness. Another perspective on semiology, provided by Michel Foucault, lays stress on the concept of 'instinct' and the axis of voluntary-involuntary behaviour. Finally, we analyse how statistics and eugenics have played an important role in our current conceptualization of the norm and therefore the scientific discourse behind the established clinical signs. © The Author(s) 2016.

  8. Ethnicity, Teacher Decision-Making, Constructivism, and Semiology: A Promising New Mix.

    Science.gov (United States)

    McGinnis, J. Randy; And Others

    The purpose of this study was to describe and interpret teacher decision-making with ethnically diverse students. A new paradigmatic theoretical framework formed through the confluence of constructivism, multiculturalism, the teacher-as-decision-maker, and semiology guided the research. The research site was a suburban middle school located in the…

  9. Does semiology tell us the origin of seizures consisting mainly of an alteration in consciousness?

    Science.gov (United States)

    Baykan, Betül; Altindag, Ebru; Feddersen, Berend; Ozel, Sevda; Noachtar, Soheyl

    2011-08-01

    Studies on seizures only with an alteration of consciousness were limited mainly to generalized epilepsy. This seizure type has been described rarely in focal epilepsy. We aimed to analyze the semiologic features of this seizure type in focal and generalized epilepsies in a blinded design. A total of 338 seizure videos in 100 patients were included exclusively by semiologic criteria. Two investigators evaluated the seizure semiology (aura, seizure duration, blinking, mild motor phenomena including automatisms, and so on) from the videos. Primarily the ictal electroencephalography (EEGs) studies and all laboratory findings were evaluated for the localization of the epileptogenic zone and delineating the syndromes, in the second step. Of the focal epilepsy patients (n = 57), the epileptogenic zone could be localized to the temporal (n = 20), frontal (n = 9), and parietooccipital (n = 3) regions. The most common etiology of the generalized epilepsy patients (n = 43) was presumably genetic (n = 33). The presence of aura (none in generalized epilepsy vs. 35% in focal epilepsy; p = 0.0008), lack of blinking (19.3% in focal vs 65.1% in generalized epilepsy; p = 0.01), and longer seizure duration (generalized 14.3 ± 17.7 s vs focal 54.9 ± 40.1 s; p semiologic and clinical features that help to differentiate between focal and generalized epilepsy should be considered in the syndrome diagnosis. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  10. A Comparative Study of Water Semiology in Sohrab Sepehri's and Gibran Kahlil Gibran's Works

    Science.gov (United States)

    Nafchi, Asghar Moulavi; Rafeirad, Mohammad Esmaeili; Kordiani, Mohsen Mohammadi

    2014-01-01

    All over the world, among various cultures, water has always been a major concept and given a lot of attention. Many nations in different ways have delivered it in different symbolic forms. The implications given to water are based on cultural and national tendencies. Being highly important, water and its semiology has beckoned prominent poets and…

  11. Pour une pedagogie de la semiologie graphique (A Methodology for Graphic Semiology)

    Science.gov (United States)

    Mariet, Francois

    1978-01-01

    Presentation of a methodology for instruction in reading and interpreting graphs and charts in a foreign language class. Illustrated by several demographic charts, the discussion includes an explanation of graphic semiology, several pedagogical approaches, the relationship between written text and graph and a bibliography. (Text is in French.)…

  12. Vestibular Contributions to Human Memory

    OpenAIRE

    Smith, Laura; N/A,

    2017-01-01

    The vestibular system is an ancient structure which supports the detection and control of self-motion. The pervasiveness of this sensory system is evidenced by the diversity of its anatomical projections and the profound impact it has on a range of higher level functions, particularly spatial memory. The aim of this thesis was to better characterise the association between the vestibular system and human memory; while many studies have explored this association from a biological perspective f...

  13. Perspectives on aging vestibular function

    Directory of Open Access Journals (Sweden)

    Eric eAnson

    2016-01-01

    Full Text Available Much is known about age related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities like standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multi-sensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multi-sensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults.

  14. Perspectives on Aging Vestibular Function.

    Science.gov (United States)

    Anson, Eric; Jeka, John

    2015-01-01

    Much is known about age-related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities such as standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multisensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper, we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multisensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults.

  15. Vestibular findings in fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Zeigelboim, Bianca Simone

    2011-07-01

    Full Text Available Introduction: Fibromyalgia (FM is a non-inflammatory musculoskeletal chronic syndrome, whose etiology is unknown, characterized by a diffuse pain, increase in palpation sensitivity and such symptoms as tiredness, insomnia, anxiety, depression, cold intolerance and otologic complaints. Objective: Evaluate the vestibular behavior in fibromyalgia patients. Method: A retrospective transversal study was performed. 25 patients aged between 26 and 65 (average age - 52.2 and standard deviation - 10.3 were evaluated and submitted to the following procedures: anamnesis, otorhinolaryngologic and vestibular evaluation by way of vector electronystamography. Results: a The most evident otoneurologic symptoms were: difficulty or pain when moving the neck and pain was spread to an arm or shoulder (92.0% in each, dizziness (84.0% and headache (76.0%. The different clinical symptoms mostly reported were: depression (80.0%, anxiety (76.0% and insomnia (72.0%; b vestibular examination showed an alteration in 12 patients (48.0% in the caloric test; c an alteration in the peripheral vestibular system prevailed, and d deficient peripheral vestibular disorders were prevalent. Conclusion: This study enabled the importance of the labyrinthic test to be verified, thus emphasizing that this kind of people must be studied better, since a range of rheumatologic diseases can cause severe vestibular changes as a result of their manifestations and impairment areas.

  16. Neuropharmacology of vestibular system disorders.

    Science.gov (United States)

    Soto, Enrique; Vega, Rosario

    2010-03-01

    This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Otolaryngologists are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in our knowledge of the fundamental mechanisms of vestibular system function and drug mechanisms of action. In this work, drugs acting on vestibular system have been grouped into two main categories according to their primary mechanisms of action: those with effects on neurotransmitters and neuromodulator receptors and those that act on voltage-gated ion channels. Particular attention is given in this review to drugs that may provide additional insight into the pathophysiology of vestibular diseases. A critical review of the pharmacology and highlights of the major advances are discussed in each case.

  17. Eye movements in vestibular disorders.

    Science.gov (United States)

    Kheradmand, A; Colpak, A I; Zee, D S

    2016-01-01

    The differential diagnosis of patients with vestibular symptoms usually begins with the question: is the lesion central or is it peripheral? The answer commonly emerges from a careful examination of eye movements, especially when the lesion is located in otherwise clinically silent areas of the brain such as the vestibular portions of the cerebellum (flocculus, paraflocculus which is called the tonsils in humans, nodulus, and uvula) and the vestibular nuclei as well as immediately adjacent areas (the perihypoglossal nuclei and the paramedian nuclei and tracts). The neural circuitry that controls vestibular eye movements is intertwined with a larger network within the brainstem and cerebellum that also controls other types of conjugate eye movements. These include saccades and pursuit as well as the mechanisms that enable steady fixation, both straight ahead and in eccentric gaze positions. Navigating through this complex network requires a thorough knowledge about all classes of eye movements to help localize lesions causing a vestibular disorder. Here we review the different classes of eye movements and how to examine them, and then describe common ocular motor findings associated with central vestibular lesions from both a topographic and functional perspective. © 2016 Elsevier B.V. All rights reserved.

  18. The seizure semiology consistent with frontal lobe symptomatogenic zone in children.

    Science.gov (United States)

    Öztoprak, Ülkühan; Yalnızoğlu, Dilek; Oğuz, Kader Karlı; Ergun, Eser Lay; Söylemezoğlu, Figen; Bilginer, Burçak; Akalan, Nejat; Topçu, Meral; Turanlı, Güzide

    2016-01-01

    The aim of this study is to analyze the seizure semiology consistent with frontal lobe symptomatogenic zone in childhood. We analyzed 549 videotaped seizures from 79 patients (mean age 9.9 ± 3.8 years). Magnetic resonance imaging was normal in 30 patients. The seizures in the time interval of 10 p.m. to 6 a.m. were considered as nocturnal. The mean number of seizures per patient was 6.8 ± 7.3. The mean seizure duration was 25.7 ± 26.9 sec; postictal confusion was 27 ± 16.1 sec (7-92 seconds). The seizures were observed in sleep with a rate of 56.8%; 43.1% of them were during wakefulness. Overall 50.4% of the seizures occured during night-time sleep. Tonic seizure (77.2%) was the most frequent simple motor seizure. Versive seizures were the second most frequent type of simple motor seizure (26.7%). Clonic seizures were 17.7%, complex motor seizures were 20.5%, and dialeptic seizures were 3% of all the seizures. Epileptic spasm, myoclonic seizures, aphasia, and akinetic semiologies were not observed. Vocalization was observed in 16% of the seizures. Frontal lobe seizures in childhood have a short duration, occur frequently, especially during night time sleep, and have a brief postictal period. Tonic semiology, versive semiology are the most frequent seizure semiologies; hypermotor and secondary generalized tonic clonic seizures and vocalizations are observed less in children compared to adults.

  19. Seizure semiology in leucine-rich glioma-inactivated protein 1 antibody-associated limbic encephalitis.

    Science.gov (United States)

    Chen, Chao; Wang, Xiu; Zhang, Chao; Cui, Tao; Shi, Wei-Xiong; Guan, Hong-Zhi; Ren, Hai-Tao; Shao, Xiao-Qiu

    2017-12-01

    The objective of this study was to advance the characterization of seizure semiology in leucine-rich glioma-inactivated protein 1 (LGI1) antibody-associated limbic encephalitis (LE). Eighteen patients diagnosed with LGI1 LE were identified. Seizure semiology, demographic features, MRI and fluorodeoxyglucose positron emission tomography (FDG-PET), electroencephalograms, and outcomes following immunotherapy were evaluated. Patients were divided into the following groups based on seizure semiology: faciobrachial dystonic seizure only (FBDS-only, n=4), epileptic seizure without FBDS (Non-FBDS, n=6), and FBDS plus epileptic seizure (FBDS+, n=8). In the group with Non-FBDS, the majority of patients (5/6) manifested mesial temporal lobe epilepsy (MTLE) like semiology (i.e., fear, epigastric rising, staring, and automatisms) with a frequency of 7±5 times per day and a duration of 15.3±14.3s. In the group with FBDS+, the distinctive symptom was FBDS followed by epileptic events, especially automatisms (7/8), with a frequency of 16±12 times per day and a duration of 13.0±8.0s. In these cases, 67% and 50% of the patients showed abnormalities on MRI and FDG-PET, respectively, and the mesial temporal lobe structures were most often involved. Ictal discharges were observed in 0/4, 6/6, and 8/8 of the patients in the groups with FBDS only, Non-FBDS, and FBDS+, respectively. The temporal lobe was mainly affected. Immunotherapy had favorable therapeutic effects. The LGI1 LE should be considered as one disease syndrome with a series of clinical manifestation. Identifying types of unique semiology features will facilitate the early diagnosis and the timely initiation of immunotherapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. [Effect of nitric oxide in vestibular compensation].

    Science.gov (United States)

    Jiang, Zi-dong; Zhang, Lian-shan

    2003-10-01

    To study the effect of nitric oxide (NO) in vestibular compensation after unilateral vestibular deafferentation. Eighteen animals were divided into two groups, 6 of group a as control, 12 of group b received gentamicin intratympanic injection in the left ear. Half of the animals were killed respectively after 5 days and 10 days. Vestibular endorgan and brainstem tissue sections were subjected to NADPH-d reactive test of NOS for histochemical examination. In group a, NOS-like reactivity in both sides of vestibular endorgan and nucli. In group b during 5 days, NOS-like reactivity in right side of vestibular endorgan and nucli, those of the left side were negative. During 10 days, NOS-like reactivity only in the right side of vestibular endorgan. Changes of NOS expression in the contralateral vestibular nucli might have played a role in vestibular compensation.

  1. Recovery of Vestibular Ocular Reflex Function and Balance Control after a Unilateral Peripheral Vestibular Deficit

    OpenAIRE

    John eAllum

    2012-01-01

    This review describes the effect of unilateral peripheral vestibular deficit (UPVD) on balance control for stance and gait tests. Because a UPVD is normally defined based on vestibular ocular reflex (VOR) tests, we compared recovery observed in balance control with patterns of recovery in VOR function. Two general types of UPVD are considered; acute vestibular neuritis (AVN) and vestibular neurectomy. The latter was subdivided into vestibular loss after cerebellar pontine angle tumor surgery ...

  2. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery

    OpenAIRE

    Lacour, Michel; Bernard-Demanze, Laurence

    2015-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to per...

  3. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: ten recommendations for optimal functional recovery

    OpenAIRE

    LACOUR eMichel; BERNARD DEMANZE eLaurence

    2015-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalogue of results but to provide clinicians with an understandable view on when and how to p...

  4. Compensation following bilateral vestibular damage

    Directory of Open Access Journals (Sweden)

    Bill J Yates

    2011-12-01

    Full Text Available Bilateral loss of vestibular inputs affects far fewer patients than unilateral inner ear damage, and thus has been understudied. In both animal subjects and human patients, bilateral vestibular hypofunction (BVH produces a variety of clinical problems, including impaired balance control, inability to maintain stable blood pressure during postural changes, difficulty in visual targeting of images, and disturbances in spatial memory and navigational performance. Experiments in animals have shown that nonlabyrinthine inputs to the vestibular nuclei are rapidly amplified following the onset of BVH, which may explain the recovery of postural stability and orthostatic tolerance that occurs within 10 days. However, the loss of the vestibulo-ocular reflex and degraded spatial cognition appear to be permanent in animals with BVH. Current concepts of the compensatory mechanisms in humans with BVH are largely inferential, as there is a lack of data from patients early in the disease process. Translation of animal studies of compensation for BVH into therapeutic strategies and subsequent application in the clinic is the most likely route to improve treatment. In addition to physical therapy, two types of prosthetic devices have been proposed to treat individuals with bilateral loss of vestibular inputs: those that provide tactile stimulation to indicate body position in space, and those that deliver electrical stimuli to branches of the vestibular nerve in accordance with head movements. The relative efficacy of these two treatment paradigms, and whether they can be combined to facilitate recovery, is yet to be ascertained.

  5. Compensation following bilateral vestibular damage.

    Science.gov (United States)

    McCall, Andrew A; Yates, Bill J

    2011-01-01

    Bilateral loss of vestibular inputs affects far fewer patients than unilateral inner ear damage, and thus has been understudied. In both animal subjects and human patients, bilateral vestibular hypofunction (BVH) produces a variety of clinical problems, including impaired balance control, inability to maintain stable blood pressure during postural changes, difficulty in visual targeting of images, and disturbances in spatial memory and navigational performance. Experiments in animals have shown that non-labyrinthine inputs to the vestibular nuclei are rapidly amplified following the onset of BVH, which may explain the recovery of postural stability and orthostatic tolerance that occurs within 10 days. However, the loss of the vestibulo-ocular reflex and degraded spatial cognition appear to be permanent in animals with BVH. Current concepts of the compensatory mechanisms in humans with BVH are largely inferential, as there is a lack of data from patients early in the disease process. Translation of animal studies of compensation for BVH into therapeutic strategies and subsequent application in the clinic is the most likely route to improve treatment. In addition to physical therapy, two types of prosthetic devices have been proposed to treat individuals with bilateral loss of vestibular inputs: those that provide tactile stimulation to indicate body position in space, and those that deliver electrical stimuli to branches of the vestibular nerve in accordance with head movements. The relative efficacy of these two treatment paradigms, and whether they can be combined to facilitate recovery, is yet to be ascertained.

  6. Ocular Vestibular Evoked Myogenic Potentials

    Directory of Open Access Journals (Sweden)

    Felipe, Lilian

    2014-01-01

    Full Text Available Introduction Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective To summarize recent developments in ocular VEMP testing. Results Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system.

  7. An adaptive vestibular rehabilitation technique.

    Science.gov (United States)

    Crane, Benjamin T; Schubert, Michael C

    2017-05-23

    There is a large variation in vestibular rehabilitation (VR) results depending on type of therapy, adherence, and the appropriateness for the patient's level of function. A novel adaptive vestibular rehabilitation (AVR) program was developed and evaluated. Technology and procedure development, and prospective multicenter trial. Those with complete unilateral vestibular hypofunction and symptomatic at least 3 months with a Dizziness Handicap Inventory (DHI) >30 were eligible. Patients were given a device to use with their own computer. They were instructed to use the program daily, with each session lasting about 10 minutes. The task consisted of reporting orientation of the letter C, which appeared when their angular head velocity exceeded a threshold. The letter size and head velocity required were adjusted based on prior performance. Performance on the task was remotely collected by the investigator as well as a weekly DHI score. Four patients aged 31 to 74 years (mean = 51 years) were enrolled in this feasibility study to demonstrate efficacy. Two had treated vestibular schwannomas and two had vestibular neuritis. Starting DHI was 32 to 56 (mean = 42), which was reduced to 0 to 16 (mean = 11.5) after a month of therapy, a clinically and statistically significant (P VR in terms of cost and customization for patient ability and obtained a major improvement in symptoms. This study demonstrated a clinically and statistically significant decrease in symptoms after 4 weeks of therapy. 2b Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  8. The Classification of Hysteria and Related Disorders: Historical and Phenomenological Considerations

    Directory of Open Access Journals (Sweden)

    Carol S. North

    2015-11-01

    Full Text Available This article examines the history of the conceptualization of dissociative, conversion, and somatoform syndromes in relation to one another, chronicles efforts to classify these and other phenomenologically-related psychopathology in the American diagnostic system for mental disorders, and traces the subsequent divergence in opinions of dissenting sectors on classification of these disorders. This article then considers the extensive phenomenological overlap across these disorders in empirical research, and from this foundation presents a new model for the conceptualization of these disorders. The classification of disorders formerly known as hysteria and phenomenologically-related syndromes has long been contentious and unsettled. Examination of the long history of the conceptual difficulties, which remain inherent in existing classification schemes for these disorders, can help to address the continuing controversy. This review clarifies the need for a major conceptual revision of the current classification of these disorders. A new phenomenologically-based classification scheme for these disorders is proposed that is more compatible with the agnostic and atheoretical approach to diagnosis of mental disorders used by the current classification system.

  9. Aging of vestibular function evaluated using correlational vestibular autorotation test

    Directory of Open Access Journals (Sweden)

    Hsieh LC

    2014-09-01

    Full Text Available Li-Chun Hsieh,1,2 Hung-Ching Lin,2,3 Guo-She Lee4,5 1Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 2Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan; 3Department of Audiology and Speech Language Pathology, Mackay Memorial Medical College, Taipei, Taiwan; 4Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 5Department of Otolaryngology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan Background: Imbalance from degeneration of vestibular end organs is a common problem in the elderly. However, the decline of vestibular function with aging was revealed in few vestibular function tests such as vestibular autorotation test (VAT. In the current VAT, there are drawbacks of poor test–retest reliability, slippage of the sensor at high-speed rotations, and limited data about the effect of aging. We developed a correlational-VAT (cVAT system that included a small, light sensor (less than 20 g with wireless data transmission technique to evaluate the aging of vestibular function. Material and methods: We enrolled 53 healthy participants aged between 25 and 75 years and divided them into five age groups. The test conditions were vertical and horizontal head autorotations of frequencies from 0 to 3 Hz with closed eyes or open eyes. The cross-correlation coefficient (CCC between eye velocity and head velocity was obtained for the head autorotations between 1 Hz and 3 Hz. The mean of the CCCs was used to represent the vestibular function. Results: Age was significantly and negatively correlated with the mean CCC for all test conditions, including horizontal or vertical autorotations with open eyes or closed eyes (P<0.05. The mean CCC with open eyes declined significantly at 55–65 years old and the mean CCC with closed eyes declined significantly at 65–75 years old.Conclusion: Vestibular function evaluated using mean CCC revealed a decline with

  10. Stereotactic radiotherapy for vestibular schwannoma

    DEFF Research Database (Denmark)

    Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno

    2014-01-01

    BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

  11. Fyodor Dostoevsky and his falling sickness: a critical analysis of seizure semiology.

    Science.gov (United States)

    Seneviratne, Udaya

    2010-08-01

    Fyodor Dostoevsky is a great Russian writer who had epilepsy. As a consequence, there are many references to seizure-related phenomena in his work. His epilepsy syndrome has been a focus of debate. The goal of this article is to delineate his epilepsy syndrome based on a semiological description of seizures, which could be considered one of the most reliable pieces of circumstantial evidence available. It was hypothesized that seizure-related descriptions in his books were based on his own personal experience. The semiology of seizures and related phenomena was compiled from Dostoevsky's own work, his letters to family and friends, and reminiscences of his wife and friend. Those descriptions were analyzed in detail to elicit localizing and lateralizing features of seizures. On the basis of this evidence, it was postulated that Dostoevsky had a partial epilepsy syndrome most probably arising from the dominant temporal lobe. Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.

  12. Subjectivity in clinical practice: on the origins of psychiatric semiology in early French alienism.

    Science.gov (United States)

    Huertas, Rafael

    2014-12-01

    The aim of this article is to contribute to the analysis of the origins of psychiatric semiology, which by emphasizing subjectivity in clinical practice, gave birth to psychopathology as the scientific and intellectual enterprise of alienism. In other words, beyond simple anatomical and clinical observation, there was an effort to 'listen to' and 'read' the patient's delirium. In essence, the basic thesis which this short paper seeks to defend is that, despite a growing anatomical and clinical mind-set and a clear interest in physically locating mental illness within the body, during the Romantic period, psychiatry was able to construct a semiology largely based on the experience of the ego, on the inner world of the individual. This makes it possible to establish, from a clinical perspective, that the birth of alienism - of psychiatry - must be situated within the framework of a modernity in which the culture of subjectivity was one of its most characteristic features. © The Author(s) 2014.

  13. Recent developments in our understanding of the semiology and treatment of psychogenic nonepileptic seizures.

    Science.gov (United States)

    Goldstein, Laura H; Mellers, John D C

    2012-08-01

    Psychogenic nonepileptic seizures (PNES) pose clinical challenges in terms of diagnosis and management. Recent studies have thrown further light on the extent to which features of PNES semiology may distinguish PNES patients from those with epilepsy. Management of this patient group will include discussion of the diagnosis, withdrawal of antiepileptic drugs, and psychological intervention when PNES persist. However, the evidence base for these different stages remains limited, although recent studies are beginning to provide guidance for clinicians and future research.

  14. The cognitive neurology of the vestibular system.

    Science.gov (United States)

    Seemungal, Barry M

    2014-02-01

    The aim is to reappraise the current state about what we know of vestibular cognition. The review focuses on cognition and perception, and hence the stress on human studies. In addition, the cerebral cortex is the main but not exclusive brain region of interest. There is a brief mention of vestibular ocular function if only to demonstrate the differential processing between reflex and perception. The effect of vestibular activation on some aspects of cognition, for example neglect, is not reviewed, as there have been no recent landmark findings in this area. The vestibular cerebellum is pivotal in the differential gating of vestibular perceptual and ocular signals to the cerebral cortex. The neuroanatomical correlates mediating vestibular sensations of self-motion ('am I moving?') and spatial orientation ('where am I now?') are distinct. Vestibular-motion perception is supported by a widespread white matter network. Vestibular activation specifically reduces visual motion cortical excitability, whereas other visual cortical regions show an increase in excitability. As the vestibular ocular reflex (VOR) and self-motion perception can be uncoupled both behaviourally and in neural correlate, deficits underlying vestibular patients' symptoms may not be revealed by simple VOR assessment. Given the pivotal cerebellar role in gating vestibular signals to perceptual regions, modulating mechanisms of cerebellar plasticity, for example by combining training with medication or brain stimulation, may prove fruitful in treating the symptoms of chronic dizzy patients.

  15. Negative emotional stimuli enhance vestibular processing.

    Science.gov (United States)

    Preuss, Nora; Ellis, Andrew W; Mast, Fred W

    2015-08-01

    Recent studies have shown that vestibular stimulation can influence affective processes. In the present study, we examined whether emotional information can also modulate vestibular perception. Participants performed a vestibular discrimination task on a motion platform while viewing emotional pictures. Six different picture categories were taken from the International Affective Picture System: mutilation, threat, snakes, neutral objects, sports, and erotic pictures. Using a Bayesian hierarchical approach, we were able to show that vestibular discrimination improved when participants viewed emotionally negative pictures (mutilation, threat, snake) when compared to neutral/positive objects. We conclude that some of the mechanisms involved in the processing of vestibular information are also sensitive to emotional content. Emotional information signals importance and mobilizes the body for action. In case of danger, a successful motor response requires precise vestibular processing. Therefore, negative emotional information improves processing of vestibular information. (c) 2015 APA, all rights reserved).

  16. [Cerebral seizures in neonatal period: semiology, evolution and factors of influence].

    Science.gov (United States)

    Rufo-Campos, M; González Meneses-López, A; Rangel-Pineda, C

    In spite of their incidence being much greater than at any other period during life, seizures occurring during the neonatal period are difficult to identify, since their patterns are not well organized on account of insufficient anatomical, physiological and/or biochemical development. To analyse the semiology of seizures during the neonatal period, their classification and subsequent evolution. We made a retrospective study of 60 patients who had convulsions during the neonatal period, selected from amongst the children admitted to the Neonatology Department of the Hospital Infantil Universitario Virgen de Rocio in Sevilla, between 1990 and 1998. We investigated 22 medical variables related to the clinical history, neurological examination, neuroimaging studies, EEG and drugs used. Anomalies were found on the initial examination in 83.3% of the cases. The hypoxic-ischemic syndrome was the commonest etiology, followed by hemorrhages, metabolic disorders, cardiopathies, malformations and infectious diseases. From the semiological angle, the seizures were seen as partial or generalised increase in muscle tone, followed by clonias, hypotonias and subtle seizures. Cerebral angiography was the most commonly used diagnostic imaging technique. There was a statistically significant relationship between the appearance of sequelae and the earliness of the occurrence of the seizures, but not with the duration, semiology or frequency. Seizures in the newborn are habitually seen in the hypoxic-ischemic syndrome, and usually present as alterations in muscle tone. Phenobarbitone is still the drug of choice for the treatment of seizures in the neonatal period.

  17. Seizure semiology: its value and limitations in localizing the epileptogenic zone.

    Science.gov (United States)

    Tufenkjian, Krikor; Lüders, Hans O

    2012-12-01

    Epilepsy surgery has become an important treatment option in patients with medically refractory epilepsy. The ability to precisely localize the epileptogenic zone is crucial for surgical success. The tools available for localization of the epileptogenic zone are limited. Seizure semiology is a simple and cost effective tool that allows localization of the symptomatogenic zone which either overlaps or is in close proximity of the epileptogenic zone. This becomes particularly important in cases of MRI negative focal epilepsy. The ability to video record seizures made it possible to discover new localizing signs and quantify the sensitivity and specificity of others. Ideally the signs used for localization should fulfill these criteria; 1) Easy to identify and have a high inter-rater reliability, 2) It has to be the first or one of the earlier components of the seizure in order to have localizing value. Later symptoms or signs are more likely to be due to ictal spread and may have only a lateralizing value. 3) The symptomatogenic zone corresponding to the recorded ictal symptom has to be clearly defined and well documented. Reproducibility of the initial ictal symptoms with cortical stimulation identifies the corresponding symptomatogenic zone. Unfortunately, however, not all ictal symptoms can be reproduced by focal cortical stimulation. Therefore, the problem the clinician faces is trying to deduce the epileptogenic zone from the seizure semiology. The semiological classification system is particularly useful in this regard. We present the known localizing and lateralizing signs based on this system.

  18. Perspectival Structure and Vestibular Processing

    DEFF Research Database (Denmark)

    Alsmith, Adrian John Tetteh

    2016-01-01

    I begin by contrasting a taxonomic approach to the vestibular system with the structural approach I take in the bulk of this commentary. I provide an analysis of perspectival structure. Employing that analysis and following the structural approach, I propose three lines of empirical investigation...

  19. [Treatment of hysteria in the 19th century--in which way did German psychiatrists view castration?].

    Science.gov (United States)

    Splett, T; Steinberg, H

    2003-01-01

    Until the late 19 th century treatment of hysteria, this inhomogeneous group of somatic, neurological and psychiatric symptoms, hardly differed from the methods of the Greco-Roman epoch. Dietetics, physical applications, and smaller surgical operations made up the standard forms of intervention for this illness which was regarded as belonging to the field of gynecology. Thus, it is not astonishing that oophorectomy (ovariectomy) was included into the therapeutic spectrum for hysteria both in Germany and beyond at the end of the 19 th century. It was above all gynecologist Alfred Hegar (1830 - 1914) who tried to extend the application of this method to nervous illnesses. This therapeutic alternative did not, however, meet with an unanimously positive response among psychiatrists. Richard von Krafft-Ebing (1840 - 1902) as a follower of the degeneration theory as well as Paul Flechsig (1847 - 1929) supported it, applying it as the ultima ratio. But since these operations produced no lasting curative impact, functional neurological disorders were regarded more important. From Emil Kraepelin (1856 - 1926) then, psychiatrists began to understand the psychological component of this illness, for which Leipzig neurologist Paul Julius Möbius (1853 - 1907) had made major contributions. Thus, surgical interventions were rejected and conservative methods of treatment were developed further considering psychological aspects. It was Adolf Strümpell (1853 - 1925) who had laid the basis for this postulating a "psychic trauma" as the cause for hysteria as early as in 1884. On the other hand, Möbius had developed a psychotherapeutic concept for the treatment of these disorders long before Sigmund Freud (1856 - 1939) came out with his psychocathartic method.

  20. Vestibular Stimulation for Stress Management in Students.

    Science.gov (United States)

    Kumar, Sai Sailesh; Rajagopalan, Archana; Mukkadan, Joseph Kurien

    2016-02-01

    Although several methods are developed to alleviate stress among college students, logistic limitations in adopting them have limited their utility. Hence, we aimed to test a very practical approach to alleviate stress among college students by achieving vestibular stimulation using swings. In this study 60 male and female participants were randomly assigned into vestibular stimulation or control groups. Depression, anxiety, stress scores, sleep quality, heart rate, blood pressure, Autonomic functions, respiratory, haematological, cognitive function, Quality of life were recorded before and after 1(st), 7(th), 14(th), 21(st), 28(th) days of vestibular stimulation. STAI S and STAI T scores were significantly improved on day 28(th) following vestibular stimulation. Diastolic and mean arterial blood pressure were significantly decreased and remained within normal limits in vestibular group on day 28(th) following vestibular stimulation. Postural fall in blood pressure was significantly improved on day 14 onwards, following vestibular stimulation. Respiratory rate was significantly improved on day 7 onwards, following vestibular stimulation. PSQI sleep disturbance, PSQI sleep latency, PSQI total score and bleeding time was significantly improved following vestibular stimulation. Our study supports the adoption of vestibular stimulation for stress management. Hence, placement of swings in college campuses must be considered, which may be a simple approach to alleviate stress among college students.

  1. Vestibular Findings in Military Band Musicians

    Directory of Open Access Journals (Sweden)

    Zeigelboim, Bianca Simone

    2014-04-01

    Full Text Available Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years. They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%, hearing difficulties (47.3%, dizziness (36.8%, headache (26.3%, intolerance to intense sounds (21.0%, and earache (15.7%. Seven musicians (37.0% showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%. There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.

  2. Vestibular findings in military band musicians.

    Science.gov (United States)

    Zeigelboim, Bianca Simone; Gueber, Crislaine; Silva, Thanara Pruner da; Liberalesso, Paulo Breno Noronha; Gonçalves, Claudia Giglio de Oliveira; Faryniuk, João Henrique; Marques, Jair Mendes; Jurkiewicz, Ari Leon

    2014-04-01

    Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.

  3. Mechanisms of vestibular compensation: recent advances.

    Science.gov (United States)

    Dutia, Mayank B

    2010-10-01

    This article reviews recent studies that have provided experimental evidence for mechanisms of neural and synaptic plasticity in the brain during vestibular compensation, the behavioural recovery that takes place following peripheral vestibular lesions. First, experimental evidence from animal studies indicates that an unbalanced vestibular commissural system is a fundamental cause of the syndrome of oculomotor and postural deficits after unilateral labyrinthectomy. Second, recent studies suggest the involvement of both GABAergic and glycinergic commissural neurons. In addition gliosis and reactive neurogenesis in the ipsilesional vestibular nuclei appear to be involved in compensation. Third, evidence from cerebellar-deficient mutant mice demonstrates an important role for cerebellum-dependent motor learning in the longer term. Factors such as stress steroids and neuromodulators such as histamine influence these plasticity mechanisms and may thus contribute to the development of compensation in patients. Vestibular compensation involves multiple, parallel plastic processes at various sites in the brain. Experimental evidence suggests that adaptive changes in the sensitivity of ipsilesional vestibular neurons to the inhibitory neurotransmitters GABA and glycine, changes in the electrophysiological excitability of vestibular neurons, changes in the inhibitory control of the brainstem vestibular networks by the cerebellum, gliosis and neurogenesis in the ipsilesional vestibular nuclei, and activity-dependent reorganization of the synaptic connectivity of the vestibular pathways are mechanisms involved in compensation.

  4. Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction.

    Science.gov (United States)

    Topuz, Oya; Topuz, Bülent; Ardiç, F Necdet; Sarhuş, Merih; Ogmen, Gülsen; Ardiç, Füsun

    2004-02-01

    To assess the efficacy of vestibular rehabilitation exercises on patients with chronic unilateral vestibular dysfunction. Prospective study. Physical Medicine and Rehabilitation Clinic and Otolaryngology Clinic of a tertiary referral hospital. One-hundred and twenty-five patients with unilateral chronic vestibular dysfunction were included in the study. Eight-week, two-staged (clinic and home) vestibular rehabilitation programme with components of Cawthorne-Cooksey and Norre exercises was applied. Dizziness Handicap Inventory (DHI) and visual analogue scale (VAS) were completed three times (at the beginning, end of the second week and end of the treatment). Data for 112 patients in the first stage and 93 patients in the second stage were evaluated because of insufficient compliance of the other patients. The mean DHI score was decreased from 50.42 +/- 24.12 points to 21.21 +/- 15.97 points (p < 0.001) at the end of first two weeks, and to 19.93 +/- 19.33 points at the end of the whole treatment. The mean VAS score was decreased from 5.87 +/- 2.27 to 2.02 +/- 1.75 (p < 0.001) at the end of second week, and to 1.51 +/- 1.29 at the end of eighth week. In respect to both VAS and DHI scores, improvement was noted in 67 patients (77.4%). Age, gender and disability level had no predictive value about therapy outcome. There was a fast recovery in the supervised exercise session, whereas there was no significant difference in the home exercise session. These findings suggest that either supervised exercise is better than home exercise or that 10 supervised sessions are sufficient to get the end result.

  5. Physical therapy for persons with vestibular disorders.

    Science.gov (United States)

    Whitney, Susan L; Alghwiri, Alia; Alghadir, Ahmad

    2015-02-01

    Persons with vestibular disorders experience symptoms of dizziness and balance dysfunction, resulting in falls, as well as impairments of daily life. Various interventions provided by physical therapists have been shown to decrease dizziness and improve postural control. In the present review, we will focus on the role of physical therapy in the management of vestibular symptoms in patients with peripheral and central vestibular disorders. Persons with both acute and chronic central and peripheral vestibular disorders improve with vestibular rehabilitation. New interventions during the past 5 years have been designed to enhance recovery from problems with balance and dizziness. Examples include the use of virtual reality, vibrotactile feedback, optokinetic flow, YouTube videos, and innovative methods to change the gain of the vestibulo-ocular reflex (VOR). Patients with central and peripheral vestibular disorders benefit from physical therapy interventions. Advances in physical therapy interventions include new methods to stimulate adaptation of the VOR and the vestibulospinal systems.

  6. The expulsion of evil and its return: an unconscious fantasy associated with a case of mass hysteria in adolescents.

    Science.gov (United States)

    Loa Zavala, Nashyiela

    2010-10-01

    The formal study of hysteria started with psychoanalysis, which opened paths to studying the unconscious. However, we have found no psychoanalytic or psychiatric studies in the literature reporting epidemics of hysteria in hundreds of adolescent girls affected for several months like the one we describe. This epidemic occurred in a religious boarding-school in a rural area of Mexico. Our study aimed to determine psychoanalytic and sociocultural elements contributing to explain a behavioural epidemic outbreak during which young girls were unable to walk normally and which led to a temporary cessation of routine activities at the boarding-school. Key informers were interviewed, including the first cases of affected adolescent girls and the nuns. Interviews included questions concerning informers' life history and their life at the boarding-school before and during the epidemic. We found that this boarding-school functioned as a large family affected by a psychotic episode which resulted from modes of communication of its members. This article describes the phenomenon and emphasizes perceived communication among members of the boarding-school and visitors at the time of the outbreak. Copyright © 2010 Institute of Psychoanalysis.

  7. Personality changes in patients with vestibular dysfunction

    OpenAIRE

    Paul eSmith; Cynthia eDarlington

    2013-01-01

    The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflex...

  8. Motor development after vestibular deprivation in rats.

    Science.gov (United States)

    Geisler, H C; Gramsbergen, A

    1998-07-01

    This review summarizes the postural development in the rat and the influences of vestibular deprivation from the 5th postnatal day on this development. Vestibular deprivation leads to a delay in motor development. Most probably this delay is caused by a delay in the development of postural control, which is characterized by a retarded EMG development in postural muscles. Our results indicate that the developing nervous system cannot compensate for a vestibular deficit during the early phase of ontogeny.

  9. Changing perspective: The role of vestibular signals

    OpenAIRE

    Deroualle, Diane; Borel, Liliane; Deveze, Arnaud; Lopez, Christophe

    2015-01-01

    Social interactions depend on mechanisms such as the ability to take another person's viewpoint, i.e. visuo-spatial perspective taking. However, little is known about the sensorimotor mechanisms underpinning perspective taking. Because vestibular signals play roles in mental rotation and spatial cognition tasks and because damage to the vestibular cortex can disturb egocentric perspective, vestibular signals stand as important candidates for the sensorimotor foundations of perspective taking....

  10. Prosthetic implantation of the human vestibular system.

    Science.gov (United States)

    Golub, Justin S; Ling, Leo; Nie, Kaibao; Nowack, Amy; Shepherd, Sarah J; Bierer, Steven M; Jameyson, Elyse; Kaneko, Chris R S; Phillips, James O; Rubinstein, Jay T

    2014-01-01

    A functional vestibular prosthesis can be implanted in human such that electrical stimulation of each semicircular canal produces canal-specific eye movements while preserving vestibular and auditory function. A number of vestibular disorders could be treated with prosthetic stimulation of the vestibular end organs. We have previously demonstrated in rhesus monkeys that a vestibular neurostimulator, based on the Nucleus Freedom cochlear implant, can produce canal-specific electrically evoked eye movements while preserving auditory and vestibular function. An investigational device exemption has been obtained from the FDA to study the feasibility of treating uncontrolled Ménière's disease with the device. The UW/Nucleus vestibular implant was implanted in the perilymphatic space adjacent to the three semicircular canal ampullae of a human subject with uncontrolled Ménière's disease. Preoperative and postoperative vestibular and auditory function was assessed. Electrically evoked eye movements were measured at 2 time points postoperatively. Implantation of all semicircular canals was technically feasible. Horizontal canal and auditory function were largely, but not totally, lost. Electrode stimulation in 2 of 3 canals resulted in canal-appropriate eye movements. Over time, stimulation thresholds increased. Prosthetic implantation of the semicircular canals in humans is technically feasible. Electrical stimulation resulted in canal-specific eye movements, although thresholds increased over time. Preservation of native auditory and vestibular function, previously observed in animals, was not demonstrated in a single subject with advanced Ménière's disease.

  11. Vestibular perception is slow: a review.

    Science.gov (United States)

    Barnett-Cowan, Michael

    2013-01-01

    Multisensory stimuli originating from the same event can be perceived asynchronously due to differential physical and neural delays. The transduction of and physiological responses to vestibular stimulation are extremely fast, suggesting that other stimuli need to be presented prior to vestibular stimulation in order to be perceived as simultaneous. There is, however, a recent and growing body of evidence which indicates that the perceived onset of vestibular stimulation is slow compared to the other senses, such that vestibular stimuli need to be presented prior to other sensory stimuli in order to be perceived synchronously. From a review of this literature it is speculated that this perceived latency of vestibular stimulation may reflect the fact that vestibular stimulation is most often associated with sensory events that occur following head movement, that the vestibular system rarely works alone, that additional computations are required for processing vestibular information, and that the brain prioritizes physiological response to vestibular stimulation over perceptual awareness of stimulation onset. Empirical investigation of these theoretical predictions is encouraged in order to fully understand this surprising result, its implications, and to advance the field.

  12. Vestibular insights into cognition and psychiatry.

    Science.gov (United States)

    Gurvich, Caroline; Maller, Jerome J; Lithgow, Brian; Haghgooie, Saman; Kulkarni, Jayashri

    2013-11-06

    The vestibular system has traditionally been thought of as a balance apparatus; however, accumulating research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is measurably unaffected. There are several brain regions that are implicated in both vestibular pathways and psychiatric disorders. The present review examines the anatomical associations between the vestibular system and various psychiatric disorders. Despite the lack of direct evidence for vestibular pathology in the key psychiatric disorders selected for this review, there is a substantial body of literature implicating the vestibular system in each of the selected psychiatric disorders. The second part of this review provides complimentary evidence showing the link between vestibular dysfunction and vestibular stimulation upon cognitive and psychiatric symptoms. In summary, emerging research suggests the vestibular system can be considered a potential window for exploring brain function beyond that of maintenance of balance, and into areas of cognitive, affective and psychiatric symptomology. Given the paucity of biological and diagnostic markers in psychiatry, novel avenues to explore brain function in psychiatric disorders are of particular interest and warrant further exploration. © 2013 Elsevier B.V. All rights reserved.

  13. Personality changes in patients with vestibular dysfunction.

    Science.gov (United States)

    Smith, Paul F; Darlington, Cynthia L

    2013-10-29

    The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalization and derealization symptoms such as feeling "spaced out", "body feeling strange" and "not feeling in control of self". We propose in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction (TPJ).

  14. International Clinical Protocol on Vestibular Disorders (Dizziness).

    Science.gov (United States)

    Trinus, Kostiantyn; Claussen, Claus-Frenz

    2017-12-01

    26-28 May at 43 Congress of Neurootological and Equilibriometric Society (Budapest, Hungary) International Clinical Protocol on Vestibular Disorders (Dizziness) being discussed and accepted as Consensus Document. Cochrane reports estimates that dizziness has prevalence of 22.9% in the last 12 months and an incidence of 3.1%. Only 1.8% of adults consulted a physician in the last 12 months. Cochrane reviews suggest that the evidence base for dizziness evaluation is weak, thus necessitates the creation of evidence-based document. Protocol is based at the new concept of vestibular system, which involves the vestibular peripheral sensors, space orientation tetrad, vestibular presentations in the brain cortex and vestibular effectory projections in the brain. Labyrinth consists of sensors, for which six modalities are adequate: 1. acceleration, 2. gravitation, 3. low frequency whole-body vibration, 4. Infrasound, 5. magnetic impulse, 6. metabolic changes. Vestibular system from rhomboid fosse gets the inputs from visual, acoustic, somatosensory organs, integrating them and forming space perception and orientation. Interaction with space is realized through sensory, motor, vegetative and limbic projections. So, vestibular disturbances may manifest as paropsia, tinnitus, numbness. Vestibular evoked potentials (not VEMP) and craniocorpography have highest sensitivity (90% and more). As vestibular dysfunction has recurrent character patients need monitoring.

  15. Vestibular activation, smooth pursuit tracking, and psychosis.

    Science.gov (United States)

    Jones, A M; Pivik, R T

    1985-04-01

    Pursuit tracking and vestibular activation procedures were combined in an investigation to determine if smooth pursuit tracking deficits could be related to abnormalities of visual-vestibular interaction in psychiatric patients. In actively psychotic patients, but not in comparison groups of schizophrenic outpatients with remitted symptomatology or normal controls, a significant failure of visual fixation to suppress caloric nystagmus was related to a higher incidence of disordered tracking during both baseline and postirrigation conditions. Other vestibular irregularities including dysrhythmia and reduced fast phase velocity were observed in these same patients. The results are supportive of a central deficit in visual-vestibular interaction that may contribute to pursuit tracking deficits in psychosis.

  16. The role of the vestibular assessment.

    Science.gov (United States)

    Phillips, J S; FitzGerald, J E; Bath, A P

    2009-11-01

    To evaluate the role of vestibular assessment in the management of the dizzy patient. A retrospective review of case notes and vestibular assessment reports of 100 consecutive patients referred for vestibular assessment. Sixty of the 100 patients had an abnormal vestibular assessment. Eleven patients had benign paroxysmal positional vertigo as the sole diagnosis, of whom nine had not had a Dix-Hallpike manoeuvre performed before referral. Of patients referred for vestibular rehabilitation, 76 per cent had an abnormal electrophysiological assessment. After vestibular assessment, 35 patients were discharged with no further follow-up appointments in the ENT department. All patients should have a Dix-Hallpike manoeuvre performed prior to referral for vestibular assessment. The majority of our patients undergoing vestibular rehabilitation had abnormal test results, although a significant number did not. Prior to referral, it is worth considering the implication of a 'normal' and 'abnormal' result for the management of the patient. Careful consideration should be given to the development of dedicated dizziness clinics run by practitioners with a specialist interest in balance disorders, in order to ensure appropriate requests for vestibular assessment.

  17. Epidemiology and natural history of vestibular schwannomas

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, Per

    2012-01-01

    This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma. A treatm......This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma....... A treatment strategy based on the natural history of tumor growth and hearing also is discussed....

  18. Personality Changes in Patients with Vestibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Paul eSmith

    2013-10-01

    Full Text Available The vestibular system is a sensory system that has evolved to detect linear and angular acceleration of the head in all planes so that the brain is not predominantly reliant on visual information to determine self-motion. Since the vestibular system first evolved in invertebrate species in order to detect gravitational vertical, it is likely that the central nervous system has developed a special dependence upon vestibular input. In addition to the deficits in eye movement and postural reflexes that occur following vestibular dysfunction, there is convincing evidence that vestibular loss also causes cognitive and emotional disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and cortex play in the sense of spatial orientation. Beyond this, however, patients with vestibular disorders have been reported to experience other personality changes that suggest that vestibular sensation is implicated in the sense of self. These are depersonalisation and derealisation symptoms such as feeling ‘spaced out’, ‘body feeling strange’ and ‘not feeling in control of self’. We suggest in this review that these symptoms suggest that the vestibular system may make a unique contribution to the concept of self through the information regarding self-motion and self-location that it transmits, albeit indirectly, to areas of the brain such as the temporo-parietal junction.

  19. Seizure semiology and electroencephalography in young children with lesional temporal lobe epilepsy.

    Science.gov (United States)

    Lv, Rui-Juan; Sun, Zhen-Rong; Cui, Tao; Shao, Xiao-Qiu

    2014-02-01

    This study aimed to discuss the clinical features of seizure semiology and electroencephalography (EEG) in young children with lesional temporal lobe epilepsy (TLE). Children with lesional TLE received presurgical evaluation for intractable epilepsy. They were followed up for more than one year after temporal lobectomy. We reviewed the medical history and video-EEG monitoring of children with TLE to analyze the semiology of seizures and EEG findings and compared the semiology of seizures and EEG findings of childhood TLE and adult TLE. A total of 84 seizures were analyzed in 11 children (aged 23-108 months). The age of seizure onset was from 1 month to 26 months (a mean of 17.6 months). All of the patients exhibited prominent motor manifestations including epileptic spasm, tonic seizure, and unilateral clonic seizure. Seven children manifested behavioral arrest similar to an automotor seizure in adult TLE but with a shorter duration and higher frequency. The automatisms were typically orofacial, whereas manual automatisms were rarely observed. The EEG recordings revealed that diffuse discharge patterns were more common in younger children, whereas focal or unilateral patterns were more typical in older children. All of the patients were seizure-free after temporal lobectomy with more than one-year follow-up. All of the children had a mental development delay or regression; however, there was improvement after surgery, especially in those with surgery performed early. In contrast to TLE in adults, young children with lesional TLE probably represent a distinct nosological and probably less homogeneous syndrome. Although they had generalized clinical and electrographic features, resective epilepsy surgery should be considered as early as possible to obtain seizure control and improvement in mental development. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  20. [THE PROPAGATION AND SEMIOLOGY OF FOCAL EPILEPTIC SEIZURES. CASES CONNECTED TO THE INSULA. THEORETICAL CONSIDERATIONS].

    Science.gov (United States)

    Balogh, Attila; Balogh, Attila

    2016-01-30

    The developing of diagnostical examinations in epileptology provides new challenges in seizure semiology. On the analysis of seizures it is important to examine the mechanisms of their propagation. The brain connectivity (based on the neuroimaging), the shadowing of the movement of excessive neuronal activity (based on computerized EEG and MEG methods), the cognition of the physiological and pathological brain networks are the footstone of the epileptic seizure propagation. The investigators prove, by means of case demonstrations of the role of the network nodes and the role of the epileptic hubs in the seizure symptomatology. The preoperative, intra and postoperative data are analised of three insular and one parietal epileptic patients in point of view of their seizure symptomes. Complex neuroimaging, noninvasive and invasive electrophysiology, intensive long-term video-EEG monitoring, computerized EEG analysis, fuctional mapping, intraoperative corticography were used. The etiology were confirmed with hystology. It is observed that on seizure semiology our patients plays the insula a double role. In some cases, it is the focus of insular seizures with their symptoms difficult to identify. However, in the majority of cases and as a consequence of its rich neural connections, the insula has a peculiar property in the evolution of the symptomatogenic features of seizures. This observations are developing new relationships between the mechanism of seizure propagation and its semiological consequences. On epileptological point of view there are brain structures which has peculiar role in the "designe" of propagation of the epileptic excitement. The numerous new methods in neuroimaging and neurophysiology allowed the connectomical examination of the epileptic networks. The role of the epileptic diathesis is approachable with the metholdology of the brain connectivity. Theoretically the node of the epileptic network consist of the potential pathes where the localised

  1. Seizure semiology in autosomal dominant epilepsy with auditory features, due to novel LGI1 mutations.

    Science.gov (United States)

    Sadleir, Lynette G; Agher, Dahbia; Chabrol, Elodie; Elkouby, Léa; Leguern, Eric; Paterson, Sarah J; Harty, Rosie; Bellows, Susannah T; Berkovic, Samuel F; Scheffer, Ingrid E; Baulac, Stéphanie

    2013-12-01

    Mutations in LGI1 are found in 50% of families with autosomal dominant epilepsy with auditory features (ADEAF). In ADEAF, family members have predominantly lateral temporal lobe seizures but mesial temporal lobe semiology may also occur. We report here three families with novel LGI1 mutations (p.Ile82Thr, p.Glu225*, c.432-2_436del). Seven affected individuals reported an auditory aura and one a visual aura. A 10-year old boy described a cephalic aura followed by an unpleasant taste and oral automatisms without auditory, visual or psychic features. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Changing perspective: The role of vestibular signals.

    Science.gov (United States)

    Deroualle, Diane; Borel, Liliane; Devèze, Arnaud; Lopez, Christophe

    2015-12-01

    Social interactions depend on mechanisms such as the ability to take another person's viewpoint, i.e. visuo-spatial perspective taking. However, little is known about the sensorimotor mechanisms underpinning perspective taking. Because vestibular signals play roles in mental rotation and spatial cognition tasks and because damage to the vestibular cortex can disturb egocentric perspective, vestibular signals stand as important candidates for the sensorimotor foundations of perspective taking. Yet, no study merged natural full-body vestibular stimulations and explicit visuo-spatial perspective taking tasks in virtual environments. In Experiment 1, we combined natural vestibular stimulation on a rotatory chair with virtual reality to test how vestibular signals are processed to simulate the viewpoint of a distant avatar. While they were rotated, participants tossed a ball to a virtual character from the viewpoint of a distant avatar. Our results showed that vestibular signals influence perspective taking in a direction-specific way: participants were faster when their physical body rotated in the same direction as the mental rotation needed to take the avatar's viewpoint. In Experiment 2, participants realized 3D object mental rotations, which did not involve perspective taking, during the same whole-body vestibular stimulation. Our results demonstrated that vestibular stimulation did not affect 3D object mental rotations. Altogether, these data indicate that vestibular signals have a direction-specific influence on visuo-spatial perspective taking (self-centered mental imagery), but not a general effect on mental imagery. Findings from this study suggest that vestibular signals contribute to one of the most crucial mechanisms of social cognition: understanding others' actions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. [Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction].

    Science.gov (United States)

    Lee, Hyun Jung; Choi-Kwon, Smi

    2016-10-01

    In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise selfefficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p=.018) exercise self-efficacy (pVR (pVR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

  4. [Vestibular influences on human locomotion: results obtained using galvanic vestibular stimulation].

    Science.gov (United States)

    Stolbkov, Iu K; Gerasimenko, Iu P

    2014-06-01

    Locomotion is the most important mode of our movement in space. The role of the vestibular system during human locomotion is not well studied, mainly due to problems associated with its isolation stimulation. It is difficult to stimulate this system in isolation during locomotion because the real movement of the head to activate the vestibular end-organs inevitably leads to the activation of other sensory inputs. Galvanic stimulation is not a natural way to stimulate the vestibular system, but it has the advantage providing an isolated stimulation of the vestibular inputs. This technique is relatively novel in the examination of vestibular contributions during human locomotion. In our review we consider the current data regarding the effect of vestibular signals on human locomotion by using galvanic vestibular stimulation.

  5. Reviewing the Role of the Efferent Vestibular System in Motor and Vestibular Circuits

    Directory of Open Access Journals (Sweden)

    Miranda A. Mathews

    2017-08-01

    Full Text Available Efferent circuits within the nervous system carry nerve impulses from the central nervous system to sensory end organs. Vestibular efferents originate in the brainstem and terminate on hair cells and primary afferent fibers in the semicircular canals and otolith organs within the inner ear. The function of this efferent vestibular system (EVS in vestibular and motor coordination though, has proven difficult to determine, and remains under debate. We consider current literature that implicate corollary discharge from the spinal cord through the efferent vestibular nucleus (EVN, and hint at a potential role in overall vestibular plasticity and compensation. Hypotheses range from differentiating between passive and active movements at the level of vestibular afferents, to EVS activation under specific behavioral and environmental contexts such as arousal, predation, and locomotion. In this review, we summarize current knowledge of EVS circuitry, its effects on vestibular hair cell and primary afferent activity, and discuss its potential functional roles.

  6. Reviewing the Role of the Efferent Vestibular System in Motor and Vestibular Circuits.

    Science.gov (United States)

    Mathews, Miranda A; Camp, Aaron J; Murray, Andrew J

    2017-01-01

    Efferent circuits within the nervous system carry nerve impulses from the central nervous system to sensory end organs. Vestibular efferents originate in the brainstem and terminate on hair cells and primary afferent fibers in the semicircular canals and otolith organs within the inner ear. The function of this efferent vestibular system (EVS) in vestibular and motor coordination though, has proven difficult to determine, and remains under debate. We consider current literature that implicate corollary discharge from the spinal cord through the efferent vestibular nucleus (EVN), and hint at a potential role in overall vestibular plasticity and compensation. Hypotheses range from differentiating between passive and active movements at the level of vestibular afferents, to EVS activation under specific behavioral and environmental contexts such as arousal, predation, and locomotion. In this review, we summarize current knowledge of EVS circuitry, its effects on vestibular hair cell and primary afferent activity, and discuss its potential functional roles.

  7. Vestibular Function and Activities of Daily Living

    Directory of Open Access Journals (Sweden)

    Aisha Harun MD

    2015-09-01

    Full Text Available Objective: Vestibular dysfunction increases with age and is associated with mobility difficulties and fall risk in older individuals. We evaluated whether vestibular function influences the ability to perform activities of daily living (ADLs. Method: We analyzed the 1999 to 2004 National Health and Nutrition Examination Survey of adults aged older than 40 years ( N = 5,017. Vestibular function was assessed with the Modified Romberg test. We evaluated the association between vestibular function and difficulty level in performing specific basic and instrumental ADLs, and total number of ADL impairments. Results: Vestibular dysfunction was associated with significantly higher odds of difficulty with nine ADLs, most strongly with difficulty managing finances (odds ratio [ OR ] = 2.64, 95% confidence interval [CI] = [1.18, 5.90]. In addition, vestibular dysfunction was associated with a significantly greater number of ADL impairments (β = .21, 95% CI = [0.09, 0.33]. This effect size was comparable with the influence of heavy smoking (β = .21, 95% CI = [0.06, 0.36] and hypertension (β = .10, 95% CI = [0.02, 0.18] on the number of ADL impairments. Conclusion: Vestibular dysfunction significantly influences ADL difficulty, most strongly with a cognitive rather than mobility-based task. These findings underscore the importance of vestibular inputs for both cognitive and physical daily activities.

  8. Motor development after vestibular deprivation in rats

    NARCIS (Netherlands)

    Geisler, HC; Gramsbergen, A

    This review summarizes the postural development in the rat and the influences of vestibular deprivation from the 5th postnatal day on this development. Vestibular deprivation leads to a delay in motor development. Most probably this delay is caused by a delay in the development of postural control,

  9. Semiology of temporal lobe seizures: value in lateralizing the seizure focus.

    Science.gov (United States)

    Marks, W J; Laxer, K D

    1998-07-01

    To determine the lateralizing value of the clinical manifestations of seizures in patients with temporal lobe epilepsy (TLE), we made a retrospective videotape analysis of complex partial seizures (CPS) in 55 patients who underwent temporal lobectomy and were seizure-free postoperatively for >2 years. Blinded to clinical details, we reviewed videotapes from video-EEG telemetry monitoring with attention paid to seizure semiology. Useful lateralizing features included unilateral clonic activity (with the seizure focus contralateral in all patients), unilateral dystonic or tonic posturing (with the seizure focus contralateral in 90 and 86%, respectively), unilateral automatisms (with the seizure focus ipsilateral in 80%), and ictal speech preservation (with the seizure focus contralateral to the language-dominant hemisphere in 80%). Versive head rotation occurring head movements occurring at times other than immediately before seizures secondarily generalized. In TLE, several clinical seizure manifestations are useful in lateralizing the seizure focus, although some provide no reliable information. Therefore, ictal semiology can assist in the evaluation of patients for seizure surgery, providing additional information in the lateralization of TLE.

  10. New onset seizures in HIV--seizure semiology, CD4 counts, and viral loads.

    Science.gov (United States)

    Modi, Mala; Mochan, Andre; Modi, Girish

    2009-05-01

    Thirty-seven HIV-positive patients with new-onset seizures (NOS) were prospectively identified during a 1-year study period. The patients were categorized according to the different mechanisms causing NOS in HIV, namely focal brain lesion (FBL) in 21 patients (57%), meningitis in 6 patients (16%), metabolic derangement (no patient), and no identified cause (NIC) other than HIV itself (10 patients, 27%). Seizure semiology, CD4 counts, and blood and cerebral spinal fluid (CSF) viral loads were studied to identify any special characteristics of the different categories. With respect to seizure semiology, all NIC patients had generalized seizures. Two-thirds of the meningitis patients had generalized seizures with one-third having focal seizures. Half of the patients with FBL had generalized seizures and one-third had focal seizures. Status epilepticus was strongly associated with FBL. No significant difference could be detected between the subgroups with respect to CD4 counts and serum and CSF viral loads. The median CD4 count in all patients was 108 cells/ml, indicating advanced immunosuppression. In the FBL group this was 104 cells/ml. In the meningitis group the median CD4 count was 298 cells/ml, and in the NIC group this was 213 cells/ml. Similarly, no differences were noted in the NOS categories with respect to serum and CSF viral loads. Seizures in HIV are a nonspecific manifestation of the seizure mechanism.

  11. Refractory chronic epilepsy associated with neuronal auto-antibodies: could perisylvian semiology be a clue?

    Science.gov (United States)

    Gillinder, Lisa; Tjoa, Linda; Mantzioris, Basil; Blum, Stefan; Dionisio, Sasha

    2017-12-20

    We report a case series of 10 patients with chronic medically refractory antibody-positive autoimmune epilepsy and assess their common clinical features. Immune-mediated seizures are most commonly reported in the context of encephalitis or encephalopathy, with few reports focusing on lone, chronic epilepsy in the outpatient setting. Our aim was to define the potential diagnostic clues that might be present in these cases, leading to consideration of an autoimmune cause of the epilepsy. We performed a retrospective review of all patients presenting to the outpatient department of our unit who underwent autoimmune screening. All patients with chronic epilepsy and a positive result for an antibody known to be associated with epilepsy were included. Sixty-three patients underwent testing. Thirteen returned a positive result, however, only 10 of these were patients which chronic epilepsy who did not present with an acute illness. Common features in these cases included: perisylvian semiology, EEG abnormalities in the mid temporal region, normal or non-specific MRI findings, depression, and head injury. In cases of medically refractory, lesion-negative epilepsy, with predominantly perisylvian semiology, clinicians should have a high level of suspicion for the diagnosis of autoimmune aetiologies and a low threshold to perform autoantibody screening. This is especially true if there are atypical electrographic findings, a previous history of head injury, or co-morbid depression.

  12. Seizure semiology in males with psychogenic nonepileptic seizures is associated with somatic complaints.

    Science.gov (United States)

    Gale, Shawn D; Hill, Stacy W; Pearson, Caleb

    2015-09-01

    Psychopathology has been studied in patients with epileptic or psychogenic non-epileptic seizures in the context of diagnosis and treatment. Unfortunately, most PNES studies include few males and do not consider possible gender differences, making findings less generalizable to males with PNES. In this study we specifically compare males with PNES to females with PNES and to males with epilepsy. Males with PNES (n=58), males with epilepsy (n=86), females with PNES (n=147), and females with ES (n=142) were evaluated on an inpatient epilepsy monitoring unit. Self-reported objective measures of psychopathology, demographics, and PNES seizure semiology were compared. Personality Assessment Inventory profiles revealed marked differences, particularly in somatic symptoms, between PNES and epilepsy. Females with PNES had higher levels of physiological depressive symptoms but lower antisocial features. Males with PNES who had clinically significant elevations on the somatic complaints scale were much more likely to have motor seizures while females with PNES classified similarly were equally likely to have either motor or non-motor events. Gender difference in PNES seizure semiology was associated with whether or not clinically significant somatic symptoms were present; males with elevated somatic symptoms were much more likely to have motor PNES. However, we did not find evidence of greater psychopathology in males with PNES compared to females with PNES. Gender differences in the behavioral manifestation of PNES in the context of presence or absence of somatization may have implications for diagnosis and treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. [A proposal for intervention in dysorthographic disorders by attending to the semiology of the mistakes].

    Science.gov (United States)

    Cervera-Mérida, J F; Ygual-Fernández, A

    2006-02-13

    A careful analysis of the mistakes made by children with learning disabilities in writing reveals a number of qualitatively distinct errors, each of which is directly related to one of the fundamental processes underlying the ability to spell correctly, that is to say, perceptive-linguistic, metalinguistic, operative memory and long-term memory processes, among others. The objective of this study is to describe our proposal for a methodology for treating children with orthography learning difficulties that takes these processes into account. A thorough analysis of the orthographic mistakes and their semiological classification is taken as our starting point, and we then put forward a sequence of instruction for each kind of error that tackles the deficient psycholinguistic processes, offsets the weaker points of the processing with the stronger points, and aims to get the child to learn a large number of words, thus favouring the metacognitive and self-regulatory processes applied to writing. Teaching pupils with dyslexic and dysorthographic problems to spell and write correctly entails important methodological difficulties. In our clinical practice we have attempted to develop teaching processes that fit the semiological characteristics of the spelling errors by trying to modify both the pupil's actual academic performance and the psycholinguistic processes that underlie such errors.

  14. Vestibular Function and Depersonalization/Derealization Symptoms.

    Science.gov (United States)

    Jáuregui Renaud, Kathrine

    2015-01-01

    Patients with an acquired sensory dysfunction may experience symptoms of detachment from self or from the environment, which are related primarily to nonspecific symptoms of common mental disorders and secondarily, to the specific sensory dysfunction. This is consistent with the proposal that sensory dysfunction could provoke distress and a discrepancy between the multi-sensory frame given by experience and the actual perception. Both vestibular stimuli and vestibular dysfunction can underlie unreal experiences. Vestibular afferents provide a frame of reference (linear and angular head acceleration) within which spatial information from other senses is interpreted. This paper reviews evidence that symptoms of depersonalization/derealization associated with vestibular dysfunction are a consequence of a sensory mismatch between disordered vestibular input and other sensory signals of orientation.

  15. [Vestibular rehabilitation in elderly patients with dizziness].

    Science.gov (United States)

    Zanardini, Francisco Halilla; Zeigelboim, Bianca Simone; Jurkiewicz, Ari Leon; Marques, Jair Mendes; Martins-Bassetto, Jackeline

    2007-01-01

    The aging of the population is a natural process and is manifested by a decline in the functions of several organs. Vestibular rehabilitation (VR) is a therapeutic process that seeks to promote a significant reduction in the symptoms of the labyrinth. To verify the benefits of VR exercises through the application of the Dizziness Handicap Inventory (DHI) questionnaire--Brazilian version--pre and post rehabilitation. Participants of this study were eight elderly patients with dizziness, ages between 63 and 82 years, three male and five female. The following procedures were carried out: medical history, otologic inspection, vestibular evaluation with vectoelectronystagmography (VENG), application of the DHI questionnaire and of the Cawthorne (1944) and Cooksey (1946) VR exercises. Regarding the auditory and vestibular complaints which were referred to in the medical history, the following was observed: presence of tinnitus, hearing loss, postural vertigo and of unbalance. In the evaluation of the vestibular function alterations were observed for all of the participants, mainly in the caloric test, with a prevalence of unilateral and bilateral hypofunction. In the vestibular exam the following was observed: three cases of unilateral peripheral vestibular deficit syndrome, three cases of bilateral peripheral vestibular deficit syndrome, one case of bilateral central vestibular deficit syndrome and one case of irritating bilateral central vestibular syndrome. There was a statistically significant improvement of the following aspects after VR: physical (p=0.00413), functional (p=0.00006) and emotional (p=0.03268). The VR protocol favored the improvement of life quality of the participants and was of assistance in the process of vestibular compensation.

  16. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study,

    Directory of Open Access Journals (Sweden)

    Cibele Brugnera

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR. OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm biofeedback equipment as a sensory substitution (SS of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG, which received the vibrotactile stimulus from Vertiguard(tm for ten days, and a control group (CG, which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT protocol of the Computerized Dynamic Posturography (CDP and two scales of balance self-perception, Activities-specific Balance Confidence (ABC and Dizziness Handicap Inventory (DHI, were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007 and C6 (p = 0.01. On the ABC scale, there was a significant difference in the SG (p= 0.04. The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04. CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

  17. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study.

    Science.gov (United States)

    Brugnera, Cibele; Bittar, Roseli Saraiva Moreira; Greters, Mário Edvin; Basta, Dietmar

    2015-01-01

    Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04). The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  18. Galvanic vestibular stimulation improves the results of vestibular rehabilitation.

    Science.gov (United States)

    Carmona, Sergio; Ferrero, Antonela; Pianetti, Guillermina; Escolá, Natalia; Arteaga, María Victoria; Frankel, Lilian

    2011-09-01

    Here, we present findings from a three-step investigation of the effect of galvanic vestibular stimulation (GVS) in normal subjects and in subjects undergoing vestibular rehabilitation (VR). In an initial study, we examined the body sway of 10 normal subjects after one minute of 2 mA GVS. The effect of the stimulation lasted for at least 20 minutes in all subjects and up to two hours in 70% of the subjects. We then compared a group of patients who received conventional VR (40 patients) with a group that received a combination of VR and GVS. Results suggest a significant improvement in the second group. Finally, we attempted to establish the optimal number of GVS sessions and to rule out a placebo effect. Fifteen patients received "systematic" GVS: five sessions, once a week. Five patients received "nonsystematic" galvanic stimulation in a sham protocol, which included two stimulations of the clavicle. These data were analyzed with Fisher's exact test and indicated that the best results were obtained after three sessions of GVS and no placebo effect was observed. © 2011 New York Academy of Sciences.

  19. Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition.

    Science.gov (United States)

    Varley, James; Wehner, Tim; Sisodiya, Sanjay

    2015-12-01

    In this report, we describe a female patient with trisomy 4p, a rare genetic condition, with unusual seizure semiology. The patient is one of the oldest reported survivors with this condition. This semiology was noted while she was being monitored by inpatient video telemetry. We observed a series of myoclonic shoulder jerks, followed by hiccup-like episodes, and finally an atonic head drop. Corresponding ictal EEG showed semi-rhythmic high-amplitude slow waves with spikes superimposed over the frontotemporal areas. This semiology was confirmed as habitual by her parents. Subsequent hiccup-like episodes had no EEG correlate, and the head drop was again associated with semi-rhythmic high-amplitude slow waves and superimposed spikes, more prominent over the right hemisphere. In addition, we review the several cases in which hiccups have been associated with seizures and how this may relate to the neural pathways involved in the pathophysiology of hiccups. We believe the ictal hiccup-like episodes followed by atonia to be a seizure semiology that has not previously been documented. [Published with video sequence].

  20. Genetic disorders of the vestibular system.

    Science.gov (United States)

    Eppsteiner, Robert W; Smith, Richard J H

    2011-10-01

    This review highlights the current body of literature related to the genetics of inherited vestibular disorders and provides a framework for the characterization of these disorders. We emphasize peripheral causes of vestibular dysfunction and highlight recent advances in the field, point out gaps in understanding, and focus on key areas for future investigation. The discovery of a modifier gene that leads to a more severe Usher syndrome phenotype calls into question the assumption that Usher syndrome is universally a monogenic disorder. Despite the use of several investigational approaches, the genetic basis of Menière's disease remains poorly understood. Evidence for a vestibular phenotype associated with DFNB1 suggests that mutations in other genes causally related to nonsyndromic hearing loss also may have an unrecognized vestibular phenotype. Our understanding of the genetic basis for vestibular disorders is superficial. Significant challenges include defining the genetics of inherited isolated vestibular dysfunction and understanding the pathological basis of Menière's disease. However, improved characterization of inherited vestibular dysfunction, coupled with advanced genetic techniques such as targeted genome capture and massively parallel sequencing, provides an opportunity to investigate these diseases at the genetic level.

  1. Anatomy of the vestibular system: a review.

    Science.gov (United States)

    Khan, Sarah; Chang, Richard

    2013-01-01

    A sense of proper sensory processing of head motion and the coordination of visual and postural movements to maintain equilibrium is critical to everyday function. The vestibular system is an intricate organization that involves multiple levels of sensory processing to achieve this goal. This chapter provides an overview of the anatomical structures and pathways of the vestibular system. The five major vestibular structures are located in the inner ear and include: the utricle, the saccule, and the lateral, superior, and posterior semicircular canals. Hair cells on the neuroepithelium of the peripheral vestibular organs carry sensory impulses to primary processing centers in the brainstem and the cerebellum. These areas send input via ascending and descending projections to coordinate vital reflexes, such as the vestibuloocular reflex and the vestibulospinal reflex, which allow for the proper orientation of the eyes and body in response to head motion. Specific connections regarding higher level cortical vestibular structures are poorly understood. Vestibular centers in the brainstem, cerebellum, and cerebral cortex function to integrate sensory information from the peripheral vestibular organs, visual system, and proprioceptive system to allow for proper balance and orientation of the body in its environment.

  2. Embryological development and large vestibular aqueduct syndrome.

    Science.gov (United States)

    Pyle, G M

    2000-11-01

    Large vestibular aqueduct syndrome (LVAS) is a significant cause of hearing loss in early childhood. Many theories on the origins and causes of LVAS have been proposed, including arrest or maldevelopment of the vestibular labyrinth in embryonic life. Prior studies have described postnatal and adult vestibular aqueduct anatomy, but none has analyzed aqueduct growth throughout embryonic life. This study was undertaken to characterize the growth of the developing vestibular aqueduct to gain a better understanding of the possible origins of LVAS. Basic science, temporal bone histopathological study. Serial sections from 48 temporal bones from human embryos ranging in age from 5 weeks' gestation to full term were studied with computer image analysis. Measurements of vestibular aqueduct internal and external aperture, midportion diameter, and length were analyzed to obtain a growth model of development. The vestibular aqueduct grows in a nonlinear fashion throughout embryonic life. All parameters fit a similar growth curve and never reached a maximum or began narrowing during development. Growth in one parameter correlated well with growth of another. There was good side-to-side correlation with all but the external aperture. Most of the membranous labyrinth reaches adult size by 20 weeks' gestation, but the vestibular aqueduct grows throughout embryonic life. The measurements and growth model obtained in this study are not consistent with the theory that LVAS results from an arrest in development early in fetal life. The data suggest that LVAS may result from postnatal and early childhood maldevelopment.

  3. Neuropharmacological basis of vestibular system disorder treatment.

    Science.gov (United States)

    Soto, Enrique; Vega, Rosario; Seseña, Emmanuel

    2013-01-01

    This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Clinicians are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in our knowledge of the fundamental mechanisms of vestibular system function and of drug action. In this work, drugs acting on vestibular system have been grouped into two main categories according to their primary mechanisms of action: those with effects on neurotransmitters and neuromodulators dynamics and those that act on voltage-gated ion channels. Particular attention is given in this review to drugs that may provide additional insight into the pathophysiology of vestibular diseases. The critical analysis of the literature reveals that there is a significant lack of information defining the real utility of diverse drugs used in clinical practice. The development of basic studies addressing drug actions at the molecular, cellular and systems level, combined with reliable and well controlled clinical trials, would provide the scientific basis for new strategies for the treatment of vestibular disorders.

  4. Progress toward development of a multichannel vestibular prosthesis for treatment of bilateral vestibular deficiency.

    Science.gov (United States)

    Fridman, Gene Y; Della Santina, Charles C

    2012-11-01

    This article reviews vestibular pathology and the requirements and progress made in the design and construction of a vestibular prosthesis. Bilateral loss of vestibular sensation is disabling. When vestibular hair cells are injured by ototoxic medications or other insults to the labyrinth, the resulting loss of sensory input disrupts vestibulo-ocular reflexes (VORs) and vestibulo-spinal reflexes that normally stabilize the eyes and body. Affected individuals suffer poor vision during head movement, postural instability, chronic disequilibrium, and cognitive distraction. Although most individuals with residual sensation compensate for their loss over time, others fail to do so and have no adequate treatment options. A vestibular prosthesis analogous to cochlear implants but designed to modulate vestibular nerve activity during head movement should improve quality of life for these chronically dizzy individuals. We describe the impact of bilateral loss of vestibular sensation, animal studies supporting feasibility of prosthetic vestibular stimulation, the current status of multichannel vestibular sensory replacement prosthesis development, and challenges to successfully realizing this approach in clinical practice. In bilaterally vestibular-deficient rodents and rhesus monkeys, the Johns Hopkins multichannel vestibular prosthesis (MVP) partially restores the three-dimensional (3D) VOR for head rotations about any axis. Attempts at prosthetic vestibular stimulation of humans have not yet included the 3D eye movement assays necessary to accurately evaluate VOR alignment, but these initial forays have revealed responses that are otherwise comparable to observations in animals. Current efforts now focus on refining electrode design and surgical technique to enhance stimulus selectivity and preserve cochlear function, optimizing stimulus protocols to improve dynamic range and reduce excitation-inhibition asymmetry, and adapting laboratory MVP prototypes into devices

  5. Reviewing the Role of the Efferent Vestibular System in Motor and Vestibular Circuits

    OpenAIRE

    Mathews, Miranda A.; Camp, Aaron J.; Murray, Andrew J.

    2017-01-01

    Efferent circuits within the nervous system carry nerve impulses from the central nervous system to sensory end organs. Vestibular efferents originate in the brainstem and terminate on hair cells and primary afferent fibers in the semicircular canals and otolith organs within the inner ear. The function of this efferent vestibular system (EVS) in vestibular and motor coordination though, has proven difficult to determine, and remains under debate. We consider current literature that implicate...

  6. Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction

    OpenAIRE

    Arash Bayat; Nader Saki

    2017-01-01

    Introduction: Although vestibular rehabilitation therapy (VRT) methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH). Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH. Materials and Methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. T...

  7. Potencial evocado miogênico vestibular

    OpenAIRE

    Felipe,Lilian; Kingma, Herman; Gonçalves, Denise Utsch

    2012-01-01

    INTRODUÇÃO: O Potencial Evocado Miogênico Vestibular (VEMP) é um teste promissor para a avaliação do sistema vestíbulo-cólico descendente. Este reflexo depende da integridade da mácula sacular, do nervo vestibular inferior, dos núcleos vestibulares, das vias vestíbulo-espinhais e do músculo efetor. OBJETIVO: Realizar revisão sistemática de literatura pertinente por meio de bases de dados (COCHRANE, MEDLINE, LILACS, CAPES). CONCLUSÃO: A aplicação clínica do VEMP expandiu-se nos últimos anos, c...

  8. Vestibular rehabilitation in a university hospital

    OpenAIRE

    Flávia da Silva Tavares; Maria Francisca Colella dos Santos; Keila Alessandra Baraldi Knobel

    2008-01-01

    A Reabilitação Vestibular visa melhorar o equilíbrio global, a qualidade de vida e orientação espacial dos pacientes com tontura. OBJETIVOS: Traçar o perfil dos pacientes atendidos no Ambulatório de Reabilitação Vestibular do Setor de Otoneurologia de um hospital universitário e verificar os resultados obtidos no período de novembro/2000 a dezembro/2004. MATERIAL E MÉTODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos à Reabilitação Vestibular no período. FORMA DE ESTU...

  9. Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo.

    Science.gov (United States)

    Martin-Sanz, Eduardo; Rueda, Almudena; Esteban-Sanchez, Jonathan; Yanes, Joaquin; Rey-Martinez, Jorge; Sanz-Fernandez, Ricardo

    2017-08-01

    To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo. Prospective. Tertiary referral center. Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled. After treatment with oral corticosteroids, patients were followed up for 6 months. Functional recovery of the facial nerve was scored according to the House-Brackman grading system. Caloric and video head impulse tests were performed in every patient at the time of enrolment. Subsequently, successive video head impulse test (vHIT) exploration was performed at the 1, 3, and 6-month follow-up. Eighteen patients with vestibular neuritis and 13 with Ramsay Hunt syndrome and associated vertigo were included. Vestibular function was significantly worse in patients with Ramsay Hunt syndrome than in those with vestibular neuritis. Similar compensatory saccades velocity and latency values were observed in both groups, in both the caloric and initial vHIT tests. Successive vHIT results showed a significantly higher vestibulo-ocular reflex gain recovery in vestibular neuritis patients than in Ramsay Hunt syndrome patients. A significantly faster reduction in the latency, velocity, and organization of the compensatory saccades was observed in neuritis than in Ramsay Hunt syndrome patients. In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.

  10. Anti-musk positive myasthenia gravis and three semiological cardinal signs

    Directory of Open Access Journals (Sweden)

    André P.C. Matta

    2017-01-01

    Full Text Available Myasthenia gravis (MG is a relatively uncommon disorder with an annual incidence of approximately 7 to 9 new cases per million. The prevalence is about 70 to 165 per million. The prevalence of the disease has been increasing over the past five decades. This is thought to be due to better recognition of the condition, aging of the population, and the longer life span of affected patients. MG causes weakness, predominantly in bulbar, facial, and extra-ocular muscles, often fluctuating over minutes to weeks, in the absence of wasting, sensory loss, or reflex changes. The picture of fluctuating, asymmetric external ophthalmoplegia with ptosis and weak eye closure is virtually diagnostic of myasthenia. We report an atypical MG case with three semiological cardinal signs.

  11. Understanding psychogenic nonepileptic seizures-Phenomenology, semiology and the Integrative Cognitive Model.

    Science.gov (United States)

    Reuber, Markus; Brown, Richard J

    2017-01-01

    Psychogenic Nonepileptic Seizures (PNES) are one of the commonest differential diagnoses of epilepsy. This paper provides a narrative review of what has been learnt in the last 25 years regarding the visible manifestations, physiological features, subjective experiences and interactional aspects of PNES. We then explore how current insights into PNES semiology and phenomenology map onto the Integrative Cognitive Model (ICM), a new account of these phenomena that unifies previous approaches within a single explanatory framework. We discuss to what extent recent psychological and neurophysiological research is consistent with the ICM and indicate how the more detailed analysis of physiological data, connectivity analyses of EEG and functional or structural MRI data may provide greater insights into the biopsychosocial underpinnings of a disabling and under-researched disorder. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Automated EEG detection algorithms and clinical semiology in epilepsy: importance of correlations.

    Science.gov (United States)

    Hogan, R Edward

    2011-12-01

    With advances in technological innovation, electroencephalography has remained the gold standard for classification and localization of epileptic seizures. Like other diagnostic modalities, technological advances have opened new avenues for assessment of data, and hold great promise to improve interpretive capabilities. However, proper overall interpretation and application of electroencephalographic findings relies on valid correlations of associated clinical semiology. This article addresses interpretation of clinical signs and symptoms in the context of the diagnostic predictive value of electroencephalographic, clinical, and electrographic definitions of seizures, and upcoming challenges of interpreting intracranial high-frequency electroencephalographic data. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Semiology of psychogenic nonepileptic seizures: An international cross-cultural study.

    Science.gov (United States)

    Asadi-Pooya, Ali A; Valente, Kette; Alessi, Ruda; Tinker, Jennifer

    2017-10-01

    We compared the semiology of psychogenic nonepileptic seizures (PNES) between patients from the USA and Brazil. This international cross-cultural comparative study may expand understanding of PNES across the borders. We retrospectively investigated all patients with PNES admitted to one epilepsy center in the USA and one in Brazil. We classified their seizures into four classes: generalized motor, akinetic, focal motor, and subjective symptoms. All patients were interviewed by an epileptologist in both countries and were administered psychological assessment measures, including questions about PNES risk factors. For the statistical analyses, we compared patients from the two nations. Eighty-nine patients (49 from the USA and 40 from Brazil) were studied. Patients from the two countries were not significantly different with regard to sex and age, but patients from Brazil had earlier age at onset (26years vs. 34years; P=0.004) and a significantly greater delay in diagnosis (9.9years vs. 5.6years; P=0.001). Some characteristics of PNES were different between the two groups; patients from the USA had generally more seizure types and more often reported subjective seizures (55% in the USA vs. 10% in Brazil; P=0.0001). Clinical and historical characteristics of the patients were not significantly different. Delay in diagnosis of PNES may represent a major factor in resource-limited countries. Large multicenter cross-cultural studies may reveal subtle but significant cross-cultural differences with respect to the semiological, clinical, and historical aspects of PNES; however, patients with PNES share more similarities than differences. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Altered fMRI connectivity dynamics in temporal lobe epilepsy might explain seizure semiology

    Directory of Open Access Journals (Sweden)

    Helmut eLaufs

    2014-09-01

    Full Text Available Abstract: Temporal lobe epilepsy (TLE can be conceptualized as a network disease. The network can be characterized by inter-regional functional connectivity, i.e. blood oxygen level-dependent (BOLD signal correlations between any two region pairs. However, functional connectivity is not constant over time, thus computing correlation at a given time and then at some later time could give different results (non-stationarity. We hypothesized (1 that non-stationarities can be induced by epilepsy (e.g. interictal epileptic activity increasing local signal variance and that (2 these transient events contribute to fluctuations in connectivity leading to pathological functioning, i.e. TLE semiology. We analyzed fMRI data from 27 patients with TLE and 22 healthy controls focusing on EEG-confirmed wake epochs only to protect against sleep-induced connectivity changes. Testing hypothesis (1, we identified brain regions where the BOLD signal variance was significantly greater in TLE than in controls: the temporal pole - including the hippocampus. Taking the latter as the seed region and testing hypothesis (2 we calculated the time-varying interregional correlation values (dynamic functional connectivity to other brain regions and found greater connectivity variance in the TLE than the control group mainly in the precuneus, the supplementary and sensori-motor and the frontal cortices.We conclude that the highest BOLD signal variance in the hippocampi is highly suggestive of a specific epilepsy-related effect. The altered connectivity dynamics in TLE patients might help to explain the hallmark semiological features of dyscognitive seizures including impaired consciousness (precuneus, frontal cortex, sensory disturbance and motor automatisms (sensorimotor cortices, supplementary motor cortex. Accounting for the non-stationarity and state-dependence of functional connectivity are a prerequisite in the search for potential connectivity-derived biomarkers in TLE.

  15. Altered FMRI connectivity dynamics in temporal lobe epilepsy might explain seizure semiology.

    Science.gov (United States)

    Laufs, Helmut; Rodionov, Roman; Thornton, Rachel; Duncan, John Sydney; Lemieux, Louis; Tagliazucchi, Enzo

    2014-01-01

    Temporal lobe epilepsy (TLE) can be conceptualized as a network disease. The network can be characterized by inter-regional functional connectivity, i.e., blood oxygen level-dependent (BOLD) signal correlations between any two regions. However, functional connectivity is not constant over time, thus computing correlation at a given time and then at some later time could give different results (non-stationarity). We hypothesized (1) that non-stationarities can be induced by epilepsy (e.g., interictal epileptic activity) increasing local signal variance and that (2) these transient events contribute to fluctuations in connectivity leading to pathological functioning, i.e., TLE semiology. We analyzed fMRI data from 27 patients with TLE and 22 healthy controls focusing on EEG-confirmed wake epochs only to protect against sleep-induced connectivity changes. Testing hypothesis (1), we identified brain regions where the BOLD signal variance was significantly greater in TLE than in controls: the temporal pole - including the hippocampus. Taking the latter as the seed region and testing hypothesis (2), we calculated the time-varying inter-regional correlation values (dynamic functional connectivity) to other brain regions and found greater connectivity variance in the TLE than the control group mainly in the precuneus, the supplementary and sensorimotor, and the frontal cortices. We conclude that the highest BOLD signal variance in the hippocampi is highly suggestive of a specific epilepsy-related effect. The altered connectivity dynamics in TLE patients might help to explain the hallmark semiological features of dyscognitive seizures including impaired consciousness (precuneus, frontal cortex), sensory disturbance, and motor automatisms (sensorimotor cortices, supplementary motor cortex). Accounting for the non-stationarity and state-dependence of functional connectivity are a prerequisite in the search for potential connectivity-derived biomarkers in TLE.

  16. Molecular aging of the mammalian vestibular system.

    Science.gov (United States)

    Brosel, Sonja; Laub, Christoph; Averdam, Anne; Bender, Andreas; Elstner, Matthias

    2016-03-01

    Dizziness and imbalance frequently affect the elderly and contribute to falls and frailty. In many geriatric patients, clinical testing uncovers a dysfunction of the vestibular system, but no specific etiology can be identified. Neuropathological studies have demonstrated age-related degeneration of peripheral and central vestibular neurons, but the molecular mechanisms are poorly understood. In contrast, recent studies into age-related hearing loss strongly implicate mitochondrial dysfunction, oxidative stress and apoptotic cell death of cochlear hair cells. While some data suggest that analogous biological pathomechanisms may underlie vestibular dysfunction, actual proof is missing. In this review, we summarize the available data on the molecular causes of vestibular dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Idiopathic scoliosis and the vestibular system

    National Research Council Canada - National Science Library

    Hawasli, Ammar H; Hullar, Timothy E; Dorward, Ian G

    2015-01-01

    ... in the etiology of scoliosis. In this article, we discuss putative mechanisms for adolescent idiopathic scoliosis and review the current evidence supporting a role for the vestibular system in adolescent idiopathic...

  18. Recovery of vestibular ocular reflex function and balance control after a unilateral peripheral vestibular deficit.

    Directory of Open Access Journals (Sweden)

    John eAllum

    2012-05-01

    Full Text Available This review describes the effect of unilateral peripheral vestibular deficit (UPVD on balance control as observed in stance and gait tests. Normally, a UPVD is defined based on vestibular ocular reflex (VOR function. Therefore, we compare recovery observed in balance control over time with similar patterns of recovery or lack thereof in VOR function. Three types of UPVD are considered; acute vestibular neuritis, vestibular loss prior to and after cerebellar pontine angle tumor (CPAT surgery during which a vestibular neurectomy was performed, and vestibular loss following neurectomy to eliminate disabling Ménière’s disease.To measure balance control, body-worn gyroscopes, mounted near the body’s centre of mass, were used for stance and gait tests. Measurement variables were the pitch (anterior-posterior and roll (lateral sway angles and angular velocities of the lower trunk-pelvis. All three groups showed balance deficits during stance tasks on foam, especially with eyes closed when stable control is highly dependent on vestibular inputs. Deficits in balance control during gait were present but were more profound for complex gait tasks such as tandem gait. Differences emerged between the groups concerning the severity of the deficit and its recovery. Generally, the effects of acute neuritis were more severe but recovered rapidly, deficits due to vestibular neurectomy were less severe but longer lasting. These results paralleled deficits in VOR function and raise questions about two modes of neural plasticity occurring in the vestibular system following vestibular loss: one mode being the limited central compensation for the loss, and the second mode being some restoration of peripheral vestibular function. Future work will need to correlate deficits in balance control during stance and gait more exactly with VOR deficits and carefully consider the differences between insufficient central compensation compared to inadequate peripheral

  19. BASIC CONCEPTS IN UNDERSTANDING RECOVERY OF FUNCTION IN VESTIBULAR REFLEX NETWORKS DURING VESTIBULAR COMPENSATION

    Directory of Open Access Journals (Sweden)

    Kenna ePeusner

    2012-02-01

    Full Text Available Unilateral peripheral vestibular lesions produce a syndrome of oculomotor and postural deficits with the symptoms at rest, the static symptoms, partially or completely normalizing shortly after the lesion due to a process known as vestibular compensation. The symptoms are thought to result from changes in the activity of vestibular sensorimotor reflexes. Since the vestibular nuclei must be intact for recovery to occur, many investigations have focused on studying these neurons after lesions. At present, the neuronal plasticity underlying early recovery from the static symptoms is not fully understood. Here we propose that knowledge of the reflex identity and input-output connections of the recorded neurons is essential to link the responses to animal behavior. We further propose that the cellular mechanisms underlying vestibular compensation can be sorted out by characterizing the synaptic responses and time course for change in morphologically-defined subsets of vestibular reflex projection neurons. Accordingly, this review focuses on the perspective gained by performing electrophysiological and immunolabeling studies on a specific subset of morphologically-defined, glutamatergic vestibular reflex projection neurons, the principal cells of the chick tangential nucleus. Reference is made to pertinent findings from other studies on vestibular nuclei neurons, but no comprehensive review of the literature is intended since broad reviews already exist. From recording excitatory and inhibitory spontaneous synaptic activity in principal cells, we find that the rebalancing of excitatory synaptic drive bilaterally is essential for vestibular compensation to proceed. This work is important for it defines for the first time the excitatory and inhibitory nature of the changing synaptic inputs and the time course for changes in a morphologically-defined subset of vestibular reflex projection neurons during early stages of vestibular compensation.

  20. Idiopathic scoliosis and the vestibular system.

    Science.gov (United States)

    Hawasli, Ammar H; Hullar, Timothy E; Dorward, Ian G

    2015-02-01

    Despite its high prevalence, the etiology underlying idiopathic scoliosis remains unclear. Although initial scrutiny has focused on genetic, biochemical, biomechanical, nutritional and congenital causes, there is growing evidence that aberrations in the vestibular system may play a role in the etiology of scoliosis. In this article, we discuss putative mechanisms for adolescent idiopathic scoliosis and review the current evidence supporting a role for the vestibular system in adolescent idiopathic scoliosis. A comprehensive search of the English literature was performed using PubMed ( http://www.ncbi.nlm.nih.gov/pubmed ). Research articles studying interactions between adolescent idiopathic scoliosis and the vestibular system were selected and evaluated for inclusion in a literature review. Eighteen manuscripts of level 3-4 clinical evidence to support an association between adolescent idiopathic scoliosis (AIS) and dysfunction of the vestibular system were identified. These studies include data from physiologic and morphologic studies in humans. Clinical data are supported by animal model studies to suggest a causative link between the vestibular system and AIS. Clinical data and a limited number of animal model studies suggest a causative role of the vestibular system in AIS, although this association has not been reproduced in all studies.

  1. Current treatment options in vestibular migraine

    Directory of Open Access Journals (Sweden)

    Mark eObermann

    2014-12-01

    Full Text Available Approximately 1% of the general population in western industrialized countries suffers from vestibular migraine. However, it remains widely unknown and often under diagnosed even despite the recently published diagnostic criteria for vestibular migraine. Treatment trials that specialize on vestibular migraine are scarce and systematic randomized controlled clinical trials are only now emerging.This review summarizes the knowledge on the currently available treatment options that were tested specifically for vestibular migraine and gives an evidence-based, informed treatment recommendation with all its limitations.To date only two randomized controlled treatment trials provide limited evidence for the use of rizatriptan and zolmitriptan for the treatment of vestibular migraine attacks because of methodological shortcommings. There is an on-going a multicenter randomized placebo-controlled trial testing metoprolol 95 mg vs. placebo (PROVEMIG-trial. Therefore, the therapeutic recommendations for the prophylactic treatment of vestibular migraine are currently widely based on the guidelines of migraine with and without aura as well as expert opinion.

  2. Nitric oxide in the rat vestibular system.

    Science.gov (United States)

    Harper, A; Blythe, W R; Zdanski, C J; Prazma, J; Pillsbury, H C

    1994-10-01

    Nitric oxide is known to function as a neurotransmitter in the central nervous system. It is also known to be involved in the central nervous system excitatory amino acid neurotransmission cascade. Activation of excitatory amino acid receptors causes an influx of calcium, which activates nitric oxide synthase. The resulting increase in intracellular nitric oxide activates soluble guanylate cyclase, leading to a rise in cyclic guanosine monophosphate. The excitatory amino acids glutamate and aspartate are found in the vestibular system and have been postulated to function as vestibular system neurotransmitters. Although nitric oxide has been investigated as a neurotransmitter in other tissues, no published studies have examined the role of nitric oxide in the vestibular system. Neuronal NADPH-diaphorase has been characterized as a nitric oxide synthase. This enzyme catalyzes the conversion of L-arginine to L-citrulline, producing nitric oxide during the reaction. We used a histochemical stain characterized by Hope et al. (Proc Natl Acad Sci 1991;88:2811) as specific for neuronal nitric oxide synthase to localize the enzyme in the rat vestibular system. An immunocytochemical stain was used to examine rat inner ear tissue for the presence of the enzyme's end product, L-citrulline, thereby demonstrating nitric oxide synthase activity. Staining of vestibular ganglion sections showed nitric oxide synthase presence and activity in ganglion cells and nerve fibers. These results indicate the presence of active nitric oxide synthase in these tissues and suggest modulation of vestibular neurotransmission by nitric oxide.

  3. Vestibular function assessment using the NIH Toolbox

    Science.gov (United States)

    Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry

    2013-01-01

    Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = −0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540

  4. Vestibular function assessment using the NIH Toolbox.

    Science.gov (United States)

    Rine, Rosemarie M; Schubert, Michael C; Whitney, Susan L; Roberts, Dale; Redfern, Mark S; Musolino, Mark C; Roche, Jennica L; Steed, Daniel P; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F; Beaumont, Jennifer; Carey, John P; Shepard, Neil P; Jacobson, Gary P; Wrisley, Diane M; Hoffman, Howard J; Furman, Gabriel; Slotkin, Jerry

    2013-03-12

    Development of an easy to administer, low-cost test of vestibular function. Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41-0.94) and sensitivity and specificity (50%-73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42-0.48) and dynamic posturography (r = -0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system.

  5. Unilateral Vestibular Loss Impairs External Space Representation

    Science.gov (United States)

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss. PMID:24523916

  6. Unilateral vestibular loss impairs external space representation.

    Directory of Open Access Journals (Sweden)

    Liliane Borel

    Full Text Available The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal and far (extrapersonal spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation, and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  7. Vestibular schwannoma: negative growth and audiovestibular features.

    Science.gov (United States)

    Stipkovits, E M; Graamans, K; Van Dijk, J E

    2001-11-01

    At the University Medical Center Utrecht, non-operative management was used for 44 patients with a unilateral vestibular schwannoma between 1990 and 1997. During that period, consecutive tumor sizes were determined by magnetic resonance imaging. Three of the 44 patients showed an average decrease in tumor size of 16.7% according to American Academy of Otolaryngology-Head and Neck Surgery standards. This study describes the initial vestibular status and audiometric changes measured over up to 10 years in these three patients. Vestibular function was determined once, by means of the bithermal caloric test, the torsion test, the saccade test, the smooth pursuit test, and the registration of spontaneous nystagmus. The three patients had severe vestibular paresis on the affected side. Pure-tone and speech audiometry were performed at regular intervals. Although the size of their tumors decreased, their hearing gradually deteriorated, just as it does in the majority of patients with a growing or stable vestibular schwannoma. The observations presented here suggest that the development of symptoms in a vestibular schwannoma does not differentiate between patients with a stable, growing or shrinking tumor. The development of symptoms may be the result of the same pathogenetic mechanism.

  8. The vestibular contribution to the head direction signal and navigation.

    Science.gov (United States)

    Yoder, Ryan M; Taube, Jeffrey S

    2014-01-01

    Spatial learning and navigation depend on neural representations of location and direction within the environment. These representations, encoded by place cells and head direction (HD) cells, respectively, are dominantly controlled by visual cues, but require input from the vestibular system. Vestibular signals play an important role in forming spatial representations in both visual and non-visual environments, but the details of this vestibular contribution are not fully understood. Here, we review the role of the vestibular system in generating various spatial signals in rodents, focusing primarily on HD cells. We also examine the vestibular system's role in navigation and the possible pathways by which vestibular information is conveyed to higher navigation centers.

  9. Top-down approach to vestibular compensation: translational lessons from vestibular rehabilitation

    Science.gov (United States)

    Balaban, Carey D.; Hoffer, Michael E.; Gottshall, Kim R.

    2012-01-01

    This review examines vestibular compensation and vestibular rehabilitation from a unified translational research perspective. Laboratory studies illustrate neurobiological principles of vestibular compensation at the molecular, cellular and systems levels in animal models that inform vestibular rehabilitation practice. However, basic research has been hampered by an emphasis on ‘naturalistic’ recovery, with time after insult and drug interventions as primary dependent variables. The vestibular rehabilitation literature, on the other hand, provides information on how the degree of compensation can be shaped by specific activity regimens. The milestones of the early spontaneous static compensation mark the re-establishment of static gaze stability, which provides a common coordinate frame for the brain to interpret residual vestibular information in the context of visual, somatosensory and visceral signals that convey gravitoinertial information. Stabilization of the head orientation and the eye orientation (suppression of spontaneous nystagmus) appear to be necessary by not sufficient conditions for successful rehabilitation, and define a baseline for initiating retraining. The lessons from vestibular rehabilitation in animal models offer the possibility of shaping the recovery trajectory to identify molecular and genetic factors that can improve vestibular compensation. PMID:22981400

  10. Clinical Evaluation of the Vestibular Nerve Using Vestibular Evoked Myogenic Potentials.

    Science.gov (United States)

    Bogle, Jamie M

    2018-01-01

    Vestibular evoked myogenic potentials are currently the most clinically accessible method to evaluate the otolith reflex pathways. These responses provide unique information regarding the status of the utriculo-ocular and sacculo-collic reflex pathways, information that has previously been unavailable. Vestibular evoked myogenic potentials are recorded from tonically contracted target muscles known to be innervated by these respective otolith organs. Diagnosticians can use vestibular evoked myogenic potentials to better evaluate the overall integrity of the inner ear and neural pathways; however, there are specific considerations for each otolith reflex protocol. In addition, specific patient populations may require protocol variations to better evaluate atypical function of the inner ear organs, vestibular nerve transmission, or subsequent reflex pathways. This is a review of the clinical application and interpretation of cervical and ocular vestibular evoked myogenic potentials.

  11. Semiology of aphasias: a critical discussion / Semiologia das afasias: uma discussão crítica

    Directory of Open Access Journals (Sweden)

    Rosana do Carmo Novaes Pinto

    2009-01-01

    Full Text Available The article discusses the semiology of aphasias, which started being developed in the 19th century by Broca and Wernicke. We do not provide an exhaustive list of symptoms and syndromes to address the theme, since we aim to critically discuss why the semiology of aphasias is still based mainly on organic perspectives in clinical practice and scientific research. We also discuss the contributions of Luria and Jakobson to a better understanding of how language is affected in aphasias and how Modern Linguistics, in special the Discursive Neurolinguistics, may enlighten the debate. We analyze some data to illustrate the theoretical and methodological assumptions of the above mentioned approaches and also discuss the excessive strength that classifications have in the clinical context.

  12. Click-evoked responses in vestibular afferents in rats

    National Research Council Canada - National Science Library

    Zhu, Hong; Tang, Xuehui; Wei, Wei; Mustain, William; Xu, Youguo; Zhou, Wu

    2011-01-01

    Sound activates not only the cochlea but also the vestibular end organs. Research on this phenomenon led to the discovery of the sound-evoked vestibular myogenic potentials recorded from the sternocleidomastoid muscles...

  13. St. Valentine--patron saint of epilepsy: illustrating the semiology of seizures over the course of six centuries.

    Science.gov (United States)

    Kluger, Gerhard; Kudernatsch, Verena

    2009-01-01

    From the 15th century to the present day, Christian art has portrayed people who suffer from epilepsy as attributes in illustrations of Saint Valentine (SV). The objective of our study was to interpret the works of art from a modern epileptological perspective on the basis of a collection of portrayals of SV in Europe that was as comprehensive as possible. The people depicted as attributes were analyzed with respect to their age, gender, social status, and possible seizure semiology. Three hundred forty-one illustrations of SV from Austria, Belgium, Croatia, Czech Republic, France, Germany, Hungary, Ireland, Italy, Luxembourg, Poland, Scotland, Slovakia, and Switzerland were systematically analyzed. Irrespective of the age of the work of art, among the 143 pictures of people with possible epilepsy characteristics, there were more males than females from various levels of society. As far as could be interpreted, there were 17 infants, 35 children, 7 adolescents, and 84 adults. With respect to possible seizure semiology, infantile spasms (n=10), atonic seizures (n=13), tonic seizures (n=53), absences (n=2), psychogenic seizures (n=4), and postictal or undefinable states (n=61) were differentiated in a subjective assessment. Despite the fact that from a modern perspective, the 15th to 20th centuries in Europe seemed to be dominated by a rather superstitious attitude toward epilepsy, there is striking accuracy in the detail of the semiology in many of the historic portrayals, and a well-founded knowledge of epilepsy is apparent.

  14. From ear to uncertainty: Vestibular contributions to cognitive function.

    OpenAIRE

    Paul eSmith; Yiwen eZheng

    2013-01-01

    In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in spatial orientation. In this review we summarize the evidence that vestibular loss causes cognitive disorders, espe...

  15. Auditory and Vestibular Issues Related to Human Spaceflight

    Science.gov (United States)

    Danielson, Richard W.; Wood, Scott J.

    2009-01-01

    Human spaceflight provides unique opportunities to study human vestibular and auditory systems. This session will discuss 1) vestibular adaptive processes reflected by pronounced perceptual and motor coordination problems during, and after, space missions; 2) vestibular diagnostic and rehabilitative techniques (used to promote recovery after living in altered gravity environments) that may be relevant to treatment of vestibular disorders on earth; and 3) unique acoustical challenges to hearing loss prevention and crew performance during spaceflight missions.

  16. Interactive Healthcare Systems in the Home: Vestibular Rehabilitation

    DEFF Research Database (Denmark)

    Aarhus, Rikke; Grönvall, Erik; Larsen, Simon Bo

    2010-01-01

    Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction.......Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction....

  17. Task, muscle and frequency dependent vestibular control of posture

    OpenAIRE

    Forbes, Patrick A.; Gunter P Siegmund; Schouten, Alfred C.; Blouin, Jean-Sébastien

    2015-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular information is relevant to postural control, while in neck muscles they are maintained regardless of the requirement to maintain head on trunk balance. Recent investigations have also shown that the bandwid...

  18. The thalamocortical vestibular system in animals and humans

    OpenAIRE

    LOPEZ, Christophe; Blanke, Olaf

    2011-01-01

    The vestibular system provides the brain with sensory signals about three-dimensional head rotations and translations. These signals are important for postural and oculomotor control, as well as for spatial and bodily perception and cognition, and they are subtended by pathways running from the vestibular nuclei to the thalamus, cerebellum and the "vestibular cortex." The present review summarizes current knowledge on the anatomy of the thalamocortical vestibular system and discusses data fro...

  19. Longitudinal performance of an implantable vestibular prosthesis.

    Science.gov (United States)

    Phillips, Christopher; Ling, Leo; Oxford, Trey; Nowack, Amy; Nie, Kaibao; Rubinstein, Jay T; Phillips, James O

    2015-04-01

    Loss of vestibular function may be treatable with an implantable vestibular prosthesis that stimulates semicircular canal afferents with biphasic pulse trains. Several studies have demonstrated short-term activation of the vestibulo-ocular reflex (VOR) with electrical stimulation. Fewer long-term studies have been restricted to small numbers of animals and stimulation designed to produce adaptive changes in the electrically elicited response. This study is the first large consecutive series of implanted rhesus macaque to be studied longitudinally using brief stimuli designed to limit adaptive changes in response, so that the efficacy of electrical activation can be studied over time, across surgeries, canals and animals. The implantation of a vestibular prosthesis in animals with intact vestibular end organs produces variable responses to electrical stimulation across canals and animals, which change in threshold for electrical activation of eye movements and in elicited slow phase velocities over time. These thresholds are consistently lower, and the slow phase velocities higher, than those obtained in human subjects. The changes do not appear to be correlated with changes in electrode impedance. The variability in response suggests that empirically derived transfer functions may be required to optimize the response of individual canals to a vestibular prosthesis, and that this function may need to be remapped over time. This article is part of a Special Issue entitled . Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Complications of Microsurgery of Vestibular Schwannoma

    Directory of Open Access Journals (Sweden)

    Jan Betka

    2014-01-01

    Full Text Available Background. The aim of this study was to analyze complications of vestibular schwannoma (VS microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225 removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI was observed in 124 cases (45% immediately after surgery and in 104 cases (33% on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%, headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.

  1. Visual dependency and dizziness after vestibular neuritis.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Symptomatic recovery after acute vestibular neuritis (VN is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI. The third of patients showing the worst clinical outcomes (mean DHI score 36-80 had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03. Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.

  2. Sensorial countermeasures for vestibular spatial disorientation.

    Science.gov (United States)

    Paillard, Aurore C; Quarck, Gaëlle; Denise, Pierre

    2014-05-01

    Spatial disorientation is defined as an erroneous body orientation perceived by pilots during flights. Limits of the vestibular system provoke frequent spatial disorientation mishaps. Although vestibular spatial disorientation is experienced frequently in aviation, there is no intuitive countermeasure against spatial disorientation mishaps to date. The aim of this review is to describe the current sensorial countermeasures and to examine future leads in sensorial ergonomics for vestibular spatial disorientation. This work reviews: 1) the visual ergonomics, 2) the vestibular countermeasures, 3) the auditory displays, 4) the somatosensory countermeasures, and, finally, 5) the multisensory displays. This review emphasizes the positive aspects of auditory and somatosensory countermeasures as well as multisensory devices. Even if some aspects such as sensory conflict and motion sickness need to be assessed, these countermeasures should be taken into consideration for ergonomics work in the future. However, a recent development in aviation might offer new and better perspectives: unmanned aerial vehicles. Unmanned aerial vehicles aim to go beyond the physiological boundaries of human sensorial systems and would allow for coping with spatial disorientation and motion sickness. Even if research is necessary to improve the interaction between machines and humans, this recent development might be incredibly useful for decreasing or even stopping vestibular spatial disorientation.

  3. A review of the interrelationship between vestibular dysfunction ...

    African Journals Online (AJOL)

    problems and dyslexia were also associated with dysfunction of the vestibular system. Different tests evaluating vestibular loss were identified of which some can be used successfully by practitionars. Various programmes and activities were identified to successfully rehabilitate vestibular function. For better understanding ...

  4. Origin of vestibular dysfunction in Usher syndrome type 1B.

    NARCIS (Netherlands)

    Sun, J.; Alphen, A.M. van; Wagenaar, M.; Huygen, P.L.M.; Hoogenraad, C.C.; Hasson, T.; Koekkoek, S.K.; Bohne, B.A.; Zeeuw, C.I. de

    2001-01-01

    It is still debated to what extent the vestibular deficits in Usher patients are due to either central vestibulocerebellar or peripheral vestibular problems. Here, we determined the origin of the vestibular symptoms in Usher 1B patients by subjecting them to compensatory eye movement tests and by

  5. [The research progress of large vestibular aqueduct syndrome].

    Science.gov (United States)

    Abulikemu, Yiming; Tang, Liang; Zhang, Jin

    2012-11-01

    Large vestibular aqueduct syndrome (LVAS) is one of common non-syndromic hearing disorders. With the rapid development of medical imaging, audiology, molecular biology, genetics, cochlear implant surgery, we have made remarkable achievements in the diagnosis and treatment of large vestibular aqueduct syndrome. This article reviewed related researches of the large vestibular aqueduct syndrome.

  6. Vestibular Schwannoma or acoustic neuroma

    Directory of Open Access Journals (Sweden)

    Hekmatara M

    1997-04-01

    Full Text Available Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response, and SDS (speech discrimination score with 90% success, but computer Tomography (CT scan and MRI (Magnetic Resonance Image are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA, since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle. Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.

  7. Can a finding of cervical vestibular evoked myogenic potentials contribute to vestibular migraine diagnostics?

    Directory of Open Access Journals (Sweden)

    Tihana Vešligaj

    2016-02-01

    Full Text Available Aim To investigate differences in vestibular evoked myogenic potentials (VEMP results with patients suffering from vestibular migraine and healthy people, taking into consideration values of threshold and latency of occurrence of the characteristic wave complex, size of amplitude, and interaural amplitude ratio. According to the results, determine the importance and usefulness of VEMP in vestibular migraine diagnostics. Methods A total number of 62 subjects were included in the study, 32 of them belonging to a group of patients suffering from vestibular migraine (VM, while other 30 were in a control group of healthy subjects. Information was collected during the diagnostic evaluation. General and otoneurological history of patients and bedside tests, audiological results, videonystagmography and cervical vestibular evoked myogenic potentials (cVEMP were made. Results There was a difference in an interaural ratio of amplitudes in the experimental and control groups, but it was not found to be clinically significant. By ToneBurst 500 Hz method, the interaural amplitude ratio higher than 35% was measured in 46.97% subjects, while the response was totally unilaterally missing in 28.8% patients. Conclusion Even the sophisticated method as cVEMP does not give the ultimate result confirming the vestibular migraine diagnosis, and neither do other diagnostic methods. cVEMP result can contribute to the completion of full mosaic of vestibular migraine diagnostics.

  8. Lateral medullary syndrome following injury of the vestibular pathway to the core vestibular cortex: Diffusion tensor imaging study.

    Science.gov (United States)

    Yeo, Sang Seok; Jang, Sung Ho; Kwon, Jung Won

    2017-12-05

    The parieto-insular vestibular cortex (PIVC) is a core region of vestibular input into regions of the cortex. The vestibular nuclei have reciprocal connections with the PIVC. However, little is known about injury of the core vestibular pathway to the PIVC in patients with dorsolateral medullary infarctions. In this study, using diffusion tensor tractography (DTT), we investigated injury of the neural connections between the vestibular nuclei and the PIVC in patients with typical central vestibular disorder. Eight consecutive patients with lateral medullary syndrome and 10 control subjects were recruited for this study. To reconstruct the core vestibular pathway to the PIVC, we defined the seed region of interest (ROI) as the vestibular nuclei of the pons and the target ROI as the PIVC. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. The core vestibular pathway to the PIVC showed significantly lower tract volume in patients compared with the control group (p0.05). In conclusion, injury of the core vestibular pathway to the PIVC was demonstrated in patients with lateral vestibular syndrome following dorsolateral medullary infarcts. We believe that analysis of the core vestibular pathway to the PIVC using DTT would be helpful in evaluating patients with lateral medullary syndrome. Copyright © 2017. Published by Elsevier B.V.

  9. Vestibular rehabilitation: useful but not universally so.

    Science.gov (United States)

    Krebs, David E; Gill-Body, Kathleen M; Parker, Stephen W; Ramirez, Jose V; Wernick-Robinson, Mara

    2003-02-01

    Although vestibular rehabilitation (VR) is gaining popularity, few data support its utility in improving locomotor stability, and no good predictors exist of whom will benefit most. A double-blind, placebo-controlled randomized trial of vestibular rehabilitation was conducted at a large tertiary care hospital on 124 patients (59 +/- 18 years old) with unilateral (n = 51) or bilateral (n = 73) vestibular hypofunction, of whom 86 completed a 12-week intervention. Of these 86, 27 returned for long-term (1-year) follow-up testing. The primary outcome measure was locomotor stability. Group A (6 weeks of VR) significantly (P VR; there were no group differences at 1 year. Of the 86 who completed the intervention, 52 (61%) had clear locomotor gains. VR is helpful for most patients in providing locomotor stability, but further work is needed to determine the factors that prevent VR from being effective for all patients with vestibulopathy.

  10. Eye Movements as Indicators of Vestibular Dysfunction.

    Science.gov (United States)

    Menshikova, Galina Ya; Kovalev, Artem I; Klimova, Oxana A; Chernorizov, Alexander M

    2015-01-01

    Virtual reality technologies are in wide use in sport psychology. An advantage of this kind of technology is the possibility to assess sportspeople's readiness to perform complex movements. This study is aimed at developing a method for the evaluation of vestibular function disturbances in young skaters. Such disturbances may occur while skaters are performing rotation movements. To achieve this goal, we induced a vection illusion, accompanied by virtual environment rotation in a CAVE virtual reality system. Vestibular disturbances were tested for two groups-professional skaters and people who had very little or no skating experience. The quantitative evaluation of vestibular dysfunction was based on eye movement characteristics, which were recorded in subjects experiencing a vection illusion. © The Author(s) 2015.

  11. A detailed analysis of symptomatic posterior cortex seizure semiology in children younger than seven years.

    Science.gov (United States)

    Fogarasi, András; Boesebeck, Frank; Tuxhorn, Ingrid

    2003-01-01

    To analyze the semiology of seizure onset and evolution in young children with posterior cortex epilepsy (PCE), compare this with adult reports, and assess age-related differences. We videotaped and analyzed 110 seizures from 18 patients with PCE, aged 3-81 months. All had a good prognosis after posterior epileptogenic zone removal. Ictal events were categorized by behavioral, consciousness, autonomic, and sensory features, as well as motor patterns, which included myoclonic, tonic, clonic, unclassified motor seizures, and epileptic spasm. A time-scaled data sheet was developed to record each epileptic event as onset, very early, early, or late manifestation. Patients had a high seizure frequency with head nod, oculomotor features, and late-appearing oral automatisms, whereas hypermotor and secondarily generalized tonic-clonic seizures were not seen. Our results suggest that PCE in infants and young children is very heterogeneous but shows important age-related features. Compared with adults, children with PCE have shorter but more frequent seizures; they rarely report aura or visual sensory signs, only sporadically develop hypermotor and secondarily generalized tonic-clonic seizures, whereas ictal smile, flush, head nod, and behavioral change are typical features at this age. Because of frequent subtle ictal phenomena, long-term video-EEG monitoring is a useful diagnostic tool with infants and young children with PCE.

  12. Seizure semiology inferred from clinical descriptions and from video recordings. How accurate are they?

    Science.gov (United States)

    Beniczky, Simona Alexandra; Fogarasi, András; Neufeld, Miri; Andersen, Noémi Becser; Wolf, Peter; van Emde Boas, Walter; Beniczky, Sándor

    2012-06-01

    To assess how accurate the interpretation of seizure semiology is when inferred from witnessed seizure descriptions and from video recordings, five epileptologists analyzed 41 seizures from 30 consecutive patients who had clinical episodes in the epilepsy monitoring unit. For each clinical episode, the consensus conclusions (at least 3 identical choices) based on the descriptions and, separately, of the video recordings were compared with the clinical conclusions at the end of the diagnostic work-up, including data from the video-EEG recordings (reference standard). Consensus conclusion was reached in significantly more cases based on the interpretation of video recordings (88%) than on the descriptions (66%), and the overall accuracy was higher for the video recordings (85%) than for the descriptions (54%). When consensus was reached, the concordance with the reference standard was substantial for the descriptions (k=0.67) and almost perfect for the video recordings (k=0.95). Video recordings significantly increase the accuracy of seizure interpretation. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome.

    Science.gov (United States)

    Power, Kjersti Nesheim; Gramstad, Arne; Gilhus, Nils Erik; Engelsen, Bernt A

    2015-01-01

    Our objective was to study the semiology, aetiology, treatment and outcome of nonconvulsive status epilepticus (NCSE) in adults. All NCSE episodes in an unselected hospital cohort in the period 2004-2009 were identified, and the files reviewed. STESS (Status Epilepticus Severity Scale) was conducted retrospectively and correlated to outcome. Follow-up was undertaken after >2 years. 48 NCSEs in 39 patients, 22 men and 17 women, were found. Mean age was 63 years. 23/39 (59%) patients had established epilepsy. The underlying cause of NCSE was cerebrovascular disease in 17/39 (44%). 37/48 (77%) NCSEs were complex focal status epilepticus. 3/48 NCSEs (6.3%) lead to death, whereas 8.5% lead to severe sequelae. Cognitive sequelae were found after 14.9% of NCSEs. The outcome was worst in the group with no prior epilepsy (p=0.013). STESS had a negative predictive value of 96% (cut-off value of 3) for severe sequelae and death combined (p<0.002). NCSE has a potential for severe sequelae and represents an emergency in need of intensive treatment. The major determinant of outcome is the underlying cause. The outcome was worse in patients without epilepsy than in patients with epilepsy. STESS is of value in predicting outcome. Cognitive sequelae following NCSE can occur, but need further investigation with prospective, systematic studies. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  14. Vestibular rehabilitation following mild traumatic brain injury.

    Science.gov (United States)

    Gurley, James M; Hujsak, Bryan D; Kelly, Jennifer L

    2013-01-01

    Vertigo, dizziness, and imbalance are a symptom complex that is commonly found following concussion. Early metabolic changes following concussion may lead to worsening of the injury and symptoms in individuals not properly managed from the outset. When symptoms do not recover spontaneously, skilled vestibular rehabilitation can be an effective modality in an attempt to normalize the individual's vestibular responses. The purpose of this review is to appraise the current and accepted methods available to the skilled clinician in quantifying and treating vestibular dysfunction following concussion. Incidence and prognostic indicators will be reviewed along with common barriers to recovery. Vestibular Rehabilitation following concussion utilizes similar tools and techniques employed when treating those solely with peripheral pathology. The clinician must not only have a solid understanding of when and why certain exercises are required, but also be willing to accept that less exercise may be indicated in this population. As injury to the system following mild traumatic brain injury can include both peripheral and central structures, the duration of therapy and the time to recovery may be prolonged. Co-morbidities including cognitive and behavioral issues, visual-perceptual dysfunction, metabolic dysfunction, and autonomic dysfunction may hamper the effectiveness of the traditional Vestibular Rehabilitation approach. As successful treatment does not occur in a vacuum, working closely with other disciplines well versed in treating these co-morbid issues will help the individual to obtain optimal recovery. Vestibular Rehabilitation is an effective modality for managing dizziness, vertigo, and imbalance following concussion. Careful consideration of the acuity of the injury, along with effective management of co-morbid conditions will optimize the result.

  15. RECORDING OF VESTIBULAR EVOKED MYOGENIC POTENTIALS

    Directory of Open Access Journals (Sweden)

    A. A. Sazgar

    2006-05-01

    Full Text Available It has been shown recently that loud clicks evoke myogenic potentials in the tonically contracting sternocleidomastoid muscles. Studies have suggested that these potentials are of vestibular origin, especially of the saccule and inferior vestibular nerve. A pilot study was undertaken in our hospital to record vestibular evoked myogenic potentials (VEMP for the first time in Iran. Eighteen healthy volunteers (32 ears without history of otologic or vestibular disorders were subjected to the VEMP test. Twenty-one patients (26 ears with unilateral (6 patients and bilateral (5 patients high frequency sensorineural hearing loss with unknown etiology, acoustic neuroma (1 patient, Meniere’s disease (4 patients and unilateral low frequency sensorineural hearing loss without vestibular complaint (5 patients were also enrolled in this study. VEMP response to clicks was obtained from 84.4% of ears of healthy subjects. These subjects demonstrated short latency waves to click stimuli during tonic neck flexor activation. Mean latencies of first positive (p13 and first negative (n23 potentials in healthy subjects were 12.45 ± 1.9 ms and 20.8 ± 3.5 ms, respectively. Median latencies of these two potentials were 12.1 and 19.3 ms, respectively. We could record VEMP in 5 patients with unilateral and all patients with high and low frequency sensorineural hearing loss without vestibular complaint. In the patient with acoustic neuroma VEMP was absent on the affected side. This technique may offer a new method to evaluate otolith and sacculocollic pathways in human.

  16. Vestibular implants studied in animal models: clinical and scientific implications.

    Science.gov (United States)

    Lewis, Richard F

    2016-12-01

    Damage to the peripheral vestibular system can result in debilitating postural, perceptual, and visual symptoms. A potential new treatment for this clinical problem is to replace some aspects of peripheral vestibular function with an implant that senses head motion and provides this information to the brain by stimulating branches of the vestibular nerve. In this review I consider animal studies performed at our institution over the past 15 years, which have helped elucidate how the brain processes information provided by a vestibular (semicircular canal) implant and how this information could be used to improve the problems experienced by patients with peripheral vestibular damage. Copyright © 2016 the American Physiological Society.

  17. Patient with headache and peripheral vestibular dysfunction: case report

    OpenAIRE

    Rossi,Tatiane Maria; Luciano,Naonne Santos Camargo; Oricoli, Polliay Freire; Marchiori,Luciana Lozza de Moraes; Melo, Juliana Jandre

    2009-01-01

    TEMA: a Reabilitação Vestibular constitui-se numa opção de tratamento para pacientes portadores de síndrome vestibular periférica e cefaleia. PROCEDIMENTOS: o paciente, do sexo feminino com 26 anos de idade apresentava síndrome vestibular periférica acompanhada de crises de cefaleia. Foi realizada avaliação e terapia fonoaudiológica com exercícios de habituação vestibular além de fisioterapia e dieta recomendada pelo nutricionista. RESULTADOS: no período de 3 meses com reabilitação vestibular...

  18. Non-linear Galilean vestibular receptive fields.

    Science.gov (United States)

    Bennequin, D; Berthoz, A

    2011-01-01

    We present a set of formulas for the receptive fields of the vestibular neurons that are motivated by Galilean invariance. We show that these formulas explain non-trivial data in neurophysiology, and suggest new hypothesis to be tested in dynamical 3D conditions. Moreover our model offers a way for neuronal computing with 3D displacements, which is reputed to be hard, underlying the vestibular reflexes. This computation is presented in a Bayesian framework. The basis of the model is the necessity of living bodies to work invariantly in space-time, allied to the necessary discreteness of neuronal transmission.

  19. Effects of vestibular rehabilitation therapy on emotional aspects in chronic vestibular patients.

    Science.gov (United States)

    Meli, Annalisa; Zimatore, Giovanna; Badaracco, Carlo; De Angelis, Ezio; Tufarelli, Davide

    2007-08-01

    A strong relationship exists between vestibular dysfunction and anxiety disorders. The aim of this study was to assess the anxiety and depression levels in patients with chronic dizziness and to assess the effects of vestibular rehabilitation (VR) therapy, on the anxiety and depression levels, without a behavioural or pharmacological therapy. Two groups of 40 patients, each affected by chronic vestibular deficit, were studied. The first one underwent VR, and the latter did not. The psychometric tests used were the State-Trait Anxiety Inventory (STAI) and the Centre for Epidemiological Studies Depression Scale (CES-D). Psychological factors influence the level of handicap experienced by chronic dizziness patients, and disequilibrium influences the anxiety and depression levels. STAI and CES-D scales significantly decrease after VR therapy (PVR therapy positively influences the emotional condition of chronic vestibular deficit patients without pharmacological or psychotherapy treatments.

  20. From ear to uncertainty: Vestibular contributions to cognitive function.

    Directory of Open Access Journals (Sweden)

    Paul eSmith

    2013-11-01

    Full Text Available In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and cortex play in spatial orientation. In this review we summarise the evidence that vestibular loss causes cognitive disorders, especially spatial memory deficits, in animals and humans and critically evaluate the evidence that these deficits are not due to hearing loss, problems with motor control, oscillopsia or anxiety and depression. We review the evidence that vestibular lesions affect head direction and place cells as well as the emerging evidence that artificial activation of the vestibular system, using galvanic vestibular stimulation, can modulate cognitive function.

  1. Interactions between Stress and Vestibular Compensation - A Review.

    Science.gov (United States)

    Saman, Yougan; Bamiou, D E; Gleeson, Michael; Dutia, Mayank B

    2012-01-01

    Elevated levels of stress and anxiety often accompany vestibular dysfunction, while conversely complaints of dizziness and loss of balance are common in patients with panic and other anxiety disorders. The interactions between stress and vestibular function have been investigated both in animal models and in clinical studies. Evidence from animal studies indicates that vestibular symptoms are effective in activating the stress axis, and that the acute stress response is important in promoting compensatory synaptic and neuronal plasticity in the vestibular system and cerebellum. The role of stress in human vestibular disorders is complex, and definitive evidence is lacking. This article reviews the evidence from animal and clinical studies with a focus on the effects of stress on the central vestibular pathways and their role in the pathogenesis and management of human vestibular disorders.

  2. From ear to uncertainty: vestibular contributions to cognitive function.

    Science.gov (United States)

    Smith, Paul F; Zheng, Yiwen

    2013-11-26

    In addition to the deficits in the vestibulo-ocular and vestibulo-spinal reflexes that occur following vestibular dysfunction, there is substantial evidence that vestibular loss also causes cognitive disorders, some of which may be due to the reflexive deficits and some of which are related to the role that ascending vestibular pathways to the limbic system and neocortex play in spatial orientation. In this review we summarize the evidence that vestibular loss causes cognitive disorders, especially spatial memory deficits, in animals and humans and critically evaluate the evidence that these deficits are not due to hearing loss, problems with motor control, oscillopsia or anxiety and depression. We review the evidence that vestibular lesions affect head direction and place cells as well as the emerging evidence that artificial activation of the vestibular system, using galvanic vestibular stimulation (GVS), can modulate cognitive function.

  3. Interactions between stress and vestibular compensation – a review

    Directory of Open Access Journals (Sweden)

    Yougan eSaman

    2012-07-01

    Full Text Available Elevated levels of stress and anxiety often accompany vestibular dysfunction, while conversely complaints of dizziness and loss of balance are common in patients with panic and other anxiety disorders. The interactions between stress and vestibular function, and plasticity have been investigated both in animal models and in clinical studies. Evidence from animal studies indicates that vestibular symptoms are effective in activating the stress axis, and that the acute stress response is important in promoting compensatory synaptic and neuronal plasticity in the vestibular system and cerebellum. The role of stress in human vestibular disorders is complex, and definitive evidence is lacking. This article reviews the evidence from animal and clinical studies with a focus on the effects of stress on the central vestibular pathways and their role in the pathogenesis and management of human vestibular disorders.

  4. Interactions between Stress and Vestibular Compensation – A Review

    Science.gov (United States)

    Saman, Yougan; Bamiou, D. E.; Gleeson, Michael; Dutia, Mayank B.

    2012-01-01

    Elevated levels of stress and anxiety often accompany vestibular dysfunction, while conversely complaints of dizziness and loss of balance are common in patients with panic and other anxiety disorders. The interactions between stress and vestibular function have been investigated both in animal models and in clinical studies. Evidence from animal studies indicates that vestibular symptoms are effective in activating the stress axis, and that the acute stress response is important in promoting compensatory synaptic and neuronal plasticity in the vestibular system and cerebellum. The role of stress in human vestibular disorders is complex, and definitive evidence is lacking. This article reviews the evidence from animal and clinical studies with a focus on the effects of stress on the central vestibular pathways and their role in the pathogenesis and management of human vestibular disorders. PMID:22866048

  5. Receptors of glutamate and neurotrophin in vestibular neuronal functions.

    Science.gov (United States)

    Chan, Y S; Chen, L W; Lai, C H; Shum, D K Y; Yung, K K L; Zhang, F X

    2003-01-01

    The last decade has witnessed advances in understanding the roles of receptors of neurotrophin and glutamate in the vestibular system. In the first section of this review, the biological actions of neurotrophins and their receptors in the peripheral and central vestibular systems are summarized. Emphasis will be placed on the roles of neurotrophins in developmental plasticity and in the maintenance of vestibular function in the adult animal. This is reviewed in relation to the developmental expression pattern of neurotrophins and their receptors within the vestibular nuclei. The second part is focused on the functional role of different glutamate receptors on central vestibular neurons. The developmental expression pattern of glutamate receptor subunits within the vestibular nuclei is reviewed in relation to the potential role of glutamate receptors in regulating the development of vestibular function. Copyright 2003 National Science Council, ROC and S. Karger AG, Basel

  6. Physiological principles of vestibular function on earth and in space

    Science.gov (United States)

    Minor, L. B.

    1998-01-01

    Physiological mechanisms underlying vestibular function have important implications for our ability to understand, predict, and modify balance processes during and after spaceflight. The microgravity environment of space provides many unique opportunities for studying the effects of changes in gravitoinertial force on structure and function of the vestibular system. Investigations of basic vestibular physiology and of changes in reflexes occurring as a consequence of exposure to microgravity have important implications for diagnosis and treatment of vestibular disorders in human beings. This report reviews physiological principles underlying control of vestibular processes on earth and in space. Information is presented from a functional perspective with emphasis on signals arising from labyrinthine receptors. Changes induced by microgravity in linear acceleration detected by the vestibulo-ocular reflexes. Alterations of the functional requirements for postural control in space are described. Areas of direct correlation between studies of vestibular reflexes in microgravity and vestibular disorders in human beings are discussed.

  7. Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure

    Directory of Open Access Journals (Sweden)

    Økstad Siri

    2006-12-01

    Full Text Available Abstract Background Vestibular neuritis (VN is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. Case presentations We describe three patients with symptoms suggestive of VN, but normal calorics. All 3 had unilateral loss of vestibular evoked myogenic potential. A slight, asymptomatic position dependent nystagmus, with the pathological ear down, was observed. Conclusion We believe that these patients suffer from pure inferior nerve vestibular neuritis.

  8. Central Vestibular Dysfunction in an Otorhinolaryngological Vestibular Unit: Incidence and Diagnostic Strategy

    Directory of Open Access Journals (Sweden)

    Mostafa, Badr E.

    2014-03-01

    Full Text Available Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years. Provisional videonystagmography (VNG results were: 40% benign paroxysmal positional vertigo (BPPV, 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41 had magnetic resonance imaging (MRI and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23% were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus. Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.

  9. Vestibular Dysfunctions in Cochlear Implant Patients; A Vestibular Evoked Myogenic Potential Study

    Directory of Open Access Journals (Sweden)

    Masoud Motasaddi Zarandy

    2011-12-01

    Full Text Available Background and Aim: Vestibular evoked myogenic potential in response to click or short tone burst stimuli have been used as a clinical test for distinguish saccule and inferior vestibular nerve diseases. Different studies show that cochlear implant could have inverse effects on vestibular structures. We aimed to investigate vestibular evoked myogenic potential in unilateral cochlear implanted individuals in compare to normal individuals.Methods: Thirty-three unilateral cochlear implanted patients (mean age 19.96 years and 30 normal hearing individuals (mean age 24-27 years as control group were enrolled in this cross- sectional study. Absolute latencies and amplitudes of myogenic potential responses were measured and compared in both groups.Results: Myogenic potential recorded in both ears of all controls were normal. No response could be recorded in 16 patients (48.48% from both ears. In three patients, responses were recorded in both ears though the amplitude of waves was reduced in implanted ear. Unilateral response could be recorded in 14 patients only in their non-implanted ear.Conclusion: Vestibular evoked myogenic potential test is a useful tool for assessing saccular function in cochlear implant patients. Damages of osseous spiral lamina and basilar membrane after cochlear implantation could result in dysfunctions of vestibular organs specially saccule. It seems that saccule could be easily damaged after cochlear implantation. This would cause absence or reduced amplitudes in myogenic potential.

  10. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: ten recommendations for optimal functional recovery

    Directory of Open Access Journals (Sweden)

    LACOUR eMichel

    2015-01-01

    Full Text Available This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation, which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalogue of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodelling, the instructive role that VR therapy may play in this functional reorganisation, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive and emotional profile of the patient to propose individual or à la carte VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life.

  11. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery.

    Science.gov (United States)

    Lacour, Michel; Bernard-Demanze, Laurence

    2014-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodeling, the instructive role that VR therapy may play in this functional reorganization, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive, and emotional profile of the patient to propose individual or "à la carte" VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life.

  12. CONTRIBUTION OF THE AUDIOLOGICAL AND VESTIBULAR ASSESSMENT TO THE DIFFERENTIAL AND ETIOLOGICAL DIAGNOSIS OF PERIPHERIC VESTIBULAR SYNDROMES

    Directory of Open Access Journals (Sweden)

    Loreta Ungureanu

    2012-09-01

    Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.

  13. Time constants of vestibular nuclei neurons in the goldfish: a model with ocular propioception.

    Science.gov (United States)

    Allum, J H; Graf, W

    1977-12-22

    A simple model of the vestibular-ocular reflex with a proprioceptive eye velocity feedback loop is used to simulate recent data on the vestibular responses of neurons in the vestibular nuclei of spinal goldfish. The data support the hypothesis that a proprioceptive feedback loop elongates the vestibular nucleus time constant to equal that of the slow phase eye movements of vestibular nystagmus.

  14. Effects of Sound on the Vestibular System

    Science.gov (United States)

    1976-03-01

    receptors and directly affects central nervous system nuclei. Visual, olfactory, and gustatory responses would be expected if sound directly affected the...AMRL-TR-75-89 EFFECTS OF SOUND ON THE VESTIBULAR SYSTEM MIAMI UNIVERSITY NO OXFORD, OHIO 45056 MARCH 1976 | j...Approvedrfor public release: distribution unlimited AEROSPACE MEDICAL RESEARCH LABORATORY AEROSPACE MEDICAL DMSION Air Force Systems Command Wright.Patterson

  15. Latent nystagmus: vestibular nystagmus with a twist.

    Science.gov (United States)

    Brodsky, Michael C; Tusa, Ronald J

    2004-02-01

    Latent nystagmus is a horizontal binocular oscillation that is evoked by unequal visual input to the 2 eyes. It develops primarily in humans with congenital esotropia. To investigate the interrelationship between latent and peripheral vestibular nystagmus and their corollary neuroanatomical pathways. Examination of subcortical neuroanatomical pathways producing latent nystagmus and review of the neurophysiological mechanisms by which they become activated in congenital esotropia. The vestibular nucleus presides over motion input from the eyes and labyrinths. Latent nystagmus corresponds to the optokinetic component of ocular rotation that is driven monocularly by nasal optic flow during a turning movement of the body in lateral-eyed animals. Congenital esotropia alters visual pathway development from the visual cortex to subcortical centers that project to the vestibular nucleus, allowing this primitive subcortical motion detection system to generate latent nystagmus under conditions of monocular fixation. Latent nystagmus is the ocular counterpart of peripheral vestibular nystagmus. Its clinical expression in humans proclaims the evolutionary function of the eyes as sensory balance organs.

  16. Vestibular migraine: clinical and epidemiological aspects

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    Ligia Oliveira Gonçalves Morganti

    Full Text Available ABSTRACT INTRODUCTION: Vestibular migraine (VM is one of the most often common diagnoses in neurotology, but only recently has been recognized as a disease. OBJECTIVE: To analyze the clinical and epidemiological profile of patients with VM. METHODS: This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic. RESULTS: 94.1% of patients were females and 5.9% were males. The mean age was 46.1 years; 65.6% of patients had had headache for a longer period than dizziness. A correlation was detected between VM symptoms and the menstrual period. 61.53% of patients had auditory symptoms, with tinnitus the most common, although tonal audiometry was normal in 68.51%. Vectoelectronystagmography was normal in 67.34%, 10.20% had hyporeflexia, and 22.44% had vestibular hyperreflexia. Electrophysiological assessment showed no abnormalities in most patients. Fasting plasma glucose and glycemic curve were normal in most patients, while the insulin curve was abnormal in 75%. 82% of individuals with MV showed abnormalities on the metabolism of carbohydrates. CONCLUSION: VM affects predominantly middle-aged women, with migraine headache representing the first symptom, several years before vertigo. Physical, auditory, and vestibular evaluations are usually normal. The most frequent vestibular abnormality was hyperreflexia. Most individuals showed abnormality related to carbohydrate metabolism.

  17. New perspectives on vestibular evoked myogenic potentials.

    Science.gov (United States)

    Rosengren, Sally M; Kingma, Herman

    2013-02-01

    Although the vestibular evoked myogenic potential (VEMP) measured from the cervical muscles (cVEMP, cervical VEMP) is well described and has documented clinical utility, its analogue recorded from the extraocular muscles (oVEMP, ocular VEMP) has been described only recently and is currently emerging as an additional test of otolith function. This review will, therefore, summarize recent developments in VEMP research with a focus on the oVEMP. Recent studies suggest that the oVEMP is produced by otolith afferents in the superior vestibular nerve division, whereas the cVEMP evoked by sound is thought to be an inferior vestibular nerve reflex. Correspondingly, the oVEMP correlates better with caloric and subjective visual vertical tests than sound-cVEMPs. cVEMPs are more complicated than often thought, as shown by the presence of crossed responses and conflicting results of recent vibration studies. Altered inner ear mechanics produced by the vestibular diseases superior semicircular canal dehiscence and Ménière's disease lead to changes in the preferred frequency of the oVEMP and cVEMP. The oVEMP provides complementary diagnostic information to the cVEMP and is likely to be a useful addition to the diagnostic test battery in neuro-otology.

  18. Stereotactic radiation therapy for large vestibular schwannomas

    NARCIS (Netherlands)

    Mandl, Ellen S.; Meijer, Otto W. M.; Slotman, Ben J.; Vandertop, W. Peter; Peerdeman, Saskia M.

    2010-01-01

    Background and purpose: To evaluate the morbidity and tumor-control rate in the treatment of large vestibular schwannomas (VS) after stereotactic radiation therapy in our institution. Material and methods: Twenty-five consecutive patients (17 men, 8 women) with large VS (diameter 3.0 cm or larger),

  19. Topographic movie of intracranial ictal high-frequency oscillations with seizure semiology: epileptic network in Jacksonian seizures.

    Science.gov (United States)

    Akiyama, Tomoyuki; Chan, Derrick W; Go, Cristina Y; Ochi, Ayako; Elliott, Irene M; Donner, Elizabeth J; Weiss, Shelly K; Snead, O Carter; Rutka, James T; Drake, James M; Otsubo, Hiroshi

    2011-01-01

    We developed a technique to produce images of dynamic changes in ictal high-frequency oscillations (HFOs) >40 Hz recorded on subdural electroencephalography (EEG) that are time-locked to the ictal EEG and ictal semiology video. We applied this technique to Jacksonian seizures to demonstrate ictal HFO propagation along the homunculus in the primary sensory-motor cortex to visualize the underlying epileptic network. We analyzed intracranial ictal EEGs from two patients with intractable Jacksonian seizures who underwent epilepsy surgery. We calculated the degrees of increase in amplitude within 40-80, 80-200, and 200-300 Hz frequency bands compared to the interictal period and converted them into topographic movies projected onto the brain surface picture. We combined these data with the ictal EEGs and video of the patient demonstrating ictal semiology. The ictal HFOs began in the sensory cortex and appeared concomitantly with the sensory aura. They then propagated to the motor cortex at the same time that focal motor symptoms evolved. As the seizure progressed, the ictal HFOs spread or reverberated in the rolandic region. However, even when the seizure became secondarily generalized, the ictal HFOs were confined to the rolandic region. In both cases, there was increased amplitude of higher frequency bands during seizure initiation compared to seizure progression. This combined movie showed the ictal HFO propagation corresponding to the ictal semiology in Jacksonian seizures and revealed the epileptic network involved in seizure initiation and progression. This method may advance understanding of neural network activities relating to clinical seizure generation and propagation. Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.

  20. Automated analysis of seizure semiology and brain electrical activity in presurgery evaluation of epilepsy: A focused survey.

    Science.gov (United States)

    Ahmedt-Aristizabal, David; Fookes, Clinton; Dionisio, Sasha; Nguyen, Kien; Cunha, João Paulo S; Sridharan, Sridha

    2017-11-01

    Epilepsy being one of the most prevalent neurological disorders, affecting approximately 50 million people worldwide, and with almost 30-40% of patients experiencing partial epilepsy being nonresponsive to medication, epilepsy surgery is widely accepted as an effective therapeutic option. Presurgical evaluation has advanced significantly using noninvasive techniques based on video monitoring, neuroimaging, and electrophysiological and neuropsychological tests; however, certain clinical settings call for invasive intracranial recordings such as stereoelectroencephalography (SEEG), aiming to accurately map the eloquent brain networks involved during a seizure. Most of the current presurgical evaluation procedures focus on semiautomatic techniques, where surgery diagnosis relies immensely on neurologists' experience and their time-consuming subjective interpretation of semiology or the manifestations of epilepsy and their correlation with the brain's electrical activity. Because surgery misdiagnosis reaches a rate of 30%, and more than one-third of all epilepsies are poorly understood, there is an evident keen interest in improving diagnostic precision using computer-based methodologies that in the past few years have shown near-human performance. Among them, deep learning has excelled in many biological and medical applications, but has advanced insufficiently in epilepsy evaluation and automated understanding of neural bases of semiology. In this paper, we systematically review the automatic applications in epilepsy for human motion analysis, brain electrical activity, and the anatomoelectroclinical correlation to attribute anatomical localization of the epileptogenic network to distinctive epilepsy patterns. Notably, recent advances in deep learning techniques will be investigated in the contexts of epilepsy to address the challenges exhibited by traditional machine learning techniques. Finally, we discuss and propose future research on epilepsy surgery assessment

  1. New Insights into Pathophysiology of Vestibular Migraine

    Science.gov (United States)

    Espinosa-Sanchez, Juan M.; Lopez-Escamez, Jose A.

    2015-01-01

    Vestibular migraine (VM) is a common disorder in which genetic, epigenetic, and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal gray, locus coeruleus, and nucleus raphe magnus) are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory–inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs, and pain. The interactions among several functional and structural neural networks could explain the pathogenic mechanisms of VM

  2. New insights into pathophysiology of vestibular migraine

    Directory of Open Access Journals (Sweden)

    Juan Manuel Espinosa-Sanchez

    2015-02-01

    Full Text Available Vestibular migraine (VM is a common disorder in which genetic, epigenetic and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal grey, locus coeruleus and nucleus raphe magnus are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory-inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs and pain. The interactions among several functional and structural neural networks could explain the pathogenic

  3. Epilepsia partialis continua: aetiology, semiology and prognosis in a Spanish adult cohort.

    Science.gov (United States)

    Bejr-Kasem, Helena; Sala-Padró, Jacint; Toledo, Manuel; Santamarina, Estevo; Sarria, Silvana; Gonzalez-Cuevas, Montserrat; Sueiras-Gil, María; Quintana, Manolo; Salas-Puig, Xavier

    2016-12-01

    To describe the semiological features in patients suffering with Epilepsia Partialis Continua (EPC), also referred as Kozhevnikov syndrome and their relationship with aetiology, duration, and prognosis, as well as recurrence during follow-up. We analysed consecutive EPC patients diagnosed and followed in our centre over a seven-and-a half year period. We collected demographic and clinical data, along with neuroimaging and EEG recordings. All patients were followed for more than six months. Patients were categorised with single body area or multiple body area involvement according to the body parts affected. Recurrence was defined as a second EPC episode after one week. We collected data from 27 adult patients; 70.4% were men, the mean age was 65.2 years old (range: 17-89 years), and 40.7% had previous epilepsy. EPC causes were structural in 85.1% (stroke being the most frequent; 44.4%), metabolic in 11.1%, and of unknown origin in 7.4%. A cortical lesion on neuroimaging was shown in 70.4%. Involvement of multiple body areas was reported in 55.6% of patients. The optimal cut-off period to predict death was nine days (with a sensitivity of 62.5% and specificity of 75%; p=0.039), and this group of patients exhibited more multiple body area involvement (88.9% vs 38.9%; p=0.04). During follow-up, patients with cortical lesions had more EPC relapses (p=0.037). The most frequent aetiology of EPC in our patients was stroke. Multiple body area involvement and duration were associated with mortality. Patients with cortical lesions had more EPC relapses during follow-up.

  4. Ictal and postictal semiology in patients with bilateral temporal lobe epilepsy.

    Science.gov (United States)

    Řehulka, Pavel; Doležalová, Irena; Janoušová, Eva; Tomášek, Martin; Marusič, Petr; Brázdil, Milan; Kuba, Robert

    2014-12-01

    Bilateral temporal lobe epilepsy is characterized by evidence of seizure onset independently in both temporal lobes. The main aim of the present study was to determine whether patients with evidence of independent bilateral temporal lobe epilepsy (biTLE) can be identified noninvasively on the basis of seizure semiology analysis. Thirteen patients with biTLE, as defined by invasive EEG, were matched with 13 patients with unilateral temporal lobe epilepsy (uniTLE). In all 26 patients, the frequency of predefined clusters of ictal and periictal signs were evaluated: ictal motor signs (IMSs), periictal motor signs (PIMSs), periictal vegetative signs (PIVSs), the frequency of early oroalimentary automatisms (EOAs), and the duration of postictal unresponsiveness (PU). Some other noninvasive and clinical data were also evaluated. A lower frequency of IMSs was noted in the group with biTLE (patients = 46.2%, seizures = 20.7%) than in the group with uniTLE (patients = 92.3%, seizures = 61.0%) (p = 0.030; p < 0.001, respectively). The individual IMS average per seizure was significantly lower in the group with biTLE (0.14; range = 0-1.0) than in the group with uniTLE (0.80; range = 0-2.6) (p = 0.003). Postictal unresponsiveness was longer than 5 min in more patients (75.0%) and seizures (42.9%) in the group with biTLE than in the group with uniTLE (patients = 30.8%, seizures = 18.6%) (p = 0.047; p = 0.002). The frequency of EOAs, PIMSs, PIVSs, and other clinical data did not differ significantly. There is a lower frequency of ictal motor signs and longer duration of postictal unresponsiveness in patients with biTLE. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Vestibular evaluation in children with otitis media with effusion.

    Science.gov (United States)

    Kolkaila, E A; Emara, A A; Gabr, T A

    2015-04-01

    Fifty per cent of children with serous otitis media may have some balance disturbances. To evaluate vestibular function in children with otitis media with effusion. The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air-bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing. Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group. The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

  6. Exhibition of Stochastic Resonance in Vestibular Perception

    Science.gov (United States)

    Galvan-Garza, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Oman, C. M.; Mulavara, A. P.

    2016-01-01

    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transitions. Post flight sensorimotor changes include spatial disorientation, along with postural and gait instability that may degrade operational capabilities of the astronauts and endanger the crew. A sensorimotor countermeasure that mitigates these effects would improve crewmember safety and decrease risk. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor perception through the phenomenon of stochastic resonance (SR), when the response of a nonlinear system to a weak input signal is enhanced by the application of a particular nonzero level of noise. This study aims to advance the development of SVS as a potential countermeasure by 1) demonstrating the exhibition of stochastic resonance in vestibular perception, a vital component of sensorimotor function, 2) investigating the repeatability of SR exhibition, and 3) determining the relative contribution of the semicircular canals (SCC) and otolith (OTO) organs to vestibular perceptual SR. A constant current stimulator was used to deliver bilateral bipolar SVS via electrodes placed on each of the mastoid processes, as previously done. Vestibular perceptual motion recognition thresholds were measured using a 6-degree of freedom MOOG platform and a 150 trial 3-down/1-up staircase procedure. In the first test session, we measured vestibular perceptual thresholds in upright roll-tilt at 0.2 Hz (SCC+OTO) with SVS ranging from 0-700 µA. In a second test session a week later, we re-measured roll-tilt thresholds with 0, optimal (from test session 1), and 1500 µA SVS levels. A subset of these subjects, plus naive subjects, participated in two additional test sessions in which we measured thresholds in supine roll-rotation at 0.2 Hz (SCC) and upright y-translation at 1 Hz

  7. Functional and anatomic alterations in the gentamicin-damaged vestibular system in the guinea pig

    NARCIS (Netherlands)

    Oei, MLYM; Segenhout, HM; Dijk, T; Stokroos, [No Value; van der Want, TJL; Albers, FWJ

    Hypothesis: The purpose of this study was to investigate the expected functional and morphologic effect of gentamicin on the vestibular system simultaneously by measurement of vestibular evoked potentials and electron microscopic evaluation. Background: Vestibular short-latency evoked potentials to

  8. Clinical vestibular testing assessed with machine-learning algorithms.

    Science.gov (United States)

    Priesol, Adrian J; Cao, Mengfei; Brodley, Carla E; Lewis, Richard F

    2015-04-01

    Dizziness and imbalance are common clinical problems, and accurate diagnosis depends on determining whether damage is localized to the peripheral vestibular system. Vestibular testing guides this determination, but the accuracy of the different tests is not known. To determine how well each element of the vestibular test battery segregates patients with normal peripheral vestibular function from those with unilateral reductions in vestibular function. Retrospective analysis of vestibular test batteries in 8080 patients. Clinical medical records were reviewed for a subset of individuals with the reviewers blinded to the vestibular test data. A group of machine-learning classifiers were trained using vestibular test data from persons who were "manually" labeled as having normal vestibular function or unilateral vestibular damage based on a review of their medical records. The optimal trained classifier was then used to categorize patients whose diagnoses were unknown, allowing us to determine the information content of each element of the vestibular test battery. The information provided by each element of the vestibular test battery to segregate individuals with normal vestibular function from those with unilateral vestibular damage. The time constant calculated from the rotational test ranked first in information content, and measures that were related physiologically to the rotational time constant were 10 of the top 12 highest-ranked variables. The caloric canal paresis ranked eighth, and the other elements of the test battery provided minimal additional information. The sensitivity of the rotational time constant was 77.2%, and the sensitivity of the caloric canal paresis was 59.6%; the specificity of the rotational time constant was 89.0%, and the specificity of the caloric canal paresis was 64.9%. The diagnostic accuracy of the vestibular test battery increased from 72.4% to 93.4% when the data were analyzed with the optimal machine-learning classifier

  9. Understanding the links between vestibular and limbic systems regulating emotions.

    Science.gov (United States)

    Rajagopalan, Archana; Jinu, K V; Sailesh, Kumar Sai; Mishra, Soumya; Reddy, Udaya Kumar; Mukkadan, Joseph Kurien

    2017-01-01

    Vestibular system, which consists of structures in the inner ear and brainstem, plays a vital role is body balance and patient well-being. In recent years, modulating this system by vestibular stimulation techniques are reported to be effective in stress relief and possibly patient's emotional well-being. Emotions refer to an aroused state involving intense feeling, autonomic activation, and related change in behavior, which accompany many of our conscious experiences. The limbic system is primarily involved in the regulation of emotions. Considering the extensive networks between vestibular and limbic system, it is likely that vestibular stimulation techniques may be useful in influencing emotions. Hence, we review here, the possible mechanisms through which vestibular system can influence emotions and highlight the necessary knowledge gaps, which warrants further research to develop vestibular stimulation techniques as a means to treat health conditions associated with emotional disturbances.

  10. Anxiety changes depersonalization and derealization symptoms in vestibular patients.

    Science.gov (United States)

    Kolev, Ognyan I; Georgieva-Zhostova, Spaska O; Berthoz, Alain

    2014-01-01

    Depersonalization and derealization are common symptoms reported in the general population. Objective. The aim of the present study was to establish the relationship between anxiety and depersonalization and derealization symptoms in patients with peripheral vestibular disorders. Twenty-four vestibular patients with anxiety and 18 vestibular patients without anxiety were examined for depersonalization and derealization symptoms. They were also compared to healthy controls. The results revealed that anxiety consistently changes depersonalization and derealization symptoms in vestibular patients. They are more frequent, more severe, and qualitatively different in vestibular patients with anxiety than in those without anxiety. Anxiety has an effect on depersonalization and derealization symptoms in vestibular patients. The various hypotheses about the underlying mechanism of this effect were discussed.

  11. Bionic balance organs: progress in the development of vestibular prostheses.

    Science.gov (United States)

    Smith, Paul F

    2017-09-01

    The vestibular system is a sensory system that is critically important in humans for gaze and image stability as well as postural control. Patients with complete bilateral vestibular loss are severely disabled and experience a poor quality of life. There are very few effective treatment options for patients with no vestibular function. Over the last 10 years, rapid progress has been made in developing artificial 'vestibular implants' or 'prostheses', based on cochlear implant technology. As of 2017, 13 patients worldwide have received vestibular implants and the results are encouraging. Vestibular implants are now becoming part of an increasing effort to develop artificial, bionic sensory systems, and this paper provides a review of the progress in this area.

  12. Evaluation of postural control in unilateral vestibular hypofunction

    Directory of Open Access Journals (Sweden)

    Rafaela Maia Quitschal

    2014-07-01

    Full Text Available INTRODUCTION: Patients with vestibular hypofunction, a typical finding in peripheral vestibular disorders, show body balance alterations. OBJECTIVE: To evaluate the postural control of patients with vertigo and unilateral vestibular hypofunction. METHOD: This is a clinical cross-sectional study. Twenty-five patients with vertigo and unilateral vestibular hypofunction and a homogeneous control group consisting of 32 healthy individuals were submitted to a neurotological evaluation including the Tetrax Interactive Balance System posturography in eight different sensory conditions. RESULTS: For different positions, vertiginous patients with unilateral vestibular hypofunction showed significantly higher values of general stability index, weight distribution index, right/left and tool/heel synchronizations, Fourier transformation index and fall index than controls. CONCLUSION: Increased values in the indices of weight distribution, right/left and tool/heel synchronizations, Fourier transformation and fall risk characterize the impairment of postural control in patients with vertigo and unilateral vestibular hypofunction.

  13. Prediction in the Vestibular Control of Arm Movements.

    Science.gov (United States)

    Blouin, Jean; Bresciani, Jean-Pierre; Guillaud, Etienne; Simoneau, Martin

    2015-01-01

    The contribution of vestibular signals to motor control has been evidenced in postural, locomotor, and oculomotor studies. Here, we review studies showing that vestibular information also contributes to the control of arm movements during whole-body motion. The data reviewed suggest that vestibular information is used by the arm motor system to maintain the initial hand position or the planned hand trajectory unaltered during body motion. This requires integration of vestibular and cervical inputs to determine the trunk motion dynamics. These studies further suggest that the vestibular control of arm movement relies on rapid and efficient vestibulomotor transformations that cannot be considered automatic. We also reviewed evidence suggesting that the vestibular afferents can be used by the brain to predict and counteract body-rotation-induced torques (e.g., Coriolis) acting on the arm when reaching for a target while turning the trunk.

  14. The value of close monitoring in vestibular rehabilitation therapy.

    Science.gov (United States)

    Itani, M; Koaik, Y; Sabri, A

    2017-03-01

    Vestibular rehabilitation therapy is a well-established treatment modality for patients with vestibular problems. Performing vestibular rehabilitation therapy in a closely monitored setting may result in a better outcome than a home exercise programme. A retrospective study was conducted of patients undergoing vestibular rehabilitation therapy between June 2005 and November 2012 in a tertiary university hospital. The Dynamic Gait Index, the main outcome measure, was utilised before and after the rehabilitation programme. The magnitude of improvement for all patients was analysed, mainly to compare the home exercise group with the closely monitored therapy group. Only 32 patients underwent the vestibular rehabilitation therapy programme. In all patients, there was significant improvement in the mean Dynamic Gait Index score (from 11.75 to 17.38; p rehabilitation therapy resulted in improved performance status. More studies are needed to establish the efficiency of vestibular rehabilitation therapy and compare closely monitored therapy with tailored home exercise rehabilitation.

  15. Vestibular Aqueduct Midpoint Width and Hearing Loss in Patients With an Enlarged Vestibular Aqueduct.

    Science.gov (United States)

    Ascha, Mustafa S; Manzoor, Nauman; Gupta, Amit; Semaan, Maroun; Megerian, Cliff; Otteson, Todd D

    2017-06-01

    Elucidating the relationship between vestibular aqueduct size and hearing loss progression may inform the prognosis and counseling of patients who have an enlarged vestibular aqueduct (EVA). To examine the association between vestibular aqueduct size and repeated measures of hearing loss. For this retrospective medical record review, 52 patients with a diagnosis of hearing loss and radiologic diagnosis of EVA according to the Valvassori criterion were included. All available speech reception threshold and word recognition score data was retrieved; mixed-effects models were constructed where vestibular aqueduct size, age at diagnosis of hearing loss, and time since diagnosis of hearing loss were used to predict repeated measures of hearing ability. This study was performed at an academic tertiary care center. Variable vestibular aqueduct size, age at first audiogram, length of time after first audiogram. Speech reception threshold (dB) and word recognition score (%) during routine audiogram. Overall, 52 patients were identified (29 females [56%] and 23 males [44%]; median age at all recorded audiograms, 7.8 years) with a total of 74 ears affected by EVA. Median (range) vestibular aqueduct size was 2.15 (1.5-5.9) mm, and a median (range) of 5 (1-18) tests were available for each patient. Each millimeter increase in vestibular aqueduct size above 1.5 mm was associated with an increase of 17.5 dB in speech reception threshold (95% CI, 7.2 to 27.9 dB) and a decrease of 21% in word recognition score (95% CI, -33.3 to -8.0 dB). For each extra year after a patient's first audiogram, there was an increase of 1.5 dB in speech recognition threshold (95% CI, 0.22 to 3.0 dB) and a decrease of 1.7% in word recognition score (95% CI, -3.08 to -0.22 dB). Hearing loss in patients with an EVA is likely influenced by vestibular aqueduct midpoint width. When considering hearing loss prognosis, vestibular aqueduct midpoint width may be useful for the clinician who counsels patients

  16. Insight into the precuneus: a novel seizure semiology in a child with epilepsy arising from the right posterior precuneus.

    Science.gov (United States)

    Mailo, Janette; Tang-Wai, Richard

    2015-09-01

    To date, there is limited understanding of the role of the precuneus. fMRI studies have suggested its involvement in a wide spectrum of highly integrated tasks, including spatially-guided behaviour, visuo-spatial imagery, and consciousness. We present a patient with intractable parietal lobe epilepsy arising from a lesion localized to the right precuneus. Two seizure types with distinct semiologies were captured on video-EEG monitoring. The first type consisted of an urge described as a "feeling of wanting to move". On video analysis, the patient is seen to turn his head and body to his left. He remains conscious, he is able to answer questions and when asked, he can look to his right. This seizure was associated with an ictal pattern localized to the right parieto-occipital region. The second seizure type consisted of reading-induced visual distortion with macropsia and micropsia. Interictally, intermittent rhythmic slowing and spikes were seen and localized to the parietal midline and the right parieto-occipital regions. Our patient's seizures are positive phenomena of the right precuneus and its related processing network. They represent unique seizure semiologies that offer further insight into the role of the precuneus in spatial awareness, visuo-spatial processing and consciousness.

  17. Induction of psychogenic nonepileptic events: success rate influenced by prior induction exposure, ictal semiology, and psychological profiles.

    Science.gov (United States)

    Chen, David K; Izadyar, Shahram; Collins, Robert L; Benge, Jared F; Lemaire, Ashley W; Hrachovy, Richard A

    2011-06-01

    To evaluate whether certain preinduction clinical characteristics may influence the success rate of induction. We prospectively enrolled and attempted inductions on 51 patients who were suspected to have psychogenic nonepileptic events based on clinical grounds. In addition to careful examination of the reported ictal semiology, we administered a battery of four psychological instruments to our enrolled patients. We found that among 42 cases of successful induction, 92.9% (n=39) of these cases were successfully induced on the first attempt (i.e., without prior induction exposure). We observed that induction showed significantly higher rate of success in cases that demonstrate: (1) hypermotor ictal semiology (p=0.029); (2) more prevalent self-reporting of uncommon cognitive and affective symptoms (p=0.035); or (3) higher tendency to rely on coping strategies of "instrumental support" (p=0.013) and "active coping" (p=0.027), when compared to noninducible cases. Singular administration of placebo induction on preselected patients with these clinical characteristics may reduce costs by shortening video electroencephalography-(EEG) monitoring sessions and improve the diagnostic yield of video-EEG even for patients with very infrequent events. Wiley Periodicals, Inc. © 2011 International League Against Epilepsy.

  18. The thalamocortical vestibular system in animals and humans.

    Science.gov (United States)

    Lopez, Christophe; Blanke, Olaf

    2011-06-24

    The vestibular system provides the brain with sensory signals about three-dimensional head rotations and translations. These signals are important for postural and oculomotor control, as well as for spatial and bodily perception and cognition, and they are subtended by pathways running from the vestibular nuclei to the thalamus, cerebellum and the "vestibular cortex." The present review summarizes current knowledge on the anatomy of the thalamocortical vestibular system and discusses data from electrophysiology and neuroanatomy in animals by comparing them with data from neuroimagery and neurology in humans. Multiple thalamic nuclei are involved in vestibular processing, including the ventroposterior complex, the ventroanterior-ventrolateral complex, the intralaminar nuclei and the posterior nuclear group (medial and lateral geniculate nuclei, pulvinar). These nuclei contain multisensory neurons that process and relay vestibular, proprioceptive and visual signals to the vestibular cortex. In non-human primates, the parieto-insular vestibular cortex (PIVC) has been proposed as the core vestibular region. Yet, vestibular responses have also been recorded in the somatosensory cortex (area 2v, 3av), intraparietal sulcus, posterior parietal cortex (area 7), area MST, frontal cortex, cingulum and hippocampus. We analyze the location of the corresponding regions in humans, and especially the human PIVC, by reviewing neuroimaging and clinical work. The widespread vestibular projections to the multimodal human PIVC, somatosensory cortex, area MST, intraparietal sulcus and hippocampus explain the large influence of vestibular signals on self-motion perception, spatial navigation, internal models of gravity, one's body perception and bodily self-consciousness. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Interactions between Stress and Vestibular Compensation – A Review

    OpenAIRE

    Saman, Yougan; Bamiou, D. E.; Gleeson, Michael; Dutia, Mayank B

    2012-01-01

    Elevated levels of stress and anxiety often accompany vestibular dysfunction, while conversely complaints of dizziness and loss of balance are common in patients with panic and other anxiety disorders. The interactions between stress and vestibular function have been investigated both in animal models and in clinical studies. Evidence from animal studies indicates that vestibular symptoms are effective in activating the stress axis, and that the acute stress response is important in promoting...

  20. The effects of vestibular lesions on hippocampal function in rats.

    Science.gov (United States)

    Smith, Paul F; Horii, Arata; Russell, Noah; Bilkey, David K; Zheng, Yiwen; Liu, Ping; Kerr, D Steve; Darlington, Cynthia L

    2005-04-01

    Interest in interaction between the vestibular system and the hippocampus was stimulated by evidence that peripheral vestibular lesions could impair performance in learning and memory tasks requiring spatial information processing. By the 1990s, electrophysiological data were emerging that the brainstem vestibular nucleus complex (VNC) and the hippocampus were connected polysynaptically and that hippocampal place cells could respond to vestibular stimulation. The aim of this review is to summarise and critically evaluate research published in the last 5 years that has seen major progress in understanding the effects of vestibular damage on the hippocampus. In addition to new behavioural studies demonstrating that animals with vestibular lesions exhibit impairments in spatial memory tasks, electrophysiological studies have confirmed long-latency, polysynaptic pathways between the VNC and the hippocampus. Peripheral vestibular lesions have been shown to cause long-term changes in place cell function, hippocampal EEG activity and even CA1 field potentials in brain slices maintained in vitro. During the same period, neurochemical investigations have shown that some hippocampal subregions exhibit long-term changes in the expression of neuronal nitric oxide synthase, arginase I and II, and the NR1 and NR2A N-methyl-D-aspartate (NMDA) receptor subunits following peripheral vestibular damage. Despite the progress, a number of important issues remain to be resolved, such as the possible contribution of auditory damage associated with vestibular lesions, to the hippocampal effects observed. Furthermore, although these studies demonstrate that damage to the vestibular system does have a long-term impact on the electrophysiological and neurochemical function of the hippocampus, they do not indicate precisely how vestibular information might be used in hippocampal functions such as developing spatial representations of the environment. Understanding this will require detailed

  1. Static Balance in Patients with Vestibular Impairments: A Preliminary Study

    OpenAIRE

    Hossein Talebi; Mohammad Taghi Karimi; Seyed Hamid Reza Abtahi; Niloofar Fereshtenejad

    2016-01-01

    Aims. Vestibular system is indicated as one of the most important sensors responsible for static and dynamic postural control. In this study, we evaluated static balance in patients with unilateral vestibular impairments. Materials and Methods. We compared static balance control using Kistler force plate platform between 10 patients with unilateral vestibular impairments and 20 normal counterparts in the same sex ratio and age limits (50 ? 7). We evaluated excursion and velocity of center of ...

  2. Anxiety Changes Depersonalization and Derealization Symptoms in Vestibular Patients

    OpenAIRE

    Kolev, Ognyan I.; Georgieva-Zhostova, Spaska O.; Alain Berthoz

    2014-01-01

    Background. Depersonalization and derealization are common symptoms reported in the general population. Objective. The aim of the present study was to establish the relationship between anxiety and depersonalization and derealization symptoms in patients with peripheral vestibular disorders. Methods. Twenty-four vestibular patients with anxiety and 18 vestibular patients without anxiety were examined for depersonalization and derealization symptoms. They were also compared to healthy controls...

  3. Responses evoked by a vestibular implant providing chronic stimulation

    OpenAIRE

    Thompson L.A.; Haburcakova C.; Gong W; Lee D.J.; Wall Iii C.; Merfeld D.M.; Lewis R.F.

    2012-01-01

    Patients with bilateral vestibular loss experience dehabilitating visual, perceptual, and postural difficulties, and an implantable vestibular prosthesis that could improve these symptoms would be of great benefit to these patients. In previous work, we have shown that a one-dimensional, unilateral canal prosthesis can improve the vestibulooccular reflex (VOR) in canal-plugged squirrel monkeys. In addition to the VOR, the potential effects of a vestibular prosthesis on more complex, highly in...

  4. The Moving History of Vestibular Stimulation as a Therapeutic Intervention

    OpenAIRE

    Grabherr, Luzia; Lenggenhager, Bigna; Macauda, Gianluca

    2015-01-01

    Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox’s chair or Hallaran’s swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recogni...

  5. Vestibular stimulation: A simple but effective intervention in diabetes care

    OpenAIRE

    Sailesh, Kumar Sai; Archana, R.; Mukkadan, J. K.

    2015-01-01

    Despite the complexities of the relationship between vestibular stimulation and endocrine disorders being well known, research efforts to understand these complexities are lacking. Interestingly vestibular stimulation may potentially prevent/delay development/progression of diabetes. Here we review the science behind this concept and highlight the need for necessary translational research in this area. Current evidence supports the use of vestibular stimulation not only as a potential interve...

  6. Internal models and neural computation in the vestibular system

    OpenAIRE

    Green, Andrea M.; Dora E. Angelaki

    2010-01-01

    The vestibular system is vital for motor control and spatial self-motion perception. Afferents from the otolith organs and the semicircular canals converge with optokinetic, somatosensory and motor-related signals in the vestibular nuclei, which are reciprocally interconnected with the vestibulocerebellar cortex and deep cerebellar nuclei. Here, we review the properties of the many cell types in the vestibular nuclei, as well as some fundamental computations implemented within this brainstem–...

  7. Virtual vestibular re-education. A new technology.

    Science.gov (United States)

    Boniver, R

    2006-01-01

    This paper will provide an introduction to the use of virtual environments for vestibular re-education. The author illustrates some of the ways in which researchers are using virtual reality to improve therapy for vertigo. Users of virtual reality must make adaptations to avoid mismatches between perception due to virtual reality and that due to vestibular and proprioceptive subsystems. Virtual reality may be an interesting new way of studying vestibular compensation in normal and pathological conditions.

  8. The vestibular system: balancing more than just the body.

    Science.gov (United States)

    Lopez, Christophe

    2016-02-01

    The review presents a selection of recent studies in the field of vestibular neuroscience, including how vestibular stimulation modulates space and body perception. Recent neuroimaging studies identified the operculo-insular/retroinsular cortex as the core vestibular cortex and showed how it is reorganized after vestibular dysfunctions. Subliminal galvanic vestibular stimulation (GVS) induces long-term reduction of hemispatial neglect and improves vertical perception in stroke patients, but the underlying mechanisms remain to be identified. Healthy volunteer research suggests that GVS and caloric vestibular stimulation (CVS) modulate visual and somatosensory processing and that beneficial effects of GVS/CVS in stroke patients are not limited to merely rebalancing brain hemispheric activity. Another mechanism would be that GVS/CVS anchors the self to the body, thus promoting an egocentric frame of reference. In addition to 'balancing the body', the vestibular cortical network contributes to modulate space, body and self-awareness. Emerging evidence suggests that the vestibular network expands into dimensions of emotion processing, mental health, and social cognition. Here, the importance of connecting vestibular physiology, affective neuroscience, and social neuroscience to better understand the psychological aspects of vertigo in otoneurology is discussed.

  9. Task, muscle and frequency dependent vestibular control of posture

    Directory of Open Access Journals (Sweden)

    Patrick A Forbes

    2015-01-01

    Full Text Available The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular information is relevant to postural control, while in neck muscles they are maintained regardless of the requirement to maintain head on trunk balance. Recent investigations have also shown that the bandwidth of vestibular input on neck muscles is much broader than appendicular muscles (up to a factor of 3. This result challenges the notion that vestibular reflexes only contribute to postural control across the behavioral and physiological frequency range of the vestibular organ (i.e., 0-20 Hz. In this review, we explore and integrate these task-, muscle- and frequency-related differences in the vestibular system’s contribution to posture, and propose that the human nervous system has adapted vestibular signals to match the mechanical properties of the system that each group of muscles controls.

  10. Task, muscle and frequency dependent vestibular control of posture.

    Science.gov (United States)

    Forbes, Patrick A; Siegmund, Gunter P; Schouten, Alfred C; Blouin, Jean-Sébastien

    2014-01-01

    The vestibular system is crucial for postural control; however there are considerable differences in the task dependence and frequency response of vestibular reflexes in appendicular and axial muscles. For example, vestibular reflexes are only evoked in appendicular muscles when vestibular information is relevant to postural control, while in neck muscles they are maintained regardless of the requirement to maintain head on trunk balance. Recent investigations have also shown that the bandwidth of vestibular input on neck muscles is much broader than appendicular muscles (up to a factor of 3). This result challenges the notion that vestibular reflexes only contribute to postural control across the behavioral and physiological frequency range of the vestibular organ (i.e., 0-20 Hz). In this review, we explore and integrate these task-, muscle- and frequency-related differences in the vestibular system's contribution to posture, and propose that the human nervous system has adapted vestibular signals to match the mechanical properties of the system that each group of muscles controls.

  11. The History and Evolution of Surgery on the Vestibular Labyrinth.

    Science.gov (United States)

    Naples, James G; Eisen, Marc D

    2016-11-01

    The history of surgery on the vestibular labyrinth is rich but sparsely documented in the literature. The story begins over a century ago with the labyrinthectomy in an era that consisted exclusively of ablative surgery for infection or vertigo. Improved understanding of vestibular physiology and pathology produced an era of selective ablation and hearing preservation that includes semicircular canal occlusion for benign paroxysmal positional vertigo. An era of restoration began with a discovery of superior semicircular canal dehiscence and its repair. The final era of vestibular replacement is upon us as the possibility of successful prosthetic vestibular implantation becomes reality. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  12. K+ Currents in Isolated Vestibular Afferent Calyx Terminals

    National Research Council Canada - National Science Library

    Dhawan, Ritu; Mann, Scott E; Meredith, Frances L; Rennie, Katherine J

    2010-01-01

    Vestibular hair cells transduce mechanical displacements of their hair bundles into an electrical receptor potential which modulates transmitter release and subsequent action potential firing in afferent neurons...

  13. Bedside examination for vestibular screening in occupational medicine

    Directory of Open Access Journals (Sweden)

    Ewa Zamysłowska-Szmytke

    2015-04-01

    Full Text Available Objectives: The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG oculomotor tests (central group and 43 subjects with normal VNG. Material and Methods: Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT, Dynamic Visual Acuity (DVA and gaze nystagmus assessment. Results: Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73% had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. Conclusions: The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes.

  14. Bedside examination for vestibular screening in occupational medicine.

    Science.gov (United States)

    Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola

    2015-01-01

    The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG) oculomotor tests (central group) and 43 subjects with normal VNG. Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT), Dynamic Visual Acuity (DVA) and gaze nystagmus assessment. Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73%) had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  15. Periosteal Pedicle Flap Harvested during Vestibular Extension for Root Coverage

    Directory of Open Access Journals (Sweden)

    Shubham Kumar

    2015-01-01

    Full Text Available Root exposure along with inadequate vestibular depth is a common clinical finding. Treatment option includes many techniques to treat such defects for obtaining predictable root coverage. Normally, the vestibular depth is increased first followed by a second surgery for root coverage. The present case report describes a single-stage technique for vestibular extension and root coverage in a single tooth by using the Periosteal Pedicle Flap (PPF. This technique involves no donor site morbidity and allows for reflection of sufficient amount of periosteal flap tissue with its own blood supply at the surgical site, thus increasing the chances of success of root coverage with simultaneous increase in vestibular depth.

  16. Gentamicin perfusion vestibular response and hearing loss.

    Science.gov (United States)

    Light, Joshua P; Silverstein, Herbert; Jackson, Lance E

    2003-03-01

    To compare hearing results as a function of vestibular ablation in the treatment of Ménière's Disease, using gentamicin perfusion. A retrospective review of patients with Ménière's Disease treated by gentamicin perfusion of the inner ear via the MicroWick device. A tertiary otologic referral center. The charts of patients treated with gentamicin perfusion via the MicroWick between the years 1998 and 2000 were reviewed. The results for patients with functional hearing in the affected ear were analyzed and were compared with the results in patients without functional hearing. Audiologic and vestibular test results as well as subjective symptoms. There were 45 patients who met the inclusion criteria. The averages for speech discrimination score and pure tone average before treatment were 92% and 38 dB, and after treatment were 82% and 47 dB. Patients were divided into two groups: Group 1 (20 patients), less than 75% ice air caloric reduced vestibular response (RVR); Group 2 (25 patients), those who reached greater than 75% ice air caloric RVR. There were 8 patients (17.6%) with persistent vertigo; 7 were from Group 1, and 1 was from Group 2, which was statistically significant (p = 0.007)wwww. The pure tone average dropped an average of 3 dB for Group 1 and 15 dB for Group 2. The difference in hearing loss between the two groups was statistically significant (p = 0.01). This study suggests that there is a correlation between the degree of vestibular ablation, the control of vertigo, and the risk of hearing loss. Patients with functional hearing seem to have a similar success rate for vertigo control, compared with patients who already had lost functional hearing before treatment. Future investigation may determine if less than 100% RVR, but greater than 75% RVR, is an alternative end point with adequate vertigo control and reduced risk of hearing loss.

  17. Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction

    Science.gov (United States)

    Bayat, Arash; Saki, Nader

    2017-01-01

    Introduction: Although vestibular rehabilitation therapy (VRT) methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH). Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH. Materials and Methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. The dizziness handicap inventory (DHI) was performed immediately before, and 2 and 8 weeks after treatment. Results: All patients showed a reduction in DHI scores during the study. The average decrease in DHI score was 25.98 points after 2 weeks’ intervention (P0.05). There were no relationships between the scores and gender. Conclusion: Our study demonstrates that VRT is an effective method for the management of elderly patients with UVH, and shows maximal effect on functional aspects. PMID:28819615

  18. Seizure semiology reflects spread from frontal to temporal lobe: evolution of hyperkinetic to automotor seizures as documented by invasive EEG video recordings.

    Science.gov (United States)

    Tezer, Fadime Irsel; Agan, Kadriye; Borggraefe, Ingo; Noachtar, Soheyl

    2013-09-01

    This patient report demonstrates the importance of seizure evolution in the localising value of seizure semiology. Spread of epileptic activity from frontal to temporal lobe, as demonstrated by invasive recordings, was reflected by change from hyperkinetic movements to arrest of activity with mild oral and manual automatisms. [Published with video sequences].

  19. Vestibular schwannoma: an unusual post radiotherapy response.

    Science.gov (United States)

    Uddin, Najam; Iqbal, Muhammad; Memon, Muhammad Ali; Farrukh, Salman

    2014-11-01

    Vestibular schwannoma is a relatively uncommon tumor. Although, it is benign but locally expansile and spreads to damage the adjacent structures. Treatment strategy includes surgery, Stereotactic Radiosurgery (SRS) either by standard or hypofractionated protocols. Due to its benign nature, radiation therapy cannot remove the tumor completely, instead radiation therapy halts the growth of vestibular schwannoma and inactivates this benign tumor. Response of radiation in the form of tumor shrinkage is seen 2 - 2.5 years after the radiations. We report a case of vestibular Schwannoma in which residual tumor of 3.1 cm size following subtotal resection was irradiated of the dose of 54 Gy in 30 equal fractions on 3-Dimensional Conformal Radiation Therapy (3-DCRT). A follow-up CT scan brain after 2 months of radiotherapy showed complete disappearance of the disease categorized as complete response. This is an unusual phenomenon and is likely due to the very rarely seen malignant transformation or presence of malignant component in this benign tumor.

  20. Non surgical treatment of vestibular schwannoma.

    Science.gov (United States)

    Arribas, Leoncio; Chust, María L; Menéndez, Antonio; Arana, Estanislao; Vendrell, Juan B; Crispín, Vicente; Pesudo, Carmen; Mengual, José L; Mut, Alejandro; Arribas, Mar; Guinot, José L

    2015-01-01

    To evaluate the results of local control and complications in the treatment of vestibular schwannoma treated with radiation. A retrospective study of 194 patients diagnosed with vestibular schwannoma, treated consecutively with radiation (either stereotactic radiosurgery or fractionated radiotherapy) from 1997 to 2012. We analyze the local control of tumors, as well as secondary complications to treatment with radiation. A total of 132 (68%) tumors 68% are grade I-II tumors of the Koos classification, 40 (19%) are grade III, and 22 (13%) are grade IV. The tumors associated with neurofibromatosis (NF2), are 3.6% (6 tumors in 4 patients). The tumor control for the overall serie is 97% at 5 years, with a median follow-up of 80.4 months. For large tumors the local control is 91% at 5 years. Free survival of chronic complications is 89% at 5 years. Additionally, 50 tumors were subjected to regular follow-up with MRI without treatment, and 28 (58%) did not experienced tumor growth. Radiation and follow up with MRI, are an alternative to surgery in the treatment of vestibular schwannoma, with a low level of complications inside of multidisciplinary approach. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  1. Molecular studies of vestibular schwannomas: a review.

    Science.gov (United States)

    Welling, D Bradley; Packer, Mark D; Chang, Long-Sheng

    2007-10-01

    To summarize advances in understanding the molecular biology of vestibular schwannomas over the past year. The role of the neurofibromatosis type 2 protein, denoted as merlin or schwannomin, in embryonic development, cellular adherence, and in cell proliferation has become better elucidated in the past year. Likewise, the role of merlin in Schwann cell-axon interaction has been studied. Additionally, two comprehensive analyses of the spectrum of human neurofibromatosis type 2 mutations have been compiled which make up a valuable resource in understanding critical regions of the neurofibromatosis type 2 gene. Neurofibromatosis type 2 screening guidelines for young patients with solitary vestibular schwannomas have been published. The role of electromagnetic radiation via cellular and portable telephones as a predisposing factor to vestibular schwannoma formation has also been the topic of several studies. Based on increased knowledge of the pathways in which merlin functions and the available transgenic and xenograft mouse models, preliminary data regarding directed pharmacotherapy are also summarized. With increased knowledge of the pathologic mechanisms and interacting proteins associated with merlin, the research community is poised to begin trials of targeted interventions in vitro and in the current mouse models.

  2. [Emergency diagnosis of the acute vestibular syndrome].

    Science.gov (United States)

    Tamás, T László; Garai, Tibor; Király, István; Mike, Andrea; Nagy, Csaba; Paukovics, Ágnes; Schmidt, Péter; Szatmári, Ferenc; Tompos, Tamás; Vadvári, Árpád; Szirmai, Ágnes

    2017-12-01

    To diagnose acute vestibular syndrome (AVS) in a prospective study by a new bedside test (providing 1A evidence) based on oculomotor analysis and assessment of hearing loss. To assess the frequency of central and peripheral causes of acute vestibular syndrome in the emergency room. To establish the diagnostic accuracy of acute cranial computed tomography as compared to oculomotor analysis done by video oculography goggles and audiometry. Between 1st March 2016 and 1st March 2017 we documented 125 patients (62 women, 63 men, average age 53 years) in the emergency room of the Petz Aladár County Teaching Hospital using the above bedside and instrumental testing. Diagnosis was verified by cranial magnetic resonance imaging. According to the results of the instrumental examination in AVS in 67% we found a peripheral cause and in 33% a central pathology. In 62% isolated posterior circulation stroke manifested itself by isolated vertigo without additional focal signs and the acute cranial computed tomography showed negative results in 96%. The instrumental examination increased diagnostic accuracy by making the diagnosis of isolated inferior semicircular canal vestibular neuritis possible. The new bedside oculomotor test is suitable for the diagnosis of posterior circulation stroke manifesting with isolated vertigo in early cases, when the routine neuroradiologic methods have a lower sensitivity or are not available. Orv Hetil. 2017; 158(51): 2029-2040.

  3. Laboratory testing of the vestibular system.

    Science.gov (United States)

    Clarke, Andrew H

    2010-10-01

    Recent reports on vestibular testing, relevant to clinical diagnosis, are reviewed.Besides the case history and bedside examination, objective measurement of the vestibuloocular reflex in all of its facets remains the cornerstone in the diagnostic process. In recent years, this has been enhanced considerably by reliable unilateral tests for the otolith organs, most notably by vestibular-evoked myogenic potential recording and estimation of subjective visual vertical. In addition, progress has been made in the investigation of multisensory interaction, involving visual acuity and posturography.Technological developments include improved eye movement measurement techniques, electrotactile and vibrotactile sensory enhancement or substitution, the use of virtual reality devices and motion stimulators such as hexapods and the rediscovery of galvanic vestibular stimulation as a research and diagnostic tool. The recent introduction of new tests, together with the development of novel technologies, is gradually increasing the scope of the physical and bedside examination of the dizzy patient (see chapter 'Medical management of peripheral disorders' in this issue). The use of more complex equipment, such as rotating chairs, linear sleds, hexapods and posturography platforms, is likely to become limited to specialized laboratories and rehabilitation centers in future years. Further, high resolution magnetic resonance tomography (MRT) and computed tomography have allowed insight into the morphology and determination of malformations of the human labyrinth.

  4. RECORRIDO DE LA TEORÍA FREUDIANA SOBRE LA HISTERIA EN LA PSIQUIATRÍA NORTEAMERICANA // OVERVIEW OF FREUD'S THEORY OF HYSTERIA IN AMERICAN PSYCHIATRY

    Directory of Open Access Journals (Sweden)

    Miguel Enrique Carvajal Vallejo

    2013-06-01

    Full Text Available Se presenta un recorrido epistémico por losartículos publicados en la revista AmericanJournal of Psychiatry (AJP —órgano de laAmerican Psychiatric Association (APA,institución que además de agrupar a la mayoríade psiquiatras norteamericanos, es la creadora delos manuales DSM (Diagnostic and StatisticalManual of Mental Disorders—, en los cuales, alocuparse de la histeria, puede observarse surecurso a conceptos freudianos referentes alsíntoma histérico. La revisión es iniciada en 1890y finalizada en el año 1980, cuando la publicacióndel DSM-III, evacúa toda teoría etiológica sobre elpadecimiento histérico, renunciando por tanto a lateoría psicoanalítica sobre la histeria, obteniendofinalmente una fragmentación de ella, a lo largo dedicho manual, en múltiples trastornos que sepresentan en ausencia de lesión orgánica.Algunas consecuencias para la psiquiatría, elpsicoanálisis y el paciente ―histérico‖ sonobservadas. El artículo es el resultado de lainvestigación ―Recorrido epistemológico de lateoría freudiana sobre la Histeria en la psiquiatríanorteamericana‖, realizado dentro de la «Maestríaen Investigación Psicoanalítica», de laUniversidad de Antioquia (Medellín, Colombia // An epistemic overview of the papers published inthe American Journal of Psychiatry (AJP is herepresented. The AJP is an organ of the AmericanPsychiatric Association (APA, an institution thatgroups most of the American psychiatrists and thatis also the creator of the DSM (Diagnostic andStatistical Manual of Mental Disorders. In thesepapers, when considering hysteria, the appeal toFreudian concepts concerning the hystericalsymptom can be observed. The review begins in1890 and ends in 1980, when the publication ofDSM-III evacuates every aetiological theory aboutthe hysterical condition, refusing thepsychoanalytic theory of hysteria, gettingthroughout such manual a fragmentation of thephenomenon in multiple disorders that occur in

  5. Otolith-Canal Convergence in Vestibular Nuclei Neurons

    Science.gov (United States)

    Dickman, J. David

    1996-01-01

    During manned spaceflight, acute vestibular disturbances often occur, leading to physical duress and a loss of performance. Vestibular adaptation to the weightless environment follows within two to three days yet the mechanisms responsible for the disturbance and subsequent adaptation are still unknown In order to understand vestibular system function in space and normal earth conditions the basic physiological mechanisms of vestibular information co coding must be determined. Information processing regarding head movement and head position with respect to gravity takes place in the vestibular nuclei neurons that receive signals From the semicircular canals and otolith organs in the vestibular labyrinth. These neurons must synthesize the information into a coded output signal that provides for the head and eye movement reflexes as well as the conscious perception of the body in three-dimensional space The current investigation will for the first time. determine how the vestibular nuclei neurons quantitatively synthesize afferent information from the different linear and angular acceleration receptors in the vestibular labyrinths into an integrated output signal. During the second year of funding, progress on the current project has been focused on the anatomical orientation of semicircular canals and the spatial orientation of the innervating afferent responses. This information is necessary in order to understand how vestibular nuclei neurons process the incoming afferent spatial signals particularly with the convergent otolith afferent signals that are also spatially distributed Since information from the vestibular nuclei is presented to different brain regions associated with differing reflexive and sensory functions it is important to understand the computational mechanisms used by vestibular neurons to produce the appropriate output signal.

  6. The Modulation of Hippocampal Theta Rhythm by the Vestibular System.

    Science.gov (United States)

    Aitken, Phillip; Zheng, Yiwen; Smith, Paul F

    2017-11-22

    The vestibular system is a sensory system that has evolved over millions of years to detect acceleration of the head, both rotational and translational, in three dimensions. One of its most important functions is to stabilize gaze during unexpected head movement; however, it is also important in the control of posture and autonomic reflexes. Theta rhythm is a 3-12 Hz oscillating EEG signal that is intimately linked to self-motion and is also known to be important in learning and memory. Many studies over the last two decades have shown that selective activation of the vestibular system, either using natural rotational or translational stimulation, or electrical stimulation of the peripheral vestibular system, can induce and modulate theta activity. Furthermore, inactivation of the vestibular system has been shown to significantly reduce theta in freely moving animals, which may be linked to its impairment of place cell function as well as spatial learning and memory. The pathways through which vestibular information modulate theta rhythm remain debatable. However, vestibular responses have been found in the pedunculopontine tegmental nucleus (PPTg) and activation of the vestibular system causes an increase in acetylcholine release into the hippocampus, probably from the medial septum. Therefore, a pathway from the vestibular nucleus complex and/or cerebellum to the PPTg, supramammillary nucleus, posterior hypothalamic nucleus and the septum, to the hippocampus, is likely. The modulation of theta by the vestibular system may have implications for vestibular effects on cognitive function and the contribution of vestibular impairment to the risk of dementia. Copyright © 2017, Journal of Neurophysiology.

  7. Differential central projections of vestibular afferents in pigeons

    Science.gov (United States)

    Dickman, J. D.; Fang, Q.

    1996-01-01

    The question of whether a differential distribution of vestibular afferent information to central nuclear neurons is present in pigeons was studied using neural tracer compounds. Discrete tracing of afferent fibers innervating the individual semicircular canal and otolith organs was produced by sectioning individual branches of the vestibular nerve that innervate the different receptor organs and applying crystals of horseradish peroxidase, or a horseradish peroxidase/cholera toxin mixture, or a biocytin compound for neuronal uptake and transport. Afferent fibers and their terminal distributions within the brainstem and cerebellum were visualized subsequently. Discrete areas in the pigeon central nervous system that receive primary vestibular input include the superior, dorsal lateral, ventral lateral, medial, descending, and tangential vestibular nuclei; the A and B groups; the intermediate, medial, and lateral cerebellar nuclei; and the nodulus, the uvula, and the paraflocculus. Generally, the vertical canal afferents projected heavily to medial regions in the superior and descending vestibular nuclei as well as the A group. Vertical canal projections to the medial and lateral vestibular nuclei were observed but were less prominent. Horizontal canal projections to the superior and descending vestibular nuclei were much more centrally located than those of the vertical canals. A more substantial projection to the medial and lateral vestibular nuclei was seen with horizontal canal afferents compared to vertical canal fibers. Afferents innervating the utricle and saccule terminated generally in the lateral regions of all vestibular nuclei in areas that were separate from the projections of the semicircular canals. In addition, utricular fibers projected to regions in the vestibular nuclei that overlapped with the horizontal semicircular canal terminal fields, whereas saccular afferents projected to regions that received vertical canal fiber terminations. Lagenar

  8. Vestibular Deficits in Neurodegenerative Disorders: Balance, Dizziness, and Spatial Disorientation.

    Science.gov (United States)

    Cronin, Thomas; Arshad, Qadeer; Seemungal, Barry M

    2017-01-01

    The vestibular system consists of the peripheral vestibular organs in the inner ear and the associated extensive central nervous system projections-from the cerebellum and brainstem to the thalamic relays to cortical projections. This system is important for spatial orientation and balance, both of critical ecological importance, particularly for successful navigation in our environment. Balance disorders and spatial disorientation are common presenting features of neurodegenerative diseases; however, little is known regarding central vestibular processing in these diseases. A ubiquitous aspect of central vestibular processing is its promiscuity given that vestibular signals are commonly found in combination with other sensory signals. This review discusses how impaired central processing of vestibular signals-typically in combination with other sensory and motor systems-may account for the impaired balance and spatial disorientation in common neurodegenerative conditions. Such an understanding may provide for new diagnostic tests, potentially useful in detecting early disease while a mechanistic understanding of imbalance and spatial disorientation in these patients may enable a vestibular-targeted therapy for such problems in neurodegenerative diseases. Studies with state of the art central vestibular testing are now much needed to tackle this important topic.

  9. Vestibular Deficits in Neurodegenerative Disorders: Balance, Dizziness, and Spatial Disorientation

    Directory of Open Access Journals (Sweden)

    Thomas Cronin

    2017-10-01

    Full Text Available The vestibular system consists of the peripheral vestibular organs in the inner ear and the associated extensive central nervous system projections—from the cerebellum and brainstem to the thalamic relays to cortical projections. This system is important for spatial orientation and balance, both of critical ecological importance, particularly for successful navigation in our environment. Balance disorders and spatial disorientation are common presenting features of neurodegenerative diseases; however, little is known regarding central vestibular processing in these diseases. A ubiquitous aspect of central vestibular processing is its promiscuity given that vestibular signals are commonly found in combination with other sensory signals. This review discusses how impaired central processing of vestibular signals—typically in combination with other sensory and motor systems—may account for the impaired balance and spatial disorientation in common neurodegenerative conditions. Such an understanding may provide for new diagnostic tests, potentially useful in detecting early disease while a mechanistic understanding of imbalance and spatial disorientation in these patients may enable a vestibular-targeted therapy for such problems in neurodegenerative diseases. Studies with state of the art central vestibular testing are now much needed to tackle this important topic.

  10. Making Sense of the Body: the Role of Vestibular Signals.

    Science.gov (United States)

    Lopez, Christophe

    2015-01-01

    The role of the vestibular system in posture and eye movement control has been extensively described. By contrast, how vestibular signals contribute to bodily perceptions is a more recent research area in the field of cognitive neuroscience. In the present review article, I will summarize recent findings showing that vestibular signals play a crucial role in making sense of the body. First, data will be presented showing that vestibular signals contribute to bodily perceptions ranging from low-level bodily perceptions, such as touch, pain, and the processing of the body's metric properties, to higher level bodily perceptions, such as the sense of owning a body, the sense of being located within this body (embodiment), and the anchoring of the visuo-spatial perspective to this body. In the second part of the review article, I will show that vestibular information seems to be crucially involved in the visual perception of biological motion and in the visual perception of human body structure. Reciprocally, observing human bodies in motion influences vestibular self-motion perception, presumably due to sensorimotor resonance between the self and others. I will argue that recent advances in the mapping of the human vestibular cortex afford neuroscientific models of the vestibular contributions to human bodily self-consciousness.

  11. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko

    2010-01-01

    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  12. Evaluation and treatment of vestibular dysfunction in children.

    Science.gov (United States)

    Rine, Rose Marie; Wiener-Vacher, Sylvette

    2013-01-01

    The effect of vestibular dysfunction since birth is more debilitating than that attained later in life, and unlike adults, children with vestibular dysfunction since or shortly after birth do not recover function without intervention. The purpose of this report is to provide an overview of the etiology of vestibular dysfunction in children as well as the related impairments, and to describe testing methods and evidence based interventions to ameliorate the vestibular related impairments in children. In recent years, investigations have revealed that vestibular dysfunction is more common in children than previously thought, with consequent impairments in motor development, balance and reading abilities. The dysfunction may be due to central or peripheral lesions, each with distinct presentation of symptoms and test results. Common etiologies and clinical presentation of vestibular dysfunction in children are reviewed; appropriate screening and diagnostic techniques and efficacious medical and rehabilitation interventions are presented. Despite advances in clinical and diagnostic testing of vestibular function in children and infants, testing of vestibular function is not typically done. Comprehensive testing of signs and symptoms is critical for diagnosis and implementation of appropriate interventions.

  13. Recent Evidence About the Effectiveness of Vestibular Rehabilitation.

    Science.gov (United States)

    Whitney, Susan L; Alghadir, Ahmad H; Anwer, Shahnawaz

    2016-03-01

    Vestibular rehabilitation of persons with peripheral and central vestibular disorders requires a thorough evaluation and a customized plan of care. Collaboration of the various members of the treatment team optimizes outcomes. Early intervention appears to be better than referring patients who have developed chronic symptoms of balance loss, dizziness, anxiety, and depression. There is a body of emerging evidence that supports that the central nervous system has the capability to reweigh sensory inputs in order to improve function. There continues to be a dearth of knowledge related to how to treat persons with otolithic dysfunction as compared to those with semicircular canal damage. With the use of vestibular rehabilitation, patients are less likely to fall, are less dizzy, balance and gait improve, and quality of life is enhanced. Recent Cochrane reviews and a clinical practice guideline support the use of vestibular rehabilitation for persons with vestibular dysfunction. Typical symptoms and their management including dysregulated gait, falling, fear of falling, increased sway in standing, visual blurring, symptoms with complex visual scenes in the periphery, and weakness are all discussed with ideas for intervention. Any patient with a vestibular disorder may benefit from a trial of vestibular rehabilitation. A discussion of recent evidence and innovations related to vestibular rehabilitation is also included.

  14. Paediatric Acquired Recto –Vestibular Fistula: Experience In Accra ...

    African Journals Online (AJOL)

    The association of acquired recto-vaginal fistula (RVF) with the human immunodeficiency virus is increasingly being recognized and reported in the literature Congenital recto - vestibular fistulae associated with imperforate anus is not uncommon, but it is rare to see children with acquired recto - vestibular fistula. From 1997 ...

  15. Connections of the vestibular nuclei in the rabbit

    NARCIS (Netherlands)

    A.H. Epema

    1990-01-01

    textabstractThis thesis descnbes the afferent, efferent and intrinsic connections of the vestibular nuclei in the Dutch belted rabbit. Different anatomical tracing techniques were used to study these projections. A description of the vestibular complex was added, since recent data for the rabbit

  16. Vestibular vertigo in emergency neurology and cervical osteochondrosis

    Directory of Open Access Journals (Sweden)

    T S Barykova

    2010-01-01

    had acute peripheral vestibular pathology that required cerebral stroke or hemorrhage to be ruled out according to clinical data in most cases. Intermittent, recurrent, short-term vestibular crisis in the examined group of patients is temporarily or clinically unrelated to an exacerbation of cervical osteochondrosis.

  17. Molecular mechanisms of vestibular compensation in the central vestibular system--review.

    Science.gov (United States)

    Kitahara, T; Takeda, N; Kiyama, H; Kubo, T

    1998-01-01

    Vestibular compensation consists of two stages: the inhibition of the contralesional medial vestibular nucleus (contra-MVe) activities at the acute stage after unilateral labyrinthectomy (UL) and the recovery and maintenance of the ipsilesional MVe (ipsi-MVe) spontaneous activities at the chronic stage after UL. In this paper, we reviewed molecular mechanisms of vestibular compensation in the central vestibular system using several morphological and pharmacological approaches in rats. Based on our examinations, we propose the following hypotheses: i) at the acute stage after UL, the activated neurons in the ipsi-MVe project their axons into the flocculus to inhibit the contra-MVe neurons via the NMDA receptor, nitric oxide (NO) and/or GABA-mediated signalling, resulting in the restoration of balance between intervestibular nuclear activities. ii) At the chronic stage after UL, the flocculus depresses the inhibitory effects on the ipsi-MVe neurons via protein phosphatase 2A (PP2A) beta, protein kinase C (PKC) and glutamate receptor (GluR) delta-2, to help the recovery and maintenance of ipsi-MVe activities.

  18. Postoperative management of nasal vestibular stenosis - The custom-made vestibular device

    NARCIS (Netherlands)

    Menger, Dirk-Jan; Lohuis, Peter J. F. M.; Kerssemakers, Steven; Nolst Trenité, Gilbert J.

    2005-01-01

    Objective: To evaluate the effect of a custom-made postoperative vestibular device on the occurrence and severity), of restenosis. Design: This was a retrospective study conducted at the Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery of

  19.  A Novel V- Silicone Vestibular Stent: Preventing Vestibular Stenosis andPreserving Nasal Valves

    Directory of Open Access Journals (Sweden)

    Rashid Al Abri

    2012-01-01

    Full Text Available  This report presents a novel style of placing nasal stents. Patientsundergoing surgical procedures in the region of nasal vestibuleand nasal valves are at risk of developing vestibular stenosis andlifelong problems with the external and internal nasal valves;sequels of the repair. The objective of the report is to demonstratea simple and successful method of an inverted V- Stent placementto prevent potential complication of vestibular stenosis and nasalvalve compromise later in life. Following a fall on a sharp edge ofa metallic bed, a sixteen month old child with a deep laceratednasal wound extending from the collumellar base toward thetip of the nose underwent surgical exploration and repair of thenasal vestibule and nasal cavity. A soft silicone stent fashioned asinverted V was placed bilaterally. The child made a remarkablerecovery with no evidence of vestibular stenosis or nasal valveabnormalities. In patients with nasal trauma involving the nasalvestibule and internal and external nasal valves stent placementavoids sequels, adhesions, contractures, synechia vestibularstenosis and fibrosis involving these anatomical structures.The advantages of the described V- stents over the traditionalreadymade ridged nasal stents, tubing’s and composite aural graftsare: a technical simplicity of use, b safety, c less morbidity, dmore comfortable, and e economical. To our knowledge, this isthe first report of such a stent for prevention of vestibular stenosisand preserving nasal valves.

  20. Regeneration of hair cells in the mammalian vestibular system.

    Science.gov (United States)

    Li, Wenyan; You, Dan; Chen, Yan; Chai, Renjie; Li, Huawei

    2016-06-01

    Hair cells regenerate throughout the lifetime of non-mammalian vertebrates, allowing these animals to recover from hearing and balance deficits. Such regeneration does not occur efficiently in humans and other mammals. Thus, balance deficits become permanent and is a common sensory disorder all over the world. Since Forge and Warchol discovered the limited spontaneous regeneration of vestibular hair cells after gentamicininduced damage in mature mammals, significant efforts have been exerted to trace the origin of the limited vestibular regeneration in mammals after hair cell loss. Moreover, recently many strategies have been developed to promote the hair cell regeneration and subsequent functional recovery of the vestibular system, including manipulating the Wnt, Notch and Atoh1. This article provides an overview of the recent advances in hair cell regeneration in mammalian vestibular epithelia. Furthermore, this review highlights the current limitations of hair cell regeneration and provides the possible solutions to regenerate functional hair cells and to partially restore vestibular function.

  1. Development and regeneration of vestibular hair cells in mammals.

    Science.gov (United States)

    Burns, Joseph C; Stone, Jennifer S

    2017-05-01

    Vestibular sensation is essential for gaze stabilization, balance, and perception of gravity. The vestibular receptors in mammals, Type I and Type II hair cells, are located in five small organs in the inner ear. Damage to hair cells and their innervating neurons can cause crippling symptoms such as vertigo, visual field oscillation, and imbalance. In adult rodents, some Type II hair cells are regenerated and become re-innervated after damage, presenting opportunities for restoring vestibular function after hair cell damage. This article reviews features of vestibular sensory cells in mammals, including their basic properties, how they develop, and how they are replaced after damage. We discuss molecules that control vestibular hair cell regeneration and highlight areas in which our understanding of development and regeneration needs to be deepened. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Vestibular schwannoma with contralateral facial pain – case report

    Directory of Open Access Journals (Sweden)

    Ghodsi Mohammad

    2003-03-01

    Full Text Available Abstract Background Vestibular schwannoma (acoustic neuroma most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. Case presentation Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. Conclusion The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.

  3. Congenital and compensated vestibular dysfunction in childhood: an overlooked entity.

    Science.gov (United States)

    Weiss, Avery H; Phillips, James O

    2006-07-01

    We report five children with previously unrecognized vestibular dysfunction detected by clinical examination and confirmed by quantitative vestibular testing. Patient 1 presented with fluctuating visual acuity and intermittent nystagmus. Patient 2 had congenital hearing loss associated with imbalance, delayed motor development, and cyclic vomiting. Patient 3 had neurotrophic keratitis with an intermittent head tilt, imbalance, and motor delays. Patient 4 showed ataxia and eye movement abnormalities following traumatic brain injury and had reading difficulties. Patient 5 had episodic vertigo and eye movement abnormalities from infancy. Clinical vestibular testing emphasized spontaneous nystagmus, rapid head thrust, and assessment of post-rotatory nystagmus. Quantitative vestibular testing included the sinusoidal chair rotation and velocity step tests, measurement of dynamic visual acuity, post-head-shake nystagmus, and computerized platform posturography. Pediatric neurologists encounter children with congenital and compensated vestibular dysfunction, which can be recognized on the basis of relevant history and clinical abnormalities of the ocular-ocular reflex.

  4. Neural network model of vestibular nuclei reaction to onset of vestibular prosthetic stimulation

    Directory of Open Access Journals (Sweden)

    Jack eDigiovanna

    2016-04-01

    Full Text Available The vestibular system incorporates multiple sensory pathways to provide crucial information about head and body motion. Damage to the semicircular canals, the peripheral vestibular organs that sense rotational velocities of the head, can severely degrade the ability to perform activities of daily life. Vestibular prosthetics address this problem by using stimulating electrodes that can trigger primary vestibular afferents to modulate their firing rates, thus encoding head movement. These prostheses have been demonstrated chronically in multiple animal models and acutely tested in short-duration trials within the clinic in humans. However, mainly due to limited opportunities to fully characterize stimulation parameters, there is a lack of understanding of ‘optimal’ stimulation configurations for humans. Here we model possible adaptive plasticity in the vestibular pathway. Specifically, this model highlights the influence of adaptation of synaptic strengths and offsets in the vestibular nuclei to compensate for the initial activation of the prosthetic. By changing the synaptic strengths, the model is able to replicate the clinical observation that erroneous eye movements are attenuated within 30 minutes without any change to the prosthetic stimulation rate. Although our model was only built to match this time-point, we further examined how it affected subsequent pulse rate and pulse amplitude modulation. Pulse amplitude modulation was more effective than pulse rate modulation for nearly all stimulation configurations during these acute tests. Two non-intuitive relationships highlighted by our model explain this performance discrepancy. Specifically the attenuation of synaptic strengths for afferents stimulated during baseline adaptation and the discontinuity between baseline and residual firing rates both disproportionally boost pulse amplitude modulation. Co-modulation of pulse rate and amplitude has been experimentally shown to induce both

  5. Presynaptic and postsynaptic ion channel expression in vestibular nuclei neurons after unilateral vestibular deafferentation.

    Science.gov (United States)

    Shao, Mei; Popratiloff, Anastas; Hirsch, June C; Peusner, Kenna D

    2009-01-01

    Vestibular compensation refers to the recovery of function occurring after unilateral vestibular deafferentation, but some patients remain uncompensated. Similarly, more than half of the operated chickens compensate three days after unilateral vestibular ganglionectomy (UVG), but the rest remain uncompensated. This review focuses on the studies performed on the principal cells of the chick tangential nucleus after UVG. The tangential nucleus is a major avian vestibular nucleus whose principal cells are all second-order, vestibular reflex projection neurons participating in the vestibuloocular and vestibulocollic reflexes controlling posture, balance, and eye movements. Using whole-cell patch-clamp approach in brain slice preparations, spontaneous spike firing, ionic conductances, and spontaneous excitatory postsynaptic currents (sEPSCs) are recorded in principal cells from controls and operated chickens three days after UVG. In compensated chickens, the proportion of spontaneous spike firing principal cells and their spike discharge rate are symmetric on the lesion and intact sides, with the rates increased over controls. However, in the uncompensated chickens, the spike discharge rate increases on the lesion side, but not on the intact side, where only silent principal cells are recorded. In all the experimental groups, including controls, silent principal cells are distinguished from spontaneous spiking cells by smaller persistent sodium conductances and higher activation thresholds for the fast sodium channel. In addition, silent principal cells on the intact side of uncompensated chickens have larger dendrotoxin-sensitive potassium conductances, with a higher ratio of immunolabeling for surface/cytoplasmic expression of a dendrotoxin-sensitive, potassium channel subunit, Kv1.1. Finally, in compensated chickens, sEPSC frequency is symmetric bilaterally, but in uncompensated chickens sEPSC frequency increased only on the lesion side, where the expression of Kv1

  6. Vestibular characterization in the menstrual cycle Caracterização vestibular no ciclo menstrual

    Directory of Open Access Journals (Sweden)

    Cintia Ishii

    2009-06-01

    Full Text Available Hormonal disorders in the menstrual cycle can affect labyrinthine fluid homeostasis, causing balance and hearing dysfunctions. STUDY DESIGN: Clinical prospective. AIM: compare the results from vestibular tests in young women, in the premenstrual and postmenstrual periods. MATERIALS AND METHODS: twenty women were selected with ages ranging from 18 to 35 years, who were not using any kind of contraceptive method for at least six months, and without vestibular or hearing complaints. The test was carried out in each subject before and after the menstrual period, respecting the limit of ten days before or after menstruation. RESULTS: there was a statistically significant difference in the menstrual cycle phases only in the following vestibular tests: calibration, saccadic movements, PRPD and caloric-induced nystagmus. We also noticed that age; a regular menstrual cycle; hearing loss or dizziness cases in the family; and premenstrual symptoms such as tinnitus, headache, sleep disorders, anxiety, nausea and hyperacusis can interfere in the vestibular test. CONCLUSION: there are differences in the vestibular tests of healthy women when comparing their pre and postmenstrual periods.As alterações hormonais do ciclo menstrual podem comprometer a homeostase dos fluidos labirínticos, gerando alterações no equilíbrio e na audição. FORMA DO ESTUDO: Clínico prospectivo. OBJETIVO: Comparar os resultados dos testes do exame vestibular em mulheres jovens, nos períodos pré e pós-menstrual. MATERIAL E MÉTODO: Foram selecionadas vinte mulheres, entre dezoito e trinta e cinco anos, que não fizessem uso de qualquer tipo de anticoncepcional, com audição normal e sem queixas vestibulares. O exame vestibular foi realizado em cada participante no período pré e no período pós-menstrual, em ordem aleatória, e respeitando o limite de até dez dias antes do início da menstruação e até dez dias após o início da menstruação. RESULTADO: Foi observada

  7. Seizures arising from the inferior parietal lobule can show ictal semiology of the second sensory seizure (SII seizure).

    Science.gov (United States)

    Yamamoto, J; Ikeda, A; Matsuhashi, M; Satow, T; Takayama, M; Ohara, S; Matsumoto, R; Mikuni, N; Takahashi, J; Miyamoto, S; Taki, W; Hashimoto, N; Shibasaki, H

    2003-03-01

    A 52-year-old right handed man presented with medically intractable partial seizures consisting of numbness on the left upper back spreading to the left upper as well as lower limbs. Head computed tomography and magnetic resonance imaging showed a round calcified lesion in the depth of the superior ramus of the right sylvian fissure. Ictal electrocorticographic recording with chronically implanted subdural electrodes showed low voltage fast activities starting exclusively from an electrode located on the right inferior parietal lobule. No apparent ictal activities were observed from the depth electrodes inserted in the parietal operculum. Somatosensory evoked potentials of 75 ms to 145 ms latency were recorded from the ictal onset zone, which was 2 cm caudal to the perisylvian area corresponding to the second somatosensory area. Seizures arising from the inferior parietal lobule including the angular and supuramarginal gyri can produce partial seizures whose ictal semiology and scalp electroencephalography are indistinguishable from the ones originating from the second somatosensory area.

  8. State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma.

    Science.gov (United States)

    Saman, Yougan; Mclellan, Lucie; Mckenna, Laurence; Dutia, Mayank B; Obholzer, Rupert; Libby, Gerald; Gleeson, Michael; Bamiou, Doris-Eva

    2016-01-01

    Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function. (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER. In Experiment 1, a significant difference (p handicap (p < 0.001). Anxiety

  9. The molecular biology and novel treatments of vestibular schwannomas.

    Science.gov (United States)

    Fong, Brendan; Barkhoudarian, Garni; Pezeshkian, Patrick; Parsa, Andrew T; Gopen, Quinton; Yang, Isaac

    2011-11-01

    Vestibular schwannomas are histopathologically benign tumors arising from the Schwann cell sheath surrounding the vestibular branch of cranial nerve VIII and are related to the NF2 gene and its product merlin. Merlin acts as a tumor suppressor and as a mediator of contact inhibition. Thus, deficiencies in both NF2 genes lead to vestibular schwannoma development. Recently, there have been major advances in our knowledge of the molecular biology of vestibular schwannomas as well as the development of novel therapies for its treatment. In this article the authors comprehensively review the recent advances in the molecular biology and characterization of vestibular schwannomas as well as the development of modern treatments for vestibular schwannoma. For instance, merlin is involved with a number of receptors including the CD44 receptor, EGFR, and signaling pathways, such as the Ras/raf pathway and the canonical Wnt pathway. Recently, merlin was also shown to interact in the nucleus with E3 ubiquitin ligase CRL4(DCAF1). A greater understanding of the molecular mechanisms behind vestibular schwannoma tumorigenesis has begun to yield novel therapies. Some authors have shown that Avastin induces regression of progressive schwannomas by over 40% and improves hearing. An inhibitor of VEGF synthesis, PTC299, is currently in Phase II trials as a potential agent to treat vestibular schwannoma. Furthermore, in vitro studies have shown that trastuzumab (an ERBB2 inhibitor) reduces vestibular schwannoma cell proliferation. With further research it may be possible to significantly reduce morbidity and mortality rates by decreasing tumor burden, tumor volume, hearing loss, and cranial nerve deficits seen in vestibular schwannomas.

  10. Evaluation of Galvanic Vestibular Stimulation System

    Science.gov (United States)

    Kofman, I. S.; Warren, E.; DeSoto, R.; Moroney, G.; Chastain, J.; De Dios, Y. E.; Gadd, N.; Taylor, L.; Peters, B. T.; Allen, E.; hide

    2017-01-01

    Microgravity exposure results in an adaptive central reinterpretation of information from multiple sensory sources to produce a sensorimotor state appropriate for motor actions in this unique environment, but this new adaptive state is no longer appropriate for the 1-g gravitational environment on Earth. During these gravitational transitions, astronauts experience deficits in both perceptual and motor functions including impaired postural control, disruption in spatial orientation, impaired control of locomotion that include alterations in muscle activation variability, modified lower limb kinematics, alterations in head-trunk coordination as well as reduced dynamic visual acuity. Post-flight changes in postural and locomotor control might have adverse consequences if a rapid egress was required following a long-duration mission, where support personnel may not be available to aid crewmembers. The act of emergency egress includes, but is not limited to standing, walking, climbing a ladder, jumping down, monitoring displays, actuating discrete controls, operating auxiliary equipment, and communicating with Mission Control and recovery teams while maintaining spatial orientation, mobility and postural stability in order to escape safely. The average time to recover impaired postural control and functional mobility to preflight levels of performance has been shown to be approximately two weeks after long-duration spaceflight. The postflight alterations are due in part to central reinterpretation of vestibular information caused by exposure to microgravity. In this study we will use a commonly used technique of transcutaneous electrical stimulation applied across the vestibular end organs (galvanic vestibular stimulation, GVS) to disrupt vestibular function as a simulation of post-flight disturbances. The goal of this project is an engineering human-in-the-loop evaluation of a device that can degrade performance of functional tasks (e.g. to maintain upright balance

  11. Semiologia das afasias: uma discussão crítica Semiology of aphasias: a critical discussion

    Directory of Open Access Journals (Sweden)

    Rosana do Carmo Novaes Pinto

    2009-01-01

    Full Text Available O artigo discute a semiologia das afasias, que teve início no século XIX com Broca e Wernicke. Não é nosso objetivo fornecer uma lista exaustiva de sintomas e síndromes para tratar do tema, já que buscamos discutir criticamente por que a semiologia das afasias ainda se baseia principalmente em perspectivas orgânicas na prática clínica e na pesquisa científica. Também discutimos as contribuições de Luria e de Jakobson para uma melhor compreensão de como a linguagem está comprometida nas afasias e como a Lingüística Moderna, sobretudo a Neurolingüística Discursiva, pode iluminar o debate. Analisamos alguns dados para ilustrar os pressupostos teóricos e metodológicos das referidas abordagens e discutimos ainda o peso excessivo que as classificações têm no contexto clínico.The article discusses the semiology of aphasias, which started being developed in the 19th century by Broca and Wernicke. We do not provide an exhaustive list of symptoms and syndromes to address the theme, since we aim to critically discuss why the semiology of aphasias is still based mainly on organic perspectives in clinical practice and scientific research. We also discuss the contributions of Luria and Jakobson to a better understanding of how language is affected in aphasias and how Modern Linguistics, in special the Discursive Neurolinguistics, may enlighten the debate. We analyze some data to illustrate the theoretical and methodological assumptions of the above mentioned approaches and also discuss the excessive strength that classifications have in the clinical context.

  12. Mesio-temporal ictal semiology as an indicator for surgical treatment of epilepsies with large multilobar cerebral lesions.

    Science.gov (United States)

    Catenoix, Hélène; Montavont, Alexandra; Isnard, Jean; Guénot, Marc; Chatillon, Claude-Edouard; Streichenberger, Nathalie; Ryvlin, Philippe; Mauguière, François

    2013-06-01

    Mesio-temporal ictal semiology is sometimes observed in patients with large multilobar lesion. In this situation, surgery is often discarded because of the lesion size and/or suspicion of extended or multifocal epileptogenic areas. In this retrospective study we evaluated the surgical outcome of such patients in order to assess whether the electro-clinical presentation of seizures could be a prognostic marker of surgical outcome. Among the temporal lobe epilepsy population explored in our department between 2000 and 2011 (240 patients), we identified 7 patients who presented an extensive lesion on brain Magnetic Resonance Imaging (MRI) (multilobar in four, hemispheric in two, and bilateral in one). All patients underwent (18)Fluorodeoxyglucose Positron Emission Tomography, which showed large, hemispheric or multilobar, areas of glucose hypometabolism. Because of the large lesion size, all patients were explored by stereoelectroencephalography (SEEG) before taking a decision regarding surgical indication. SEEG confirmed the temporal origin of the seizures and discarded the possibility of multiple epileptogenic zones. A temporal lobectomy, tailored on the basis of SEEG data, was proposed to the seven patients. The seven patients are classified Engel class I after the surgery (mean follow-up: 37.4±22.1 months). Our data thus suggest that, even in the absence of hippocampal MRI abnormality, ictal symptoms compatible with a temporal origin of seizures should be considered as a reliable indicator for surgery eligibility regardless of MRI lesion size. On the basis of our findings, the mesio-temporal semiology of seizures appears as one of the most reliable markers of operability in patients with large MRI lesions. These patients should not be excluded a priori from invasive exploration and surgical treatment, even if a large portion of their lesion is likely to be left in place after surgery. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All

  13. Semiologic classification of psychogenic non epileptic seizures (PNES) based on video EEG analysis: do we need new classification systems?

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    Wadwekar, Vaibhav; Nair, Pradeep Pankajakshan; Murgai, Aditya; Thirunavukkarasu, Sibi; Thazhath, Harichandrakumar Kottyen

    2014-03-01

    Different studies have described useful signs to diagnose psychogenic non-epileptic seizure (PNES). A few authors have tried to describe the semiologic groups among PNES patients; each group consisting of combination of features. But there is no uniformity of nomenclature among these studies. Our aim was to find out whether the objective classification system proposed by Hubsch et al. was useful and adequate to classify PNES patient population from South India. We retrospectively analyzed medical records and video EEG monitoring data of patients, recorded during 3 year period from June 2010 to July 2013. We observed the semiologic features of each PNES episode and tried to group them strictly adhering to Hubsch et al. classification. Minor modifications were made to include patients who were left unclassified. A total of 65 patients were diagnosed to have PNES during this period, out of which 11 patients were excluded due to inadequate data. We could classify 42(77.77%) patients without modifying the defining criteria of the Hubsch et al. groups. With minor modification we could classify 94.96% patients. The modified groups with patient distribution are as follows: Class 1--dystonic attacks with primitive gestural activities [3(5.6%)]. Class 2 – paucikinetic attacks with or without preserved responsiveness [5(9.3%)]. Class 3--pseudosyncope with or without hyperventilation [21(38.9%)]. Class 4--hyperkinetic prolonged attacks with hyperventilation, involvement of limbs and/or trunk [14(25.9%)]. Class 5--axial dystonic attacks [8(14.8%)]. Class 6--unclassified type [3(5.6%)]. This study demonstrates that the Hubsch's classification with minor modifications is useful and adequate to classify PNES patients from South India. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  14. Neurosonology Accuracy for Isolated Acute Vestibular Syndromes.

    Science.gov (United States)

    Tábuas-Pereira, Miguel; Sargento-Freitas, João; Isidoro, Luís; Silva, Fernando; Galego, Orlando; Nunes, César; Cordeiro, Gustavo; Cunha, Luís

    2017-12-01

    The clinical approach to acute vestibular syndromes is often complex for the physician. Neurosonology offers a noninvasive method to study the cervicocephalic circulation when a vascular etiology is suspected. We aim to evaluate the diagnostic accuracy of a vascular neurosonological exam in isolated acute vestibular syndrome. All patients submitted to cerebrovascular ultrasound and magnetic resonance imaging during the period between 2011 and 2015 with acute isolated vestibular syndrome. Those with any clinical sign of brainstem lesion on presentation were excluded. All patients performed the neuroimaging study (brain computed tomography and magnetic resonance imaging) and neurologic surveillance. Neurosonological exam included all intra- and extracranial segments of the vertebrobasilar circulation. Positive ultrasound exam was defined as the presence of stenotic or occlusive disease in any of these segments related to the infarcted area. A total of 108 patients were included: 60 (53.6%) were males (mean age: 60.75 years (standard deviation, 14.17)). In 27 patients (25.0%) a cerebral ischemic lesion was found to be the cause of the vertigo. Neurosonological assessment showed a sensitivity of 40.7% (95% confidence interval (CI): 22.4; 61.2), specificity of 100% (95% CI: 95.5; 100.0), positive predictive value (PPV) of 100% (95% CI: 71.5; 100.0), and negative predictive value (NPV) of 83.5% (95% CI: 74.6; 90.3). Our study suggests that cerebrovascular ultrasound is a highly specific method for the diagnosis of cerebrovascular vertigo. However, its low sensitivity makes it a poor candidate for screening. © 2017 by the American Institute of Ultrasound in Medicine.

  15. EL SINDROME VESTIBULAR EN EL ADULTO MAYOR

    OpenAIRE

    Suárez, Hamlet; Suárez, Alejo

    2016-01-01

    El vértigo, la inestabilidad y las caídas tienen una incidencia relevante en el adulto mayor, disminuye su calidad de vida y puede ser causa de muerte en esta población. Este artículo describe las presentaciones clínicas y el abordaje de la evaluación de la patología vestibular en este grupo de edad, utilizando diferentes instrumentos para el diagnóstico así como también las reglas generales del tratamiento.

  16. EL SINDROME VESTIBULAR EN EL ADULTO MAYOR

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    Dr. Hamlet Suárez

    2016-11-01

    Full Text Available El vértigo, la inestabilidad y las caídas tienen una incidencia relevante en el adulto mayor, disminuye su calidad de vida y puede ser causa de muerte en esta población. Este artículo describe las presentaciones clínicas y el abordaje de la evaluación de la patología vestibular en este grupo de edad, utilizando diferentes instrumentos para el diagnóstico así como también las reglas generales del tratamiento.

  17. Vestibular schwannoma presenting with sudden facial paralysis.

    Science.gov (United States)

    Wexler, D B; Fetter, T W; Gantz, B J

    1990-04-01

    Facial paralysis is an unusual manifestation of vestibular schwannoma, and generally signifies an advanced stage of tumor growth. We describe a case of eighth-nerve schwannoma that presented initially with rapid-onset complete unilateral facial paralysis. At the time of operation the nerve was found to be electrically intact despite marked compression by tumor. The facial nerve was preserved and facial motion has partially recovered postoperatively. All unexplained persistent facial paralysis should be evaluated by magnetic resonance imaging with paramagnetic contrast enhancement.

  18. Symptomatic recovery in Miller Fisher Syndrome parallels vestibular-perceptual and not vestibular-ocular reflex function

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    Barry M Seemungal

    2011-02-01

    Full Text Available Unpleasant visual symptoms including oscillopsia and dizziness may occur when there is unexpected motion of the visual world across the subject’s retina (‘retinal-slip’ as in an acute spontaneous nystagmus or on head movement with an acute ophthalmoplegia. In contrast, subjects with chronic ocular dysmotility, e.g. congenital nystagmus or CPEO (chronic progressive external ophthalmoplegia, are typically symptom free. The adaptive processes that render chronic patients asymptomatic are obscure but may include a suppression of oscillopsia perception as well as an increased tolerance to perceived oscillopsia. Such chronic asymptomatic patients display an attenuation of vestibular-mediated angular velocity perception, implying a possible contributory role in the adaptive process. In order to assess causality between symptoms, signs (i.e. eye-movements and vestibular perceptual function, we prospectively assessed symptom ratings and ocular-motor and perceptual vestibular function, in a patient with acute but transient ophthalmoplegia due to Miller Fisher Syndrome (as a model of visuo-vestibular adaptation. The data show that perceptual measures of vestibular function display a significant attenuation as compared to ocularmotor measures during the acute, symptomatic period. Perhaps significantly, both symptomatic recovery and normalisation of vestibular perceptual function were delayed and then occurred in a parallel fashion. This is the first report showing that symptomatic recovery of visuo-vestibular symptoms is better paralleled by vestibular-perceptual testing than VOR (vestibular ocular reflex measures. The findings may have implications for the understanding of patients with chronic vestibular symptoms where VOR testing is often unhelpful.

  19. Reabilitação vestibular na criança: estudo preliminar Vestibular rehabilitation in children: preliminary study

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    Roseli S. M. Bittar

    2002-08-01

    Full Text Available Forma de estudo: Clínico prospectivo. Objetivo: O estudo analisa prospectivamente os resultados da Reabilitação Vestibular pelo método de Cawtorne & Cooksey em 22 crianças, portadoras de vestibulopatia periférica, associada ou não a sintomas centrais, com idade média de 8,6 anos. Material e método: Os exames quantitativos da função vestibular utilizados para quantificar a vestibulopatia foram a eletronistagmografia e a prova rotatória pendular decrescente (PRPD, mas a história clínica altamente sugestiva de processo vestibular foi considerada diagnóstica mesmo na presença de exames normais. Resultado: Os resultados apontam a Reabilitação Vestibular como uma opção válida no tratamento das vestibulopatias na infância, uma vez que não houve casos não responsivos ao tratamento.Study design: Clinical prospective. Aim: The authors analyze prospectively 22 children (mean age 8,6 years with vestibulopathy treated with Vestibular Rehabilitation in order to verify its results. Material and methody: Twenty two children with peripheral vestibular disorders associated or not to central symptoms were submitted to vestibular stimulation by the method of Cawthorne & Cooksey. The methods used to quantify the vestibular abnormalities were the electronystagmography and rotational chair testing, but a suggestive history of vestibular disorder was accepted even the exams were normal. Results: All the patients improved and our results suggest that VR is a therapeutic alternative for the treatment of vestibular disorders in the children.

  20. STATE ANXIETY, SUBJECTIVE IMBALANCE AND HANDICAP IN VESTIBULAR SCHWANNOMA

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    Yougan Saman

    2016-07-01

    Full Text Available ABSTRACTEvidence is emerging of a significant clinical and neuro-anatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety and there is a relationship between increased state anxiety and worsening balance function. Aims1.To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit.2.To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap. MethodsTwo separate cohorts Vestibular Schwannoma (VS patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials and caloric responses and questionnaire assessment (Vertigo handicap Questionnaire, Vertigo Symptom Scale, State Trait Anxiety InventoryFifteen post resection Vestibular schwannoma patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1. Forty-five patients with VS in-situ and with preserved vestibular function formed the cohort for Experiment 2 (Aim 2. Experiment 1: VS subjects (N=15 with a complete post-resection unilateral vestibular deafferentation completed a State anxiety questionnaire before caloric assessment and again afterwards with the point of maximal vertigo as the reference (Aim 1. Experiment 2: State anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of presenting with balance symptoms (Group 1 N=26 and without balance symptoms (Group 2 N=11 (Aim 2. The presence of balance symptoms was defined as having a positive score on the VSS-VER.ResultsIn experiment 1, a significant difference (p<0.01 was found when comparing

  1. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

    Science.gov (United States)

    Song, Hyun Seok; Kim, Ji Soo

    2011-01-01

    Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals. PMID:22259614

  2. Impedance pattern of vaginal and vestibular mucosa in cyclic goats

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    Ivo Křivánek

    2008-01-01

    Full Text Available The changes of vaginal and vestibular impedance during the oestrous cycle in goats were examined. The onset of oestrus was teased with a buck once a day during the experiment. Impedance was mea­sured by a four-terminal method. The vaginal impedance was recorded under slight pressure of electrodes to the vaginal dorsal wall at the cervix. The vestibular impedance was recorded under slight pressure of electrodes to the vestibular dorsal wall 5 cm from the vulva and at the vulva. The im­pe­dan­ce was measured once a day from 4 days before the expected oestrus to 6 days after onset of oestrus. The vaginal impedance at the cervix decreased during pro-oestrus (P < 0.01 and increased du­ring oestrus (P < 0.01. The vestibular impedance 5 cm from the vulva decreased during pro-oestrus (P < 0.01 and increased after oestrus (P < 0.01. The decrease of vaginal impedance during peri-oestrus was nearly twofold in comparison with the vestibular impedance 5 cm from the vulva. No sig­ni­fi­cant decrease of the vestibular impedance at the vulva was found during the oestrous cycle. The results indicate that the vaginal impedance at the cervix and vestibular impedance 5 cm from the vulva measured by means of a four-terminal method during the oestrous cycle display cyclic changes that are closely related to the oestrous behaviour of goats.

  3. Betahistine treatment in managing vertigo and improving vestibular compensation: clarification.

    Science.gov (United States)

    Lacour, Michel

    2013-01-01

    Betahistine dihydrochloride (betahistine) is currently used in the management of vertigo and vestibular pathologies with different aetiologies. The main goal of this review is to clarify the mechanisms of action of this drug, responsible for the symptomatic relief of vertigo and the improvement of vestibular compensation. The review starts with a brief summary recalling the role of histamine as a neuromodulator/neurotransmitter in the control of the vestibular functions, and the role of the histaminergic system in vestibular compensation. Then are presented data recorded in animal models demonstrating that betahistine efficacy can be explained by mechanisms targeting the histamine receptors (HRs) at three different levels: the vascular tree, with an increase of cochlear and vestibular blood flow involving the H1R; the central nervous system, with an increase of histamine turnover implicating the H3R, and the peripheral labyrinth, with a decrease of vestibular input implying the H3R/H4R. Clinical data from vestibular loss patients show the impact of betahistine treatment for the long-term control of vertigo, improvement of balance and quality of life that can be explained by these mechanisms of action. However, two conditions, at least, are required for reaching the betahistine therapeutic effect: the dose and the duration of treatment. Experimental and clinical data supporting these requirements are exposed in the last part of this review.

  4. Adaptive plasticity in vestibular influences on cardiovascular control

    Science.gov (United States)

    Yates, B. J.; Holmes, M. J.; Jian, B. J.

    2000-01-01

    Data collected in both human subjects and animal models indicate that the vestibular system influences the control of blood pressure. In animals, peripheral vestibular lesions diminish the capacity to rapidly and accurately make cardiovascular adjustments to changes in posture. Thus, one role of vestibulo-cardiovascular influences is to elicit changes in blood distribution in the body so that stable blood pressure is maintained during movement. However, deficits in correcting blood pressure following vestibular lesions diminish over time, and are less severe when non-labyrinthine sensory cues regarding body position in space are provided. These observations show that pathways that mediate vestibulo-sympathetic reflexes can be subject to plastic changes. This review considers the adaptive plasticity in cardiovascular responses elicited by the central vestibular system. Recent data indicate that the posterior cerebellar vermis may play an important role in adaptation of these responses, such that ablation of the posterior vermis impairs recovery of orthostatic tolerance following subsequent vestibular lesions. Furthermore, recent experiments suggest that non-labyrinthine inputs to the central vestibular system may be important in controlling blood pressure during movement, particularly following vestibular dysfunction. A number of sensory inputs appear to be integrated to produce cardiovascular adjustments during changes in posture. Although loss of any one of these inputs does not induce lability in blood pressure, it is likely that maximal blood pressure stability is achieved by the integration of a variety of sensory cues signaling body position in space.

  5. The relationship between senile hearing loss and vestibular activity

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    Hanifi Kurtaran

    Full Text Available Abstract Introduction: A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. Objective: To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL in adult patients. Methods: Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP. Patients were divided into two groups: a study group (patients with SNHL and a control group (patients without SNHL. VEMP results of the groups were calculated and compared. Results: Mean P1 (23.54 and N1 (30.70 latencies were prolonged in the study group (p < 0.001 and the amplitudes of the study group were significantly reduced (p < 0.001. Both parameters of the VEMP test were abnormal in the study group when compared to the control group. Conclusions: These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy.

  6. Recovery of dynamic visual acuity in bilateral vestibular hypofunction.

    Science.gov (United States)

    Herdman, Susan J; Hall, Courtney D; Schubert, Michael C; Das, Vallabh E; Tusa, Ronald J

    2007-04-01

    To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with bilateral vestibular hypofunction (BVH). Prospective, randomized, double-blinded study. Outpatient clinic, academic setting. Thirteen patients with BVH, aged 47 to 73 years. One group (8 patients) performed vestibular exercises designed to enhance remaining vestibular function, and the other (5 patients) performed placebo exercises. Measurements of dynamic visual acuity (DVA) during predictable head movements using a computerized test; measurement of intensity of oscillopsia using a visual analog scale. As a group, patients who performed vestibular exercises showed a significant improvement in DVA (P = .001), whereas those performing placebo exercises did not (P = .07). Only type of exercise (ie, vestibular vs placebo) was significantly correlated with change in DVA. Other factors examined, including age, time from onset, initial DVA, and complaints of oscillopsia and disequilibrium, were not significantly correlated with change in DVA. Change in oscillopsia did not correlate with change in DVA. Use of vestibular exercises is the main factor involved in recovery of DVA in patients with BVH. We theorize that exercises may foster the use of centrally programmed eye movements that could substitute for the vestibulo-ocular reflex. clinicaltrials.gov Identifier: NCT00411216.

  7. Responses evoked by a vestibular implant providing chronic stimulation.

    Science.gov (United States)

    Thompson, Lara A; Haburcakova, Csilla; Gong, Wangsong; Lee, Daniel J; Wall, Conrad; Merfeld, Daniel M; Lewis, Richard F

    2012-01-01

    Patients with bilateral vestibular loss experience dehabilitating visual, perceptual, and postural difficulties, and an implantable vestibular prosthesis that could improve these symptoms would be of great benefit to these patients. In previous work, we have shown that a one-dimensional, unilateral canal prosthesis can improve the vestibulooccular reflex (VOR) in canal-plugged squirrel monkeys. In addition to the VOR, the potential effects of a vestibular prosthesis on more complex, highly integrative behaviors, such as the perception of head orientation and posture have remained unclear. We tested a one-dimensional, unilateral prosthesis in a rhesus monkey with bilateral vestibular loss and found that chronic electrical stimulation partially restored the compensatory VOR and also that percepts of head orientation relative to gravity were improved. However, the one-dimensional prosthetic stimulation had no clear effect on postural stability during quiet stance, but sway evoked by head-turns was modestly reduced. These results suggest that not only can the implementation of a vestibular prosthesis provide partial restitution of VOR but may also improve perception and posture in the presence of bilateral vestibular hypofunction (BVH). In this review, we provide an overview of our previous and current work directed towards the eventual clinical implementation of an implantable vestibular prosthesis.

  8. Biomimetic smart sensors for autonomous robotic behavior II: vestibular processing

    Science.gov (United States)

    Xue, Shuwan; Deligeorges, Socrates; Soloway, Aaron; Lichtenstein, Lee; Gore, Tyler; Hubbard, Allyn

    2009-05-01

    Limited autonomous behaviors are fast becoming a critical capability in the field of robotics as robotic applications are used in more complicated and interactive environments. As additional sensory capabilities are added to robotic platforms, sensor fusion to enhance and facilitate autonomous behavior becomes increasingly important. Using biology as a model, the equivalent of a vestibular system needs to be created in order to orient the system within its environment and allow multi-modal sensor fusion. In mammals, the vestibular system plays a central role in physiological homeostasis and sensory information integration (Fuller et al, Neuroscience 129 (2004) 461-471). At the level of the Superior Colliculus in the brain, there is multimodal sensory integration across visual, auditory, somatosensory, and vestibular inputs (Wallace et al, J Neurophysiol 80 (1998) 1006-1010), with the vestibular component contributing a strong reference frame gating input. Using a simple model for the deep layers of the Superior Colliculus, an off-the-shelf 3-axis solid state gyroscope and accelerometer was used as the equivalent representation of the vestibular system. The acceleration and rotational measurements are used to determine the relationship between a local reference frame of a robotic platform (an iRobot Packbot®) and the inertial reference frame (the outside world), with the simulated vestibular input tightly coupled with the acoustic and optical inputs. Field testing of the robotic platform using acoustics to cue optical sensors coupled through a biomimetic vestibular model for "slew to cue" gunfire detection have shown great promise.

  9. The relationship between senile hearing loss and vestibular activity.

    Science.gov (United States)

    Kurtaran, Hanifi; Acar, Baran; Ocak, Emre; Mirici, Emre

    A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients. Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared. Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p<0.001) and the amplitudes of the study group were significantly reduced (p<0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group. These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  10. The clinical manifestations of vestibular migraine: A review.

    Science.gov (United States)

    O'Connell Ferster, Ashley P; Priesol, Adrian J; Isildak, Huseyin

    2017-06-01

    To provide an overview of vestibular migraines presentation, pathology, and diagnosis, as well as an update on current diagnostic criteria. A review of the most recent literature on vestibular migraines was performed. Vestibular migraine is a process with significant impact on the quality of life for those afflicted with the disease, with attacks of spontaneous or positional vertigo and migraine symptoms lasting several minutes to 72h. Inner ear disease can co-exist with migraine and the vestibular symptoms occurring with vestibular migraine can mimic inner ear disorders providing a challenge for clinicians in establishing diagnosis. Recent diagnostic criteria for vestibular migraine proposed by a joint committee of the Bárány Society and the International Headache Society provide an important standard for clinical diagnosis and research endeavor. Vestibular migraine is a challenging disease process to both diagnose and treat. Proper diagnosis and treatment requires a thorough understanding of the current literature. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Hyperventilation-induced nystagmus in patients with vestibular schwannoma.

    Science.gov (United States)

    Califano, Luigi; Iorio, Giuseppina; Salafia, Francesca; Mazzone, Salvatore; Califano, Maria

    2015-02-01

    To determine the utility of the hyperventilation test (HVT) in the diagnosis of vestibular schwannoma (VS). A retrospective analysis of hyperventilation-induced nystagmus (HVIN) in 45 patients with unilateral VS. A tertiary referral center. Forty-five patients with VS; 30 patients with chronic vestibular neuritis; 20 healthy subjects with normal hearing and without symptoms or a history of vertigo, migraine, or neurological diseases (control group). Audiological and vestibular examination; "side-stream" measurement of end-tidal CO2 pressure (P(EtCO2)) to standardize the procedure; magnetic resonance imaging (MRI) centered on the cerebellopontine angle. An analysis of HVIN, its patterns, and its appearance threshold via the measurement of P(EtCO2) correlations with the tumor size. HVIN was observed in 40 of 45 cases (88.9%) in the schwannoma group and in 12 of 30 cases (40%) in the chronic vestibular neuritis group; HVIN was not observed in the control group (0/20 cases) (p hyperventilation event causes metabolic changes in the vestibular system and reveals a latent vestibular asymmetry. The presence of an excitatory pattern is the major criterion that suggests VS in patients with signs of unilateral vestibular deficit.

  12. Vestibular animal models: contributions to understanding physiology and disease.

    Science.gov (United States)

    Straka, Hans; Zwergal, Andreas; Cullen, Kathleen E

    2016-04-01

    Our knowledge of the vestibular sensory system, its functional significance for gaze and posture stabilization, and its capability to ensure accurate spatial orientation perception and spatial navigation has greatly benefitted from experimental approaches using a variety of vertebrate species. This review summarizes the attempts to establish the roles of semicircular canal and otolith endorgans in these functions followed by an overview of the most relevant fields of vestibular research including major findings that have advanced our understanding of how this system exerts its influence on reflexive and cognitive challenges encountered during daily life. In particular, we highlight the contributions of different animal models and the advantage of using a comparative research approach. Cross-species comparisons have established that the morpho-physiological properties underlying vestibular signal processing are evolutionarily inherent, thereby disclosing general principles. Based on the documented success of this approach, we suggest that future research employing a balanced spectrum of standard animal models such as fish/frog, mouse and primate will optimize our progress in understanding vestibular processing in health and disease. Moreover, we propose that this should be further supplemented by research employing more "exotic" species that offer unique experimental access and/or have specific vestibular adaptations due to unusual locomotor capabilities or lifestyles. Taken together this strategy will expedite our understanding of the basic principles underlying vestibular computations to reveal relevant translational aspects. Accordingly, studies employing animal models are indispensible and even mandatory for the development of new treatments, medication and technical aids (implants) for patients with vestibular pathologies.

  13. Intrinsic membrane properties of central vestibular neurons in rodents.

    Science.gov (United States)

    Eugène, Daniel; Idoux, Erwin; Beraneck, Mathieu; Moore, L E; Vidal, Pierre-Paul

    2011-05-01

    Numerous studies in rodents have shown that the functional efficacy of several neurotransmitter receptors and the intrinsic membrane excitability of central vestibular neurons, as well as the organization of synaptic connections within and between vestibular nuclei can be modified during postnatal development, after a lesion of peripheral vestibular organs or in vestibular-deficient mutant animals. This review mainly focuses on the intrinsic membrane properties of neurons of the medial vestibular nuclei of rodents, their postnatal maturation, and changes following experimental or congenital alterations in vestibular inputs. It also presents the concomitant modifications in the distribution of these neurons into different neuron types, which has been based on their membrane properties in relation to their anatomical, biochemical, or functional properties. The main points discussed in this review are that (1) the intrinsic membrane properties can be used to distinguish between two dominant types of neurons, (2) the system remains plastic throughout the whole life of the animal, and finally, (3) the intracellular calcium concentration has a major effect on the intrinsic membrane properties of central vestibular neurons.

  14. Treating vertigo with vestibular rehabilitation: results in 155 patients.

    Science.gov (United States)

    Bittar, R S M; Pedalini, M E B; Lorenzi, M C; Formigoni, L G

    2002-01-01

    Balance is fundamental to our daily activities and the vestibular system, together with vision and proprioceptive functions, are the main structures involved in this process. Dizziness is the main clinical manifestation of malfunction of these systems. The mechanisms of vestibular compensation are one of the most studied aspects since they play an important role in the patient's everyday activities. In this retrospective description of a series of cases the authors present their results in 155 patients that underwent a program of vestibular rehabilitation (VR). The program, first described by Cawthorne and Coosey, is based on mechanisms of potentiation of the cervico-ocular reflex and substitution of the lost vestibular cues for visual and somatosensory cues. The results were satisfactory (remission or partial cure) in 75.5% of the patients, with an average treatment time of up to 2 months and 5 or fewer sessions performed in most of the cases. The results were somewhat inferior in those cases in which a central vestibular lesion or more than one etiologic factor was present. The results of a subgroup of elderly patients (age > 65 years) were similar to those of the total number of studied subjects. Vestibular rehabilitation, associated to the specific etiological treatment, appears to be a very useful tool in the management of patients suffering from dizziness of all ages, although different clinical responses to the therapy may vary according to the presence of a central or a peripheral vestibular lesion or multiple etiological factors.

  15. Laboratory examinations for the vestibular system.

    Science.gov (United States)

    van de Berg, Raymond; Rosengren, Sally; Kingma, Herman

    2018-02-01

    In the last decades, researchers suggested that clinical assessment of labyrinthine function in detail became easy thanks to video head impulse tests (VHITs), vestibular evoked myogenic potential test (VEMP) and video-oculography (VOG). It has been argued that they can replace electronystagmography, the caloric and rotatory chair tests. This review addresses the latest evaluations of these tests and the opportunities they offer, but also the limitations in clinical practice. The VHIT and suppression head impulse test (SHIMP) are under ideal circumstances able to accurately identify deficits of the VOR in 3D. However, in a relevant part of the patient population, pupil tracking is inaccurate, video-goggles slip and VOR quantification is problematic. The dissociation between the VHIT and caloric test suggests that these tests are complementary. A new 3D-VOG technique claims to quantify eye torsion better than before, opening multiple diagnostic possibilities. VEMPs remain difficult to standardize. Variability in normal cervical vestibular-evoked myogenic potential amplitude is large. VEMPs become smaller or absent with age, raising questions of whether there is a lower normal limit at all. Recent research shows that the labyrinth is directly stimulated in the MRI offering new opportunities for diagnostics and research. In clinical practice, the VHIT, SHIMP, VEMP and new 3D-VOG techniques improve diagnostic power. Unfortunately, technical issues or variability prevent reliable quantitative evaluation in a part of the regular patient population. The traditional caloric and rotatory chair test can still be considered as valuable complementary tests.

  16. Treatment of peripheral vestibular dysfunction using photobiomodulation

    Science.gov (United States)

    Lee, Min Young; Hyun, Jai-Hwan; Suh, Myung-Whan; Ahn, Jin-Chul; Chung, Phil-Sang; Jung, Jae Yun; Rhee, Chung Ku

    2017-08-01

    Gentamicin, which is still used in modern medicine, is a known vestibular toxic agent, and various degrees of balance problems have been observed after exposure to this pharmacologic agent. Photobiomodulation is a candidate therapy for vertigo due to its ability to reach deep inner ear organs such as the cochlea. Previous reports have suggested that photobiomodulation can improve hearing and cochlea function. However, few studies have examined the effect of photobiomodulation on balance dysfunction. We used a rat model to mimic human vestibulopathy resulting from gentamicin treatment and evaluated the effect of photobiomodulation on vestibular toxicity. Slow harmonic acceleration (SHA) rotating platform testing was used for functional evaluation and both qualitative and quantitative epifluorescence analyses of cupula histopathology were performed. Animals were divided into gentamicin only and gentamicin plus laser treatment groups. Laser treatment was applied to one ear, and function and histopathology were evaluated in both ears. Decreased function was observed in both ears after gentamicin treatment, demonstrated by low gain and no SHA asymmetry. Laser treatment minimized the damage resulting from gentamicin treatment as shown by SHA asymmetry and recovered gain in the treated ear. Histology results reflected the functional results, showing increased hair cell density and epifluorescence intensity in laser-treated cupulae.

  17. Galvanic vestibular stimulation speeds visual memory recall.

    Science.gov (United States)

    Wilkinson, David; Nicholls, Sophie; Pattenden, Charlotte; Kilduff, Patrick; Milberg, William

    2008-08-01

    The experiments of Alessandro Volta were amongst the first to indicate that visuo-spatial function can be altered by stimulating the vestibular nerves with galvanic current. Until recently, the beneficial effects of the procedure were masked by the high levels of electrical current applied, which induced nystagmus-related gaze deviation and spatial disorientation. However, several neuropsychological studies have shown that much weaker, imperceptible currents that do not elicit unpleasant side-effects can help overcome visual loss after stroke. Here, we show that visual processing in neurologically healthy individuals can also benefit from galvanic vestibular stimulation. Participants first learnt the names of eight unfamiliar faces and then after a short delay, answered questions from memory about how pairs of these faces differed. Mean correct reaction times were significantly shorter when sub-sensory, noise-enhanced anodal stimulation was administered to the left mastoid, compared to when no stimulation was administered at all. This advantage occurred with no loss in response accuracy, and raises the possibility that the procedure may constitute a more general form of cognitive enhancement.

  18. Improving Sensorimotor Function Using Stochastic Vestibular Stimulation

    Science.gov (United States)

    Galvan, R. C.; Clark, T. K.; Merfeld, D. M.; Bloomberg, J. J.; Mulavara, A. P.; Oman, C. M.

    2014-01-01

    Astronauts experience sensorimotor changes during spaceflight, particularly during G-transition phases. Post flight sensorimotor changes may include postural and gait instability, spatial disorientation, and visual performance decrements, all of which can degrade operational capabilities of the astronauts and endanger the crew. Crewmember safety would be improved if these detrimental effects of spaceflight could be mitigated by a sensorimotor countermeasure and even further if adaptation to baseline could be facilitated. The goal of this research is to investigate the potential use of stochastic vestibular stimulation (SVS) as a technology to improve sensorimotor function. We hypothesize that low levels of SVS will improve sensorimotor performance through stochastic resonance (SR). The SR phenomenon occurs when the response of a nonlinear system to a weak input signal is optimized by the application of a particular nonzero level of noise. Two studies have been initiated to investigate the beneficial effects and potential practical usage of SVS. In both studies, electrical vestibular stimulation is applied via electrodes on the mastoid processes using a constant current stimulator. The first study aims to determine the repeatability of the effect of vestibular stimulation on sensorimotor performance and perception in order to better understand the practical use of SVS. The beneficial effect of low levels of SVS on balance performance has been shown in the past. This research uses the same balance task repeated multiple times within a day and across days to study the repeatability of the stimulation effects. The balance test consists of 50 sec trials in which the subject stands with his or her feet together, arms crossed, and eyes closed on compliant foam. Varying levels of SVS, ranging from 0-700 micro A, are applied across different trials. The subject-specific optimal SVS level is that which results in the best balance performance as measured by inertial

  19. Vestibular syndrome: a change in internal spatial representation.

    Science.gov (United States)

    Borel, L; Lopez, C; Péruch, P; Lacour, M

    2008-12-01

    The vestibular system contributes to a wide range of functions from reflexes to spatial representation. This paper reviews behavioral, perceptive, and cognitive data that highlight the role of changes in internal spatial representation on the vestibular syndrome. Firstly, we review how visual vertical perception and postural orientation depend on multiple reference frames and multisensory integration and how reference frames are selected according to the status of the peripheral vestibular system (i.e., unilateral or bilateral hyporeflexia), the environmental constraints (i.e., sensory cues), and the postural constraints (i.e., balance control). We show how changes in reference frames are able to modify vestibular lesion-induced postural and locomotor deficits and propose that fast changes in reference frame may be considered as fast-adaptive processes after vestibular loss. Secondly, we review data dealing with the influence of vestibular loss on higher levels of internal representation sustaining spatial orientation and navigation. Particular emphasis is placed on spatial performance according to task complexity (i.e., the required level of spatial knowledge) and to the sensory cues available to define the position and orientation within the environment (i.e., real navigation in darkness or visual virtual navigation without any actual self-motion). We suggest that vestibular signals are necessary for other sensory cues to be properly integrated and that vestibular cues are involved in extrapersonal space representation. In this respect, vestibular-induced changes would be based on a dynamic mental representation of space that is continuously updated and that supports fast-adaptive processes.

  20. Isosorbide delays gentamicin-induced vestibular sensory cell death.

    Science.gov (United States)

    Takumida, Masaya; Anniko, Matti

    2005-01-01

    The efficacy of isosorbide for protection from vestibular sensory cell damage was investigated. The effects of isosorbide on gentamicin-induced production of nitric oxide (NO) and reactive oxygen species (ROS) were studied by means of the fluorescence indicators 4,5-diaminofluorescein diacetate and dihydrotetramethylrosamine. The effect on gentamicin-induced vestibular sensory cell damage was examined by using an in vitro LIVE/DEAD system. Isosorbide inhibited the production of both NO and ROS. Isosorbide limited the vestibular sensory cell damage caused by gentamicin. It is, therefore, suggested that isosorbide may help to treat inner ear disorders.

  1. Diagnosis of acute unilateral vestibular deficit by virtual reality.

    Science.gov (United States)

    Mora, Renzo; Cesarani, Antonio; Meloni, Francesco; Passali, Francesco Maria; Mora, Francesco; Passali, Giulio Cesare; Barbieri, Marco

    2004-01-01

    The aim of our study was to establish a new diagnostic approach, through the use of virtual reality, to the study of the subjective vertical bar in unilateral peripheral vestibular dysfunction. We subjected 174 patients with unilateral peripheral vestibular dysfunction (ages 18-82 years) to vestibular diagnosis with the virtual reality system. We changed the classic configuration of the subjective visual vertical into a subjective visual horizontal bar. This technique revealed values of the subjective visual horizontal outside the normal range in 91% of patients.

  2. Vestibular rehabilitation using a wide field of view virtual environment.

    Science.gov (United States)

    Sparto, P J; Furman, J M; Whitney, S L; Hodges, L F; Redfern, M S

    2004-01-01

    This paper presents a theoretical justification for using a wide field of view (FOV) virtual reality display system for use in vestibular rehabilitation. A wide FOV environment offers some unique features that may be beneficial to vestibular rehabilitation. Primarily, optic flow information extracted from the periphery may be critical for recalibrating the sensory processes used by people with vestibular disorders. If this hypothesis is correct, then wide FOV systems will have an advantage over narrow field of view input devices such as head mounted or desktop displays. Devices that we have incorporated into our system that are critical for monitoring improvement in this clinical population will also be described.

  3. Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction.

    Science.gov (United States)

    Verdecchia, Daniel H; Mendoza, Marcela; Sanguineti, Florencia; Binetti, Ana C

    2014-01-01

    Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  4. Effects of electrotactile vestibular substitution on rehabilitation of patients with bilateral vestibular loss.

    Science.gov (United States)

    Barros, Camila Giacomo Carneiro; Bittar, Roseli Saraiva Moreira; Danilov, Yuri

    2010-06-07

    The present study evaluated the effectiveness of electrotactile tongue biofeedback (BrainPort((R))) as a sensory substitute for the vestibular apparatus in patients with bilateral vestibular loss (BVL) who did not have a good response to conventional vestibular rehabilitation (VR). Seven patients with BVL were trained to use the device. Stimulation on the surface of the tongue was created by a dynamic pattern of electrical pulses and the patient was able to adjust the intensity of stimulation and spatially centralize the stimulus on the electrode array. Patients were directed to continuously adjust head orientation and to maintain the stimulus pattern at the center of the array. Postural tasks that present progressive difficulties were given during the use of the device. Pre- and post-treatment distribution of the sensory organization test (SOT) composite score showed an average value of 38.3+/-8.7 and 59.9+/-11.3, respectively, indicating a statistically significant improvement (p=0.01). Electrotactile tongue biofeedback significantly improved the postural control of the study group, even if they had not improved with conventional VR. The electrotactile tongue biofeedback system was able to supply additional information about head position with respect to gravitational vertical orientation in the absence of vestibular input, improving postural control. Patients with BVL can integrate electrotactile information in their postural control in order to improve stability after conventional VR. These results were obtained and verified not only by the subjective questionnaire but also by the SOT composite score. The limitations of the study are the small sample size and short duration of the follow-up. The current findings show that the sensory substitution mediated by electrotactile tongue biofeedback may contribute to the improved balance experienced by these patients compared to VR. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Vestibular compensation after vestibular schwannoma surgery: normalization of the subjective visual vertical and disability.

    Science.gov (United States)

    Batuecas-Caletrio, Angel; Santacruz-Ruiz, Santiago; Muñoz-Herrera, Angel; Sousa, Pablo; Otero, Alvaro; Perez-Fernandez, Nicolas

    2013-05-01

    The degree of caloric weakness before surgery influences faster or slower recovery of patients undergoing vestibular schwannoma surgery. The Dizziness Handicap Inventory (DHI) is a good index to show the recovery of patients as it relates directly to an improvement or not of the subjective visual vertical (SVV). To evaluate the process of recovery of patients as measured by the SVV and the DHI after surgical removal of vestibular schwannoma. We studied 24 consecutive patients of the University Hospital of Salamanca who underwent vestibular schwannoma surgery. We assessed age, tumour size, degree of canalicular weakness and preoperative SVV, and their relationship with DHI and SVV at discharge and also at 1, 3 and 6 months postoperatively. Patients with lesser degrees of caloric weakness took longer to normalize SVV than those with a higher caloric weakness before surgery (p < 0.05). There was a significant correlation between DHI and improvements in SVV with time. The differences disappeared in 6 months where all patients, with greater or lesser degree of caloric weakness, had the same results.

  6. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review.

    Science.gov (United States)

    Porciuncula, Franchino; Johnson, Connie C; Glickman, Leslie B

    2012-01-01

    Adults with bilateral vestibular hypofunction (BVH) experience significant disability. A systematic review assessed evidence for vestibular rehabilitation (VR). NUMBER OF STUDIES: 14 studies. Search identification of studies based on inclusion criteria: (a) population: adults with BVH of peripheral origin; (b) interventions: vestibular exercises, balance training, education, or sensory prosthetics; (c) comparison: single interventions or compared to another psychophysical intervention, placebo, or healthy population; (d) outcomes: based on International Classification of Functioning, Disability and Health (ICF) Body Functions and Structure, Activity, and Participation; (e) study designs: prospective and interventional, Levels of Evidence I to III per Centre of Evidence-based Medicine grading. Coding and appraisal based on ICF framework and strength of evidence synthesis. Five Level II studies and nine Level III studies: All had outcomes on gaze and postural stability, five with outcomes on gait speed and perceptions of oscillopsia and disequilibrium. (a) Moderate evidence strength on improved gaze and postural stability (ICF-Body Functions) following exercise-based VR; (b) Inadequate number of studies supporting benefit of VR on ICF-Participation outcomes; (c) Sensory prosthetics in early phase of development. Moderate evidence strength in support of VR from an impairment level; clinical practice and research needed to explore interventions extending to ICF-Activity and Participation.

  7. Effects of vestibular rehabilitation and social reinforcement on recovery following ablative vestibular surgery.

    Science.gov (United States)

    Mruzek, M; Barin, K; Nichols, D S; Burnett, C N; Welling, D B

    1995-07-01

    This study investigated the relative effects of vestibular rehabilitation (VR) and social reinforcement (SR) on recovery following ablative vestibular surgery. Twenty-four subjects were randomly assigned to three treatment groups of either VR with SR, VR without SR, or general range of motion (ROM) exercises with SR. Outcome measures included equilibrium scores in dynamic posturography, asymmetry index in rotation testing, motion sensitivity quotient (MSQ), and dizziness handicap inventory (DHI). A multiple comparison of the overall outcome measures showed no significant differences in group performance over an 8-week period. When individual outcome measures were compared, MSQ and DHI results at the end of the 8-week treatment period revealed less motion sensitivity and dizziness handicap in groups who received VR, with or without SR, as compared with the group who received ROM exercises. These results suggest that after a vestibular injury most patients can effectively utilize central compensation mechanisms to recover from such an injury, regardless of the type of therapeutic intervention used. On the other hand, the reduction in motion sensitivity and dizziness handicap for patients who received VR could indicate a more rapid and complete recovery for these patients. This investigation is continuing as a long-term follow-up study to determine whether there are any long-term benefits in participating in a VR program.

  8. Saccadic entropy of head impulses in acute unilateral vestibular loss

    Directory of Open Access Journals (Sweden)

    Li-Chun Hsieh

    2017-10-01

    Conclusion: Entropy and gain analysis of HIT using wireless electro-oculography system could be used to detect the VOR dysfunctions of AUVL and may become effective methods for evaluating vestibular disorders.

  9. Audio-Vestibular Findings in Increased Intracranial Hypertension Syndrome.

    Science.gov (United States)

    Çoban, Kübra; Aydın, Erdinç; Özlüoğlu, Levent Naci

    2017-04-01

    Idiopathic intracranial hypertension (IIH) can be manifested by audiological and vestibular complaints. The aim of the present study is to determine the audio-vestibular pathologies and their pathophysiologies in this syndrome by performing current audio-vestibular tests. The study was performed prospectively on 40 individuals (20 IIH patients, 20 healthy volunteers). Pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, and electronystagmography tests were performed in both groups and the results were compared. The mean age of both groups was found to be 30.2±18.7. There were 11 females and 9 males in each group. The study group patients had significantly worse hearing levels. Pure tone averages were significantly higher in both ears of the study group (pintracranial pressure may affect the inner ear with similar mechanisms as in hydrops.

  10. Natural history of hearing deterioration in intracanalicular vestibular schwannoma

    NARCIS (Netherlands)

    Pennings, R.J.E.; Morris, D.P.; Clarke, L.; Allen, S.; Walling, S.; Bance, M.L.

    2011-01-01

    BACKGROUND: Intracanalicular vestibular schwannomas have a range of treatment options that can preserve hearing: microsurgery, stereotactic radiotherapy, and conservative observation. OBJECTIVE: To evaluate the natural course of hearing deterioration during a period of conservative observation.

  11. Inner ear malformations in siblings presenting with vestibular ...

    African Journals Online (AJOL)

    frequency 's' sounds. ... endolymphatic ducts and sacs, and a type II incomplete partition. (classic Mondini) defect (Figs 3 and 4). ABR/auditory ... MRI confirmed bilateral enlarged vestibular aqueducts and type. II incomplete partition defects. He was ...

  12. [Neuronal plasticity of otolith-related vestibular system].

    Science.gov (United States)

    Lai, Suk-King; Lai, Chun-Hong; Zhang, Fu-Xing; Ma, Chun-Wai; Shum, Daisy K Y; Chan, Ying-Shing

    2008-12-01

    This review focuses on our effort in addressing the development and lesion-induced plasticity of the gravity sensing system. After severance of sensory input from one inner ear, there is a bilateral imbalance in response dynamics and spatial coding behavior between neuronal subpopulations on the two sides. These data provide the basis for deranged spatial coding and motor deficits accompanying unilateral labyrinthectomy. Recent studies have also confirmed that both glutamate receptors and neurotrophin receptors within the bilateral vestibular nuclei are implicated in the plasticity during vestibular compensation and development. Changes in plasticity not only provide insight into the formation of a spatial map and recovery of vestibular function but also on the design of drugs for therapeutic strategies applicable to infants or vestibular disorders such as vertigo and dizziness.

  13. Vestibular stimulation: A simple but effective intervention in diabetes care.

    Science.gov (United States)

    Sailesh, Kumar Sai; Archana, R; Mukkadan, J K

    2015-01-01

    Despite the complexities of the relationship between vestibular stimulation and endocrine disorders being well known, research efforts to understand these complexities are lacking. Interestingly vestibular stimulation may potentially prevent/delay development/progression of diabetes. Here we review the science behind this concept and highlight the need for necessary translational research in this area. Current evidence supports the use of vestibular stimulation not only as a potential intervention to prevent or delay the development of diabetes mellitus in at-risk population, but also to use it as supplementary therapy for diabetic patients management. We urge clinicians to recommend vestibular stimulation by simple means like swing as a goal in maintaining a healthy lifestyle.

  14. Probing the human vestibular system with galvanic stimulation

    National Research Council Canada - National Science Library

    Richard C. Fitzpatrick; Brian L. Day

    2004-01-01

    .... This paper examines the electrophysiology and anatomy of the vestibular organs and the effects of GVS on human balance control and develops a model that explains the observed balance responses...

  15. Distinct spontaneous shrinkage of a sporadic vestibular schwannoma

    DEFF Research Database (Denmark)

    Huang, Xiaowen; Cayé-Thomasen, Per; Stangerup, Sven-Eric

    2013-01-01

    We present a case with outspoken spontaneous vestibular schwannoma shrinkage and review the related literature. The patient was initially diagnosed with a left-sided, intrameatal vestibular schwannoma, which subsequently grew into the cerebello-pontine angle (CPA), followed by total shrinkage...... of the CPA component without any intervention over a 12-year observation period. The literature on spontaneous tumor shrinkage was retrieved by searching the subject terms "vestibular schwannoma, conservative management" in PubMed/MEDLINE database, without a time limit. Of the published data, the articles...... on "shrinkage" or "negative growth" or "regression" or "involution" of the tumor were selected, and the contents on the rate, extent and mechanism of spontaneous tumor shrinkage were extracted and reviewed. The reported rate of spontaneous shrinkage of vestibular schwannoma is 5-10% of patients managed...

  16. Vestibulary rehabilitation--election treatment method for compensating vestibular impairment.

    Science.gov (United States)

    Georgescu, Mădălina; Stoian, Sorina; Mogoantă, Carmen Aurelia; Ciubotaru, Gh V

    2012-01-01

    This paper aims to reveal the actual benefit of vestibular rehabilitation (VR) in patients with unilateral vestibular loss. Case report of a young female patient with acute unilateral vestibular loss due to facial nerve schwannoma developed above the internal auditory canal (IAC) from where it seems to have entered the IAC. Betahistine associated to VR treatment was recommended due to persisting imbalance after tumor removal. The benefit of the combined therapy was evaluated objectively (sensory organization test) and subjectively (questionnaires regarding self-perception of the deficit in quality of life). Both evaluations revealed great improvement in stability (SOT scores) as well as in health-related quality of life (HRQoL)--improvement of self-perception scores of disequilibrium in all questionnaires used. Combined recommended treatment (betahistine and VR) improves HRQoL after acute unilateral vestibular loss. It reduces self-perceived disability and intensity of symptoms during usual activities.

  17. [Presbyastasis and application of vestibular rehabilitation in geriatrics].

    Science.gov (United States)

    Costa de Araujo, P; Demanez, L; Lechien, J; Bauvir, P; Petermans, J

    2011-03-01

    Balance disorders can have a major functional impact among the elderly. The main risk is falling. Three elements are implicated in the loss of balance: vision, proprioception and the vestibular system. This article will discuss mainly vestibular damage and its implications. The assessment of balance disorders, particularly in geriatric patients, is based on validated scales composed of several items. These provide scores and are based on the results of chronometric measurements. They can be useful for the application of Vestibular Rehabilitation (VR), a technique improving the adaptation and autonomy of these patients. Vestibular rehabilitation is therefore part of an overall support, the goal of therapy being to improve daily life and to reduce the risk of falls.

  18. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease.

    Science.gov (United States)

    Zeigelboim, Bianca Simone; Klagenberg, Karlin Fabianne; Teive, Hélio A Ghizoni; Munhoz, Renato Puppi; Martins-Bassetto, Jackeline

    2009-06-01

    To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.

  19. Clinical evaluation of elderly people with chronic vestibular disorder

    OpenAIRE

    Juliana Maria Gazzola; Fernando Freitas Ganança; Mayra Cristina Aratani; Monica Rodrigues Perracini; Maurício Malavasi Ganança

    2006-01-01

    A tontura de origem vestibular é comum entre idosos. OBJETIVO: Caracterizar idosos com disfunção vestibular crônica em relação aos dados sociodemográficos, clínico-funcionais e otoneurológicos. MATERIAL E MÉTODO: Estudo de casos que incluiu 120 idosos com disfunção vestibular crônica. Foram realizadas análises descritivas simples. RESULTADOS: A 5,77±amostra apresentou maioria feminina (68,3%), com média etária de 73,40 1,84±anos. O número médio de doenças associadas ao quadro vestibular foi d...

  20. Vestibular dysfunction in a child with embryonic exposure to accutane.

    Science.gov (United States)

    Westerman, S T; Gilbert, L M; Schondel, L

    1994-05-01

    Children with a history of embryonic exposure to Accutane (isotretinoin) are at great risk for major physical malformations, brain malformations, and decreased intelligence. A case is presented of a 4-year 7-month-old black male with a history of embryonic exposure to Accutane who was born with embryopathy that includes bilateral major ear deformities. The child has a significant bilateral conductive hearing loss, and, in addition, a left sided sensorineural loss. Vestibular function testing revealed evidence of peripheral and central vestibular dysfunction. A course of diphenhydramine hydrochloride and Donnatal (phenobarbital, hyoscyamine sulfate, atropine sulfate, and scopolamine hydrobromide) significantly alleviated the symptoms of vestibular dysfunction. Otologic management of these children should include clinical documentation of the external deformities, evaluation of cochlear function, and early auditory habilitation. Vestibular function should also be evaluated in all children with a history of embryonic exposure to isotretinoin.

  1. Sustained and Transient Vestibular Systems: A Physiological Basis for Interpreting Vestibular Function.

    Science.gov (United States)

    Curthoys, Ian S; MacDougall, Hamish G; Vidal, Pierre-Paul; de Waele, Catherine

    2017-01-01

    Otolithic afferents with regular resting discharge respond to gravity or low-frequency linear accelerations, and we term these the static or sustained otolithic system. However, in the otolithic sense organs, there is anatomical differentiation across the maculae and corresponding physiological differentiation. A specialized band of receptors called the striola consists of mainly type I receptors whose hair bundles are weakly tethered to the overlying otolithic membrane. The afferent neurons, which form calyx synapses on type I striolar receptors, have irregular resting discharge and have low thresholds to high frequency (e.g., 500 Hz) bone-conducted vibration and air-conducted sound. High-frequency sound and vibration likely causes fluid displacement which deflects the weakly tethered hair bundles of the very fast type I receptors. Irregular vestibular afferents show phase locking, similar to cochlear afferents, up to stimulus frequencies of kilohertz. We term these irregular afferents the transient system signaling dynamic otolithic stimulation. A 500-Hz vibration preferentially activates the otolith irregular afferents, since regular afferents are not activated at intensities used in clinical testing, whereas irregular afferents have low thresholds. We show how this sustained and transient distinction applies at the vestibular nuclei. The two systems have differential responses to vibration and sound, to ototoxic antibiotics, to galvanic stimulation, and to natural linear acceleration, and such differential sensitivity allows probing of the two systems. A 500-Hz vibration that selectively activates irregular otolithic afferents results in stimulus-locked eye movements in animals and humans. The preparatory myogenic potentials for these eye movements are measured in the new clinical test of otolith function-ocular vestibular-evoked myogenic potentials. We suggest 500-Hz vibration may identify the contribution of the transient system to vestibular controlled

  2. Effect of gravity on vestibular neural development

    Science.gov (United States)

    Ross, M. D.; Tomko, D. L.

    1998-01-01

    The timing, molecular basis, and morphophysiological and behavioral consequences of the interaction between external environment and the internal genetic pool that shapes the nervous system over a lifetime remain important questions in basic neuroscientific research. Space station offers the opportunity to study this interaction over several life cycles in a variety of organisms. This short review considers past work in altered gravity, particularly on the vestibular system, as the basis for proposing future research on space station, and discusses the equipment necessary to achieve goals. It is stressed that, in keeping with the international investment being made in this research endeavor, both the questions asked and the technologies to be developed should be bold. Advantage must be taken of this unique research environment to expand the frontiers of neuroscience. Copyright 1998 Published by Elsevier Science B.V.

  3. Vestibular ataxia and its measurement in man

    Science.gov (United States)

    Fregly, A. R.

    1974-01-01

    Methods involved in and results obtained with a new comprehensive ataxia test battery are described, and definitions of spontaneous and induced vestibular ataxia in man are given in terms of these findings. In addition, the topic of alcohol-induced ataxia in relation to labyrinth function is investigated. Items in the test battery comprise a sharpened Romberg test, in which the subject stands on the floor with eyes closed and arms folded against his chest, feet heel-to-toe, for 60 seconds; an eyes-open walking test; an eyes-open standing test; an eyes-closed standing test; an eyes-closed on-leg standing test; an eyes-closed walk a line test; an eyes-closed heel-to-toe walking test; and supplementary ataxia tests such as the classical Romberg test.

  4. Effect of gravity on vestibular neural development.

    Science.gov (United States)

    Ross, M D; Tomko, D L

    1998-11-01

    The timing, molecular basis, and morphophysiological and behavioral consequences of the interaction between external environment and the internal genetic pool that shapes the nervous system over a lifetime remain important questions in basic neuroscientific research. Space station offers the opportunity to study this interaction over several life cycles in a variety of organisms. This short review considers past work in altered gravity, particularly on the vestibular system, as the basis for proposing future research on space station, and discusses the equipment necessary to achieve goals. It is stressed that, in keeping with the international investment being made in this research endeavor, both the questions asked and the technologies to be developed should be bold. Advantage must be taken of this unique research environment to expand the frontiers of neuroscience. Copyright 1998 Published by Elsevier Science B.V.

  5. Vestibular rehabilitation in elderly patients with dizziness

    OpenAIRE

    Zanardini, Francisco Halilla; Zeigelboim, Bianca Simone [UNIFESP; Jurkiewicz, Ari Leon; Marques, Jair Mendes; Martins-Bassetto,Jackeline

    2007-01-01

    TEMA: o envelhecimento populacional é um processo natural, manifesta-se por um declínio das funções de diversos órgãos. A reabilitação vestibular (RV) é um processo terapêutico que visa promover a redução significativa dos sintomas labirínticos. OBJETIVO: verificar os benefícios dos exercícios de RV por meio da avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) - adaptação brasileira. MÉTODO: participaram deste estudo oito idosos com queixa de tontura, na faixa e...

  6. The Semiology of Motor Disorders in Autism Spectrum Disorders as Highlighted from a Standardized Neuro-Psychomotor Assessment.

    Science.gov (United States)

    Paquet, Aude; Olliac, Bertrand; Bouvard, Manuel-Pierre; Golse, Bernard; Vaivre-Douret, Laurence

    2016-01-01

    Altered motor performance has been described in Autism Spectrum Disorders (ASD) with disturbances in walking; posture, coordination, or arm movements, but some individuals with ASD show no impairment of motor skills. The neuro-developmental processes that underpin the performance of neuro-psychomotor functions have not been widely explored, nor is it clear whether there are neuro-psychomotor functions specifically affected in ASD. Our objective was to focus on the semiology of motor disorders among children with ASD using a neuro-developmental assessment tool. Thirty-four children with ASD, with or without intellectual deficit (ID) were recruited in a child psychiatry department and Autism Resource Centers. Initial standard evaluations for diagnosis (psychiatric; psychological; psychomotor) were supplemented by a standardized assessment battery for neuro-developmental psychomotor functions (NP-MOT). The results of some NP-MOT tests differed between children with ASD with ID and those without. However, on the NP-MOT battery, neither of the two groups did well in the bi-manual and finger praxia tests (36 and 52% respectively failed). Manual and digital gnosopraxia showed some deficit (63 and 62% respectively failed). Postural deficits were found in tests for both static equilibrium (64%) and dynamic (52%). There were also difficulties in coordination between the upper and lower limbs in 58% of children. We found 75% failure in motor skills on the M-ABC test. Concerning muscular tone, significant laxity was observed in distal parts of the body (feet and hands), but hypertonia was observed in the proximal muscles of the lower limbs (reduced heel-ear angle). The results of manual and digital gnosopraxia tests point to a planning deficit in children with autism. A gesture programming deficit is also highlighted by the poor results in manual praxis, and by failures in the M-ABC tests despite prior training of the child. However, concerning global motor function, a

  7. The semiology of motor disorders in Autism Spectrum Disorders as highlighted from a standardized neuro-psychomotor assessment

    Directory of Open Access Journals (Sweden)

    Aude Paquet

    2016-09-01

    Full Text Available Background: Altered motor performance has been described in Autism Spectrum Disorders (ASD with disturbances in walking; posture, coordination or arm movements, but some individuals with ASD show no impairment of motor skills. The neuro-developmental processes that underpin the performance of neuro-psychomotor functions have not been widely explored,nor is it clear whether there areneuro-psychomotor functions specifically affected in ASD. Our objective was to focus on the semiology of motor disorders among children with ASD using a neuro-developmental assessment tool.Method: Thirty-four children with ASD, with or without intellectual deficit (ID were recruited in a child psychiatry department and Autism Resource Centers. Initial standard evaluations for diagnosis (psychiatric; psychological; psychomotor were supplemented by a standardized assessment battery for neuro-developmental psychomotor functions (NP-MOT.Results: The results of some NP-MOT tests differed between children with ASD with intellectual deficit (ID and those without. However, on the NP-MOT battery, neither of the two groups did well in the bi-manual and finger praxia tests (36% and 52% respectively failed. Manual and digital gnosopraxia showed some deficit (63% and 62% respectively failed. Postural deficits were found in tests for both static equilibrium (64% and dynamic (52%. There were also difficulties in coordination between the upper and lower limbs in 58% of children. We found 75% failure in motor skills on the M-ABC test. Concerning muscular tone, significant laxity was observed in distal parts of the body (feet and hands, but hypertonia was observed in the proximal muscles of the lower limbs (reduced heel-ear angle.Discussion: The results of manual and digital gnosopraxia tests point to a planning deficit in children with autism. A gesture programming deficit is also highlighted by the poor results in manual praxis, and by failures in the M-ABC tests despite prior

  8. Treatment of Vestibular Dysfunction Using a Portable Stimulator

    Science.gov (United States)

    2017-04-01

    AWARD NUMBER: W81XWH-14-2-0012 TITLE: Treatment of Vestibular Dysfunction Using a Portable Stimulator PRINCIPAL INVESTIGATOR: Jorge M...PAGE UU 17 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18 Treatment of Vestibular...noise over a 2week stimulation paradigm Significant Results of Year 3 1) Research flyers have been posted to aid in recruitment. Fourteen

  9. Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Claesson, Magnus; Stangerup, Sven-Eric

    2012-01-01

    To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hear......To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea...

  10. Early and phasic cortical metabolic changes in vestibular neuritis onset.

    Directory of Open Access Journals (Sweden)

    Marco Alessandrini

    Full Text Available Functional brain activation studies described the presence of separate cortical areas responsible for central processing of peripheral vestibular information and reported their activation and interactions with other sensory modalities and the changes of this network associated to strategic peripheral or central vestibular lesions. It is already known that cortical changes induced by acute unilateral vestibular failure (UVF are various and undergo variations over time, revealing different cortical involved areas at the onset and recovery from symptoms. The present study aimed at reporting the earliest change in cortical metabolic activity during a paradigmatic form of UVF such as vestibular neuritis (VN, that is, a purely peripheral lesion of the vestibular system, that offers the opportunity to study the cortical response to altered vestibular processing. This research reports [(18F]fluorodeoxyglucose positron emission tomography brain scan data concerning the early cortical metabolic activity associated to symptoms onset in a group of eight patients suffering from VN. VN patients' cortical metabolic activity during the first two days from symptoms onset was compared to that recorded one month later and to a control healthy group. Beside the known cortical response in the sensorimotor network associated to vestibular deafferentation, we show for the first time the involvement of Entorhinal (BAs 28, 34 and Temporal (BA 38 cortices in early phases of symptomatology onset. We interpret these findings as the cortical counterparts of the attempt to reorient oneself in space counteracting the vertigo symptom (Bas 28, 34 and of the emotional response to the new pathologic condition (BA 38 respectively. These interpretations were further supported by changes in patients' subjective ratings in balance, anxiety, and depersonalization/derealization scores when tested at illness onset and one month later. The present findings contribute in expanding

  11. Vestibular animal models: contributions to understanding physiology and disease

    OpenAIRE

    Straka, Hans; Zwergal, Andreas; Cullen, Kathleen E.

    2016-01-01

    Our knowledge of the vestibular sensory system, its functional significance for gaze and posture stabilization, and its capability to ensure accurate spatial orientation perception and spatial navigation has greatly benefitted from experimental approaches using a variety of vertebrate species. This review summarizes the attempts to establish the roles of semicircular canal and otolith endorgans in these functions followed by an overview of the most relevant fields of vestibular research inclu...

  12. Treatment of Vestibular Dysfunction Using a Portable Simulator

    Science.gov (United States)

    2015-04-01

    Project Major Goal 1 - Develop a portable stimulator which can be worn continuously and used to improve vestibular function (April 2014 to June 2016...AD______________ AWARD NUMBER: W81XWH-14-2-0012 TITLE: TREATMENT OF VESTIBULAR DYSFUNCTION USING A PORTABLE STIMULATOR PRINCIPAL...hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and

  13. Neuropharmacological Targets for Drug Action in Vestibular Sensory Pathways

    OpenAIRE

    Lee, Choongheon; Jones, Timothy A

    2017-01-01

    The use of pharmacological agents is often the preferred approach to the management of vestibular dysfunction. In the vestibular sensory pathways, the sensory neuroepithelia are thought to be influenced by a diverse number of neuroactive substances that may act to enhance or inhibit the effect of the primary neurotransmitters [i.e., glutamate (Glu) and acetylcholine (ACh)] or alter their patterns of release. This review summarizes various efforts to identify drug targets including neurotransm...

  14. Morphological analysis of the vestibular aqueduct by computerized tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Sergio Ricardo [Morphology and Genetics Department, Sao Paulo Federal University-Paulista Medical School, Disciplina de Anatomia Descritiva e Topografica, Rua Botucatu, 740-Edificio Leitao da Cunha, CEP 04023-900, Vila Clementino, Sao Paulo (Brazil)]. E-mail: sergioanat.morf@epm.br; Smith, Ricardo Luiz [Morphology and Genetics Department, Sao Paulo Federal University-Paulista Medical School, Disciplina de Anatomia Descritiva e Topografica, Rua Botucatu, 740-Edificio Leitao da Cunha, CEP 04023-900, Vila Clementino, Sao Paulo (Brazil); Isotani, Sadao [Institute of Physics, University of Sao Paulo, Sao Paulo (Brazil); Alonso, Luis Garcia [Morphology and Genetics Department, Sao Paulo Federal University-Paulista Medical School, Disciplina de Anatomia Descritiva e Topografica, Rua Botucatu, 740-Edificio Leitao da Cunha, CEP 04023-900, Vila Clementino, Sao Paulo (Brazil); Anadao, Carlos Augusto [Otorhinolaryngology Department, Sao Paulo Federal University-Paulista Medical School, Sao Paulo (Brazil); Prates, Jose Carlos [Morphology and Genetics Department, Sao Paulo Federal University-Paulista Medical School, Disciplina de Anatomia Descritiva e Topografica, Rua Botucatu, 740-Edificio Leitao da Cunha, CEP 04023-900, Vila Clementino, Sao Paulo (Brazil); Lederman, Henrique Manoel [Image Diagnosis Department, Sao Paulo Federal University-Paulista Medical School, Sao Paulo (Brazil)

    2007-01-15

    Objective: In the last two decades, advances in the computerized tomography (CT) field revise the internal and medium ear evaluation. Therefore, the aim of this study is to analyze the morphology and morphometric aspects of the vestibular aqueduct on the basis of computerized tomography images (CTI). Material and method: Computerized tomography images of vestibular aqueducts were acquired from patients (n = 110) with an age range of 1-92 years. Thereafter, from the vestibular aqueducts images a morphometric analysis was performed. Through a computerized image processing system, the vestibular aqueduct measurements comprised of its area, external opening, length and the distance from the vestibular aqueduct to the internal acoustic meatus. Results: The morphology of the vestibular aqueduct may be funnel-shaped, filiform or tubular and the respective proportions were found to be at 44%, 33% and 22% in children and 21.7%, 53.3% and 25% in adults. The morphometric data showed to be of 4.86 mm{sup 2} of area, 2.24 mm of the external opening, 4.73 mm of length and 11.88 mm of the distance from the vestibular aqueduct to the internal acoustic meatus, in children, and in adults it was of 4.93 mm{sup 2}, 2.09 mm, 4.44 mm, and 11.35 mm, respectively. Conclusions: Computerized tomography showed that the vestibular aqueduct presents high morphological variability. The morphometric analysis showed that the differences found between groups of children and adults or between groups of both genders were not statistically significant.

  15. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease

    OpenAIRE

    Zeigelboim, Bianca Simone [UNIFESP; Klagenberg, Karlin Fabianne; TEIVE, HÉLIO A. GHIZONI; Munhoz,Renato Puppi; Martins-Bassetto,Jackeline

    2009-01-01

    OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instabili...

  16. Ontogenetic development of vestibular reflexes in amphibians

    Directory of Open Access Journals (Sweden)

    Hans Straka

    2016-11-01

    Full Text Available Vestibulo-ocular reflexes ensure gaze stability during locomotion and passively induced head/body movements. In precocial vertebrates such as amphibians, vestibular reflexes are required very early at the onset of locomotor activity. While the formation of inner ears and the assembly of sensory-motor pathways is largely completed soon after hatching, angular and translational/tilt vestibulo-ocular reflexes (VOR display differential functional onsets and mature with different time courses. Otolith-derived eye movements appear immediately after hatching, whereas the appearance and progressive amelioration of semicircular canal-evoked eye movements is delayed and dependent on the acquisition of sufficiently large semicircular canal diameters. Moreover, semicircular canal functionality is also required to tune the initially omnidirectional otolith-derived VOR. The tuning is due to a reinforcement of those vestibulo-ocular connections that are co-activated by semicircular canal and otolith inputs during natural head/body motion. This suggests that molecular mechanisms initially guide the basic ontogenetic wiring, whereas semicircular canal-dependent activity is required to establish the spatio-temporal specificity of the reflex. While a robust VOR is activated during passive head/body movements, locomotor efference copies provide the major source for compensatory eye movements during tail- and limb-based swimming of larval and adult frogs. The integration of active/passive motion-related signals for gaze stabilization occurs in central vestibular neurons that are arranged as segmentally iterated functional groups along rhombomere 1-8. However, at variance with the topographic maps of most other sensory systems, the sensory-motor transformation of motion-related signals occurs in segmentally specific neuronal groups defined by the extraocular motor output targets.

  17. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials.

    Science.gov (United States)

    Kantner, C; Gürkov, R

    2012-12-01

    Recently, ocular vestibular evoked myogenic potentials (oVEMPs) have been described and added to the neuro-otologic test battery as a new measure for the vestibulo-ocular reflex. oVEMPs represent extraocular muscle activity in response to otolith stimulation e.g. by air-conducted sound or bone-conducted vibration. In response to vestibular stimulation, electromyographic activity of the extraocular muscles can be recorded by means of surface electrodes placed beneath the contralateral eye. oVEMPs are likely to reflect predominantly utricular function, while the widely established cervical vestibular evoked myogenic potentials (cVEMPs) assess saccular function. Thus, measuring oVEMPs and cVEMPs in addition to caloric and head impulse testing provides further evaluation of the vestibular system and enables quick and cost-effective assessment of otolith function. This review summarizes the neurophysiological properties of oVEMPs, gives recommendations for recording conditions and discusses oVEMP alterations in various disorders of the vestibular system. With increasing insight into oVEMP characteristics in vestibular disorders, e.g. Menière's disease and superior semicircular canal dehiscence syndrome, oVEMPs are becoming a promising new diagnostic tool for evaluating utricular function. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Vestibular contributions to high-level sensorimotor functions.

    Science.gov (United States)

    Medendorp, W Pieter; Selen, Luc J P

    2017-10-01

    The vestibular system, which detects motion and orientation of the head in space, is known to be important in controlling gaze to stabilize vision, to ensure postural stability and to provide our sense of self-motion. While the brain's computations underlying these functions are extensively studied, the role of the vestibular system in higher level sensorimotor functions is less clear. This review covers new research on the vestibular influence on perceptual judgments, motor decisions, and the ability to learn multiple motor actions. Guided by concepts such as optimization, inference, estimation and control, we focus on how the brain determines causal relationships between memorized and visual representations in the updating of visual space, and how vestibular, visual and efferent motor information are integrated in the estimation of body motion. We also discuss evidence that these computations involve multiple coordinate representations, some of which can be probed in parietal cortex using neuronal oscillations derived from EEG. In addition, we describe work on decision making during self-motion, showing a clear modulation of bottom-up acceleration signals on decisions in the saccadic system. Finally, we consider the importance of vestibular signals as contextual cues in motor learning and recall. Taken together, these results emphasize the impact of vestibular information on high-level sensorimotor functions, and identify future directions for theoretical, behavioral, and neurophysiological investigations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Visuo-vestibular contributions to anxiety and fear.

    Science.gov (United States)

    Coelho, Carlos M; Balaban, Carey D

    2015-01-01

    The interactive roles of the visual and vestibular systems allow for postural control within boundaries of perceived safety. In specific circumstances, visual vestibular and postural interactions act as a cue that trigger fear, similarly to what occurs in motion sickness. Unusual patterns of visuo-vestibular interaction that emerge without warning can elicit fear, which can then become associated to a certain stimuli or situation, creating a CS-US association, (i.e., phobia), or can emerge without warning but also without becoming associated to a particular concomitant event (i.e., panic). Depending on the individual sensitivity to visuo-vestibular unusual patterns and its impact in postural control, individuals will be more or less vulnerable to develop these disorders. As such, the mechanism we here propose is also sufficient to explain the lack of certain fears albeit exposure. Following this rationale, a new subcategory of anxiety disorders, named visuo-vestibular fears can be considered. This model brings important implications for developmental and evolutionary psychological science, and invites to place visuo-vestibular fears in a particular subtype or specification within the DSM-5 diagnostic criteria. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Effects of vestibular rehabilitation in the elderly: a systematic review.

    Science.gov (United States)

    Martins E Silva, Diandra Caroline; Bastos, Victor Hugo; de Oliveira Sanchez, Mariana; Nunes, Monara Kedma Gomes; Orsini, Marco; Ribeiro, Pedro; Velasques, Bruna; Teixeira, Silmar Silva

    2016-08-01

    Aging is characterized by gradual physiological changes in body systems. Changes in the vestibular system can occur and cause dizziness, vertigo and imbalance, symptoms that are common in the elderly. Vestibular rehabilitation is a therapeutic resource that has been widely used to improve this condition. To complete a systematic review of the effects of vestibular rehabilitation on the elderly. A search for relevant publications was conducted in SCIELO, PUBMED, MEDLINE, COCHRANE and LILACS databases. Clinical trials and cohort studies that were written in the English language and published over the course of the last 10 years were selected. The methodological quality of the studies was assessed using the PEDro scale. A critical analysis of the studies was composed. Eight studies that involved subjects who were over the age of 60 were selected for inclusion in the systematic review. The most common vestibular dysfunction identified was complaints about dizziness and imbalance. The Dizziness Handicap Inventory was the most frequently used assessment instrument, and the treatment protocol that prevailed was that suggested by Cawthorne and Cooksey. The PEDro scale showed that only one article was of an acceptable methodological quality and presented satisfactory outcome measures. This was due, in part, to a lack of a hidden randomization, masking of the subject, evaluators and therapists, and lack of outcome measures, which can reduce the quality of the evidence presented in this study. Clinical trials indicate that vestibular rehabilitation represents an effective means of treating elderly patients with vestibular disorders; however, evidence of its effectiveness remains lacking.

  1. Evaluation of postural control in unilateral vestibular hypofunction.

    Science.gov (United States)

    Quitschal, Rafaela Maia; Fukunaga, Jackeline Yumi; Ganança, Maurício Malavasi; Caovilla, Heloísa Helena

    2014-01-01

    Patients with vestibular hypofunction, a typical finding in peripheral vestibular disorders, show body balance alterations. To evaluate the postural control of patients with vertigo and unilateral vestibular hypofunction. This is a clinical cross-sectional study. Twenty-five patients with vertigo and unilateral vestibular hypofunction and a homogeneous control group consisting of 32 healthy individuals were submitted to a neurotological evaluation including the Tetrax Interactive Balance System posturography in eight different sensory conditions. For different positions, vertiginous patients with unilateral vestibular hypofunction showed significantly higher values of general stability index, weight distribution index, right/left and tool/heel synchronizations, Fourier transformation index and fall index than controls. Increased values in the indices of weight distribution, right/left and tool/heel synchronizations, Fourier transformation and fall risk characterize the impairment of postural control in patients with vertigo and unilateral vestibular hypofunction. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  2. Replacing semicircular canal function with a vestibular implant.

    Science.gov (United States)

    Merfeld, Daniel M; Lewis, Richard F

    2012-10-01

    To summarize the recent progress in the development of vestibular implants. The review is timely because of the recent advances in the field and because MED-EL has recently announced that they are developing a vestibular implant for clinical applications. The handicap experienced by patients suffering from bilateral vestibulopathy has a strong negative impact on physical and social functioning that appears to justify a surgical intervention. Two different surgical approaches to insert electrodes to stimulate ampullary neurons have been shown to be viable. The three-dimensional vestibulo-ocular reflex in rhesus monkeys produced with a three-dimensional vestibular implant showed gains that were relatively normal during acute stimulation. Rotation cues provided by an implant interact with otolith cues in a qualitatively normal manner. The brain appears to adapt plastically to the cues provided via artificial electrical stimulation. Research to date includes just a few human studies, but available data from both humans and animals support the technological and physiological feasibility of vestibular implants. Although vestibular implant users should not expect normal vestibular function - any more than cochlear implant users should expect normal hearing - data suggest that significant functional improvements are possible.

  3. Neuropharmacological Targets for Drug Action in Vestibular Sensory Pathways.

    Science.gov (United States)

    Lee, Choongheon; Jones, Timothy A

    2017-09-01

    The use of pharmacological agents is often the preferred approach to the management of vestibular dysfunction. In the vestibular sensory pathways, the sensory neuroepithelia are thought to be influenced by a diverse number of neuroactive substances that may act to enhance or inhibit the effect of the primary neurotransmitters [i.e., glutamate (Glu) and acetylcholine (ACh)] or alter their patterns of release. This review summarizes various efforts to identify drug targets including neurotransmitter and neuromodulator receptors in the vestibular sensory pathways. Identifying these receptor targets provides a strategic basis to use specific pharmacological tools to modify receptor function in the treatment and management of debilitating balance disorders. A review of the literature reveals that most investigations of the neuropharmacology of peripheral vestibular function have been performed using in vitro or ex vivo animal preparations rather than studying drug action on the normal intact vestibular system in situ. Such noninvasive approaches could aid the development of more accurate and effective intervention strategies for the treatment of dizziness and vertigo. The current review explores the major neuropharmacological targets for drug action in the vestibular system.

  4. The Moving History of Vestibular Stimulation as a Therapeutic Intervention.

    Science.gov (United States)

    Grabherr, Luzia; Macauda, Gianluca; Lenggenhager, Bigna

    2015-01-01

    Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox's chair or Hallaran's swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective.

  5. Patterning of sympathetic nerve activity in response to vestibular stimulation

    Science.gov (United States)

    Kerman, I. A.; McAllen, R. M.; Yates, B. J.

    2000-01-01

    Growing evidence suggests a role for the vestibular system in regulation of autonomic outflow during postural adjustments. In the present paper we review evidence for the patterning of sympathetic nerve activity elicited by vestibular stimulation. In response to electrical activation of vestibular afferents, firing of sympathetic nerves located throughout the body is altered. However, activity of the renal nerve is most sensitive to vestibular inputs. In contrast, high-intensity simultaneous activation of cutaneous and muscle inputs elicits equivalent changes in firing of the renal, superior mesenteric and lumbar colonic nerves. Responses of muscle vasoconstrictor (MVC) efferents to vestibular stimulation are either inhibitory (Type I) or are comprised of a combination of excitation and inhibition (Type II). Interestingly, single MVC units located in the hindlimb exhibited predominantly Type I responses while those located in the forelimb and face exhibited Type II responses. Furthermore, brachial and femoral arterial blood flows were dissociated in response to vestibular stimulation, such that brachial vascular resistance increased while femoral resistance decreased. These studies demonstrate that vestibulosympathetic reflexes are patterned according to both the anatomical location and innervation target of a particular sympathetic nerve, and can lead to distinct changes in local blood flow.

  6. Vestibular telemedicine and rehabilitation. Applications for virtual reality.

    Science.gov (United States)

    Viirre, E

    1996-01-01

    This paper will discuss the use of Virtual Reality (VR) technologies in the rehabilitation of patients with vestibular disorders and in the provision of remote medical consultations for those patients. Patients with a vestibular problem are very common (vertigo is the second most common neurological complaint after headache) and yet there are very few vestibular neurotologists: specialists in their diagnosis and treatment. New treatments for various disorders causing vertigo now exist. This means that appropriate diagnosis can significantly improve patients' well-being. Remote medical diagnosis and treatment facilities could make the few vestibular disorder specialists much more available to patients. An analysis of the technological and economic factors influencing the provision of this service is necessary. The main long term effect of many vestibular disorders is damage to the sensing apparatus of the inner ear. The damage can lead to inappropriate interaction between visually driven orientation sensing and sensing of orientation by the inner ear. The consequence for the patient is vertigo (a sensation of turning), motion sickness and imbalance. Current rehabilitation efforts are intended to drive the nervous system to adapt to the disordered vestibular input. Adaptation appears to occur slowly in many subjects, even those within rehabilitation programs. An appropriately designed VR experience could greatly increase the rate of adaptation in these patients.

  7. Paciente com cefaleia e síndrome vestibular periférica: relato de caso Patient with headache and peripheral vestibular dysfunction: case report

    OpenAIRE

    Tatiane Maria Rossi; Naonne Santos Camargo Luciano; Polliay Freire Oricoli; Luciana Lozza de Moraes Marchiori; Juliana Jandre Melo

    2009-01-01

    TEMA: a Reabilitação Vestibular constitui-se numa opção de tratamento para pacientes portadores de síndrome vestibular periférica e cefaleia. PROCEDIMENTOS: o paciente, do sexo feminino com 26 anos de idade apresentava síndrome vestibular periférica acompanhada de crises de cefaleia. Foi realizada avaliação e terapia fonoaudiológica com exercícios de habituação vestibular além de fisioterapia e dieta recomendada pelo nutricionista. RESULTADOS: no período de 3 meses com reabilitação vestibular...

  8. Scapegoating Non-Conforming Identities: Witchcraft Hysteria in Arthur Miller’s The Crucible and Caryl Churchill’s Vinegar Tom

    Directory of Open Access Journals (Sweden)

    Neslihan Yılmaz Demirkaya

    2015-12-01

    Full Text Available Scapegoating Non-Conforming Identities: Witchcraft Hysteria in Arthur Miller’s The Crucible and Caryl Churchill’s Vinegar Tom Abstract When people are faced with different takes on their traditions that they firmly cling to so as to remain being who they purport to be, they are generally inclined to ostracise those who are different. In this sense, ostracising people by discarding them from their community is, metaphorically speaking, the same as leaving the goat in the wilderness as the verses from Leviticus explain the history of scapegoating. Just as the goat story from Leviticus, political and patriarchal power groups blame non-conforming individuals for all the problems in society, and ostracise them as witches only to take the upper hand, and enjoy absolute power. The pattern of punishment proves to be the same, that is, to leave the victim alone in a place away from home, be it the wilderness for a goat, or the loneliness and isolation for an individual. Besides, one of the most used and most efficient ways of scapegoating people, as the evidence shows, is to rekindle the tall-tale of witchcraft. This paper explores how and why witchcraft is deployed as a scapegoating strategy to silence and stigmatise non-conforming individuals on the pretext of maintaining order in society in Arthur Miler’s The Crucible (1953 and Caryl Churchill’s Vinegar Tom (1976 respectively.

  9. [Ictal semiology of temporal partial complex seizures: usefulness for localizing and lateralizing the origin of the attacks].

    Science.gov (United States)

    Fernández Torre, J L

    1999-01-01

    To review signs and symptoms associated with temporal complex partial seizures (CPS) and their utility in the localization and lateralization of seizure onset. CPS are particularly resistant to the standard antiepileptic drugs. Since surgical treatment is a therapeutical alternative in patients with intractable seizures, localization and lateralization of seizure origin are the principal aims in the preoperative assessment. Video-EEG monitorization has made possible characterization of ictal behaviour and correlation with cerebral regions generating the epileptic discharge. Therefore, ictal semiology has increased its importance in the localization and lateralization of seizures. The utility of auras, automatisms, motor manifestations, speech disturbances and autonomic features have been reviewed in relation to this approach. Viscerosensorial and experiential auras have been associated with temporal lobe epilepsy. The automatisms are not exclusive of temporal seizures and may be observed in frontal epilepsy and parietal and occipital seizures with spreading to temporal structures. There is not agreement in relation to head turning and version, therefore, this clinical sign should be used in correlation to other clinical manifestations. Distonic posturing, comprehensible ictal speech and postictal dysphasia appear to be the most reliable clinical signs in the lateralisation of temporal lobe seizures.

  10. Avaliação vestibular no tremor essencial Vestibular evaluation in the essential tremor

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2008-01-01

    Full Text Available TEMA: o tremor essencial é familial em cerca de 50% dos casos, com uma herança autossômica, possui início insidioso e é lentamente progressivo. PROCEDIMENTOS: avaliou-se no Setor de Otoneurologia de um Hospital Particular em fevereiro de 2007, uma paciente do sexo feminino, branca, 59 anos, casada, artista plástica, com história de tremor na cabeça desde os dois anos de idade (sic. A paciente relata queixa de tontura há vários meses de origem súbita sem acompanhamento de náusea e/ou queda. Nega perda de força muscular e formigamento em membros superiores e inferiores, rebaixamento da acuidade auditiva e zumbido. A paciente relata que um de seus filhos possuiu tremor nas mãos há dois anos e avós maternos e paternos com Parkinson. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica e avaliação vestibular por meio da vectoeletronistagmografia. RESULTADOS: observaram-se os seguintes achados ao exame vestibular: nistagmo de posicionamento com características centrais, nistagmo espontâneo presente com os olhos abertos, nistagmo semi-espontâneo do tipo múltiplo e hiper-reflexia em valor absoluto à prova calórica 20ºC (OD e OE. CONCLUSÃO: o exame vestibular mostrou-se sensível e importante para captar alterações em provas que sugerissem envolvimento do sistema nervoso central.BACKGROUND: essential tremors are family-related in about 50% of the cases with an autosomal inheritance and they register an insidious beginning with a slow progression. PROCEDURE: a 59 year old, white female patient, married and whose occupation is a plastic artist with a history of head tremors since she was two years (sic old was evaluated in the Otoneurology sector of a private hospital, during the period from February 2007. The patient had been complaining of dizziness from unknown origin for several months without accompanying nausea and/or falls. She denied any loss of muscular strength or tingling in her upper and lower

  11. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input.

    Science.gov (United States)

    Sprenger, Andreas; Wojak, Jann F; Jandl, Nico M; Helmchen, Christoph

    2017-01-01

    Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive

  12. Postural Control in Bilateral Vestibular Failure: Its Relation to Visual, Proprioceptive, Vestibular, and Cognitive Input

    Science.gov (United States)

    Sprenger, Andreas; Wojak, Jann F.; Jandl, Nico M.; Helmchen, Christoph

    2017-01-01

    Patients with bilateral vestibular failure (BVF) suffer from postural and gait unsteadiness with an increased risk of falls. The aim of this study was to elucidate the differential role of otolith, semicircular canal (SSC), visual, proprioceptive, and cognitive influences on the postural stability of BVF patients. Center-of-pressure displacements were recorded by posturography under six conditions: target visibility; tonic head positions in the pitch plane; horizontal head shaking; sensory deprivation; dual task; and tandem stance. Between-group analysis revealed larger postural sway in BVF patients on eye closure; but with the eyes open, BVF did not differ from healthy controls (HCs). Head tilts and horizontal head shaking increased sway but did not differ between groups. In the dual task condition, BVF patients maintained posture indistinguishable from controls. On foam and tandem stance, postural sway was larger in BVF, even with the eyes open. The best predictor for the severity of bilateral vestibulopathy was standing on foam with eyes closed. Postural control of our BVF was indistinguishable from HCs once visual and proprioceptive feedback is provided. This distinguishes them from patients with vestibulo-cerebellar disorders or functional dizziness. It confirms previous reports and explains that postural unsteadiness of BVF patients can be missed easily if not examined by conditions of visual and/or proprioceptive deprivation. In fact, the best predictor for vestibular hypofunction (VOR gain) was examining patients standing on foam with the eyes closed. Postural sway in that condition increased with the severity of vestibular impairment but not with disease duration. In the absence of visual control, impaired otolith input destabilizes BVF with head retroflexion. Stimulating deficient SSC does not distinguish patients from controls possibly reflecting a shift of intersensory weighing toward proprioceptive-guided postural control. Accordingly, proprioceptive

  13. Enhancement of Otolith Specific Ocular Responses Using Vestibular Stochastic Resonance

    Science.gov (United States)

    Fiedler, Matthew; De Dios, Yiri E.; Esteves, Julie; Galvan, Raquel; Wood, Scott; Bloomberg, Jacob; Mulavara, Ajitkumar

    2011-01-01

    Introduction: Astronauts experience disturbances in sensorimotor function after spaceflight during the initial introduction to a gravitational environment, especially after long-duration missions. Our goal is to develop a countermeasure based on vestibular stochastic resonance (SR) that could improve central interpretation of vestibular input and mitigate these risks. SR is a mechanism by which noise can assist and enhance the response of neural systems to relevant, imperceptible sensory signals. We have previously shown that imperceptible electrical stimulation of the vestibular system enhances balance performance while standing on an unstable surface. Methods: Eye movement data were collected from 10 subjects during variable radius centrifugation (VRC). Subjects performed 11 trials of VRC that provided equivalent tilt stimuli from otolith and other graviceptor input without the normal concordant canal cues. Bipolar stochastic electrical stimulation, in the range of 0-1500 microamperes, was applied to the vestibular system using a constant current stimulator through electrodes placed over the mastoid process behind the ears. In the VRC paradigm, subjects were accelerated to 216 deg./s. After the subjects no longer sensed rotation, the chair oscillated along a track at 0.1 Hz to provide tilt stimuli of 10 deg. Eye movements were recorded for 6 cycles while subjects fixated on a target in darkness. Ocular counter roll (OCR) movement was calculated from the eye movement data during periods of chair oscillations. Results: Preliminary analysis of the data revealed that 9 of 10 subjects showed an average increase of 28% in the magnitude of OCR responses to the equivalent tilt stimuli while experiencing vestibular SR. The signal amplitude at which performance was maximized was in the range of 100-900 microamperes. Discussion: These results indicate that stochastic electrical stimulation of the vestibular system can improve otolith specific responses. This will have a

  14. Frequency response of human vestibular reflexes characterized by stochastic stimuli.

    Science.gov (United States)

    Dakin, Christopher J; Son, Gregory M Lee; Inglis, J Timothy; Blouin, Jean-Sébastien

    2007-09-15

    Stochastic vestibular stimulation (SVS) can be used to study the postural responses to unpredictable vestibular perturbations. The present study seeks to determine if stochastic vestibular stimulation elicits lower limb muscular responses and to estimate the frequency characteristics of these vestibulo-motor responses in humans. Fourteen healthy subjects were exposed to unpredictable galvanic currents applied on their mastoid processes while quietly standing (+/-3 mA, 0-50 Hz). The current amplitude and stimulation configuration as well as the subject's head position relative to their feet were manipulated in order to determine that: (1) the muscle responses evoked by stochastic currents are dependent on the amplitude of the current, (2) the muscle responses evoked by stochastic currents are specific to the percutaneous stimulation of vestibular afferents and (3) the lower limb muscle responses exhibit polarity changes with different head positions as previously described for square-wave galvanic vestibular stimulation (GVS) pulses. Our results revealed significant coherence (between 0 and 20 Hz) and cumulant density functions (peak responses at 65 and 103 ms) between SVS and the lower limbs' postural muscle activity. The polarity of the cumulant density functions corresponded to that of the reflexes elicited by square-wave GVS pulses. The SVS-muscle activity coherence and time cumulant functions were modulated by current amplitude, electrode position and head orientation with respect to the subject's feet. These findings strongly support the vestibular origin of the lower limb muscles evoked by SVS. In addition, specific frequency bandwidths in the stochastic vestibular signal contributed to the early (12-20 Hz) and late components (2-10 Hz) of the SVS-evoked muscular responses. These frequency-dependent SVS-evoked muscle responses support the view that the biphasic muscle response is conveyed by two distinct physiological processes.

  15. Prevalence of vestibular disorder in older people who experience dizziness

    Directory of Open Access Journals (Sweden)

    Allan T Chau

    2015-12-01

    Full Text Available Dizziness and imbalance are clinically poorly defined terms, which affect ~30% of people over 65 years of age. In these people it is often difficult to define the primary cause of dizziness, as it can stem from cardiovascular, vestibular, psychological and neuromuscular causes. However, identification of the primary cause is vital in determining the most effective treatment strategy for a patient. Our aim was to accurately identify the prevalence of: Benign Paroxysmal Positional Vertigo (BPPV, peripheral, and central vestibular hypofunction in people aged over 50 years who had experienced dizziness within the past year. Seventy six participants aged 51 to 92 (mean ± SD = 69 ± 9.5 years were tested using the Head Thrust Dynamic Visual Acuity (htDVA test, Dizziness Handicap Inventory (DHI, as well as sinusoidal and unidirectional rotational chair testing, in order to obtain data for: htDVA score; DHI score; sinusoidal (whole-body, 0.1 - 2 Hz with peak-velocity at 30deg/s Vestibulo-Ocular Reflex (VOR gain and phase; transient (whole-body, acceleration at 150deg/s/s to a constant velocity rotation of 50deg/s VOR gain and time constant; OptoKinetic Nystagmus (OKN gain and time constant (whole-body, constant velocity rotation at 50deg/s. We found that BPPV, peripheral and central vestibular hypofunction were present in 38% and 1% of participants respectively, suggesting a likely vestibular cause of dizziness in these people. Of those with a likely vestibular cause, 63% had BPPV; a figure higher than previously reported in dizziness clinics of ~25%. Our results indicate that htDVA, sinusoidal (particularly 0.5 - 1 Hz and transient VOR testing were the most effective at detecting people with BPPV or vestibular hypofunction, whereas DHI and OKN were effective at only detecting non-BPPV vestibular hypofunction.

  16. Genetics of peripheral vestibular dysfunction: lessons from mutant mouse strains.

    Science.gov (United States)

    Jones, Sherri M; Jones, Timothy A

    2014-03-01

    A considerable amount of research has been published about genetic hearing impairment. Fifty to sixty percent of hearing loss is thought to have a genetic cause. Genes may also play a significant role in acquired hearing loss due to aging, noise exposure, or ototoxic medications. Between 1995 and 2012, over 100 causative genes have been identified for syndromic and nonsyndromic forms of hereditary hearing loss. Mouse models have been extremely valuable in facilitating the discovery of hearing loss genes and in understanding inner ear pathology due to genetic mutations or elucidating fundamental mechanisms of inner ear development. Whereas much is being learned about hereditary hearing loss and the genetics of cochlear disorders, relatively little is known about the role genes may play in peripheral vestibular impairment. Here we review the literature with regard to genetics of vestibular dysfunction and discuss what we have learned from studies using mutant mouse models and direct measures of peripheral vestibular neural function. Several genes are considered that when mutated lead to varying degrees of inner ear vestibular dysfunction due to deficits in otoconia, stereocilia, hair cells, or neurons. Behavior often does not reveal the inner ear deficit. Many of the examples presented are also known to cause human disorders. Knowledge regarding the roles of particular genes in the operation of the vestibular sensory apparatus is growing, and it is clear that gene products co-expressed in the cochlea and vestibule may play different roles in the respective end organs. The discovery of new genes mediating critical inner ear vestibular function carries the promise of new strategies in diagnosing, treating, and managing patients as well as predicting the course and level of morbidity in human vestibular disease. American Academy of Audiology.

  17. Cognitive deficits in patients with a chronic vestibular failure.

    Science.gov (United States)

    Popp, Pauline; Wulff, Melanie; Finke, Kathrin; Rühl, Maxine; Brandt, Thomas; Dieterich, Marianne

    2017-03-01

    Behavioral studies in rodents and humans have demonstrated deficits of spatial memory and orientation in bilateral vestibular failure (BVF). Our aim was to explore the functional consequences of chronic vestibular failure on different cognitive domains including spatial as well as non-spatial cognitive abilities. Sixteen patients with a unilateral vestibular failure (UVF), 18 patients with a BVF, and 17 healthy controls (HC) participated in the study. To assess the cognitive domains of short-term memory, executive function, processing speed and visuospatial abilities the following tests were used: Theory of Visual Attention (TVA), TAP Alertness and Visual Scanning, the Stroop Color-Word, and the Corsi Block Tapping Test. The cognitive scores were correlated with the degree of vestibular dysfunction and the duration of the disease, respectively. Groups did not differ significantly in age, sex, or handedness. BVF patients were significantly impaired in all of the examined cognitive domains but not in all tests of the particular domain, whereas UVF patients exhibited significant impairments in their visuospatial abilities and in one of the two processing speed tasks when compared independently with HC. The degree of vestibular dysfunction significantly correlated with some of the cognitive scores. Neither the side of the lesion nor the duration of disease influenced cognitive performance. The results demonstrate that vestibular failure can lead to cognitive impairments beyond the spatial navigation deficits described earlier. These cognitive impairments are more significant in BVF patients, suggesting that the input from one labyrinth which is distributed into bilateral vestibular circuits is sufficient to maintain most of the cognitive functions. These results raise the question whether BVF patients may profit from specific cognitive training in addition to physiotherapy.

  18. Vestibular rehabilitation ameliorates chronic dizziness through the SIRT1 axis

    Directory of Open Access Journals (Sweden)

    Chung-Lan eKao

    2014-03-01

    Full Text Available Dizziness is a common clinical symptom frequently referred to general neurologists and practitioners. Exercise intervention, in the form of vestibular rehabilitation, is known as an effective clinical management for dizziness. This intervention is reported to have a functional role in correcting dizziness, improving gaze stability, retraining balance and gait and enhancing physical fitness. Dizziness is known to be highly related to inflammation and oxidative stress. SIRT1 is a major molecule for regulation of inflammation and mitigation of oxidative stress in chronic diseases such as atherosclerosis and chronic obstructive pulmonary disease. However, the bio-molecular roles of SIRT1 involved in the pathogenesis of dizziness are still largely unclear. In this study, a total of 30 subjects were recruited (15 patients with chronic dizziness, and 15 age/gender matched non-dizzy control subjects. The dizzy subjects group received 18 sessions of 30-minutes vestibular training. We found that the mRNA and protein expression levels of SIRT1 in the blood samples of chronic dizzy patients were repressed compared with those of healthy controls. After vestibular training, the dizzy patients had significant symptomatic improvements. The SIRT1 expression and its downstream genes (PPAR-γ and PGC-1α were upregulated after vestibular exercises in dizzy subjects. Notably, the catalytic activity of SIRT1, NADPH and antioxidant enzyme activities were also activated in dizzy patients after vestibular training. Furthermore, vestibular exercise training reduced oxidative events and p53 expression in patients with dizziness. This study demonstrated that vestibular exercise training improved dizziness symptoms, and mechanisms for alleviation of chronic dizziness may partly involve the activation of the SIRT1 axis and the repression of redox status.

  19. Older adults demonstrate superior vestibular perception for virtual rotations.

    Science.gov (United States)

    Peters, Ryan M; Blouin, Jean-Sébastien; Dalton, Brian H; Inglis, J Timothy

    2016-09-01

    Adult ageing results in a progressive loss of vestibular hair cell receptors and afferent fibres. Given the robustness of vestibulo-ocular and vestibular-evoked whole-body responses to age-related deterioration, it was proposed that the vestibular system compensates centrally. Here we examine the potential for central compensation in vestibular sensitivity with adult ageing by using a combination of real and virtual rotation-based psychophysical testing at two stimulus frequencies (0.1 & 1Hz). Real rotations activate semi-circular canal hair cell receptors naturally via mechanotransduction, while electrical current used to evoke virtual rotations does not rely on mechanical deformation of hair cell receptors to activate vestibular afferents. This two-pronged approach allows us to determine the independent effects of age-related peripheral afferent receptor loss and potential compensatory mechanisms. Older adults had thresholds for discriminating real rotations that were significantly greater than young adults at 0.1Hz (7.2 vs. 3°/s), but the effect of age was weaker (non-significant) at 1Hz (2.4 vs. 1.3°/s). For virtual rotations, older adults had greater thresholds than young adults at 0.1Hz (1.2 vs. 0.5mA), however, older adults outperformed young adults at 1Hz (0.6 vs. 1.1mA). Based on these thresholds, we argue that central vestibular processing gain is enhanced in older adults for 1Hz real and virtual rotations, partially offsetting the negative impact of normal age-related hair cell receptor and primary afferent loss. We propose that the frequency dependence of this compensation reflects the physiological importance of the 1-5Hz range in natural vestibular input. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  20. Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: a review.

    Science.gov (United States)

    Franke, Laura M; Walker, William C; Cifu, David X; Ochs, Alfred L; Lew, Henry L

    2012-01-01

    Vestibular symptoms are persistent and problematic sequelae of blast exposure. Several lines of evidence suggest that these symptoms often stem from injury to the central nervous system. Current methods of assessing the vestibular system have described vestibular deficits that follow traumatic brain injury and differentiate blunt and blast trauma but have not examined the full range of vestibular functions that depend on the cerebral structures above the midbrain. Damage to the central vestibular circuits can lead to deficits in vital processes of spatial perception and navigation, in addition to dizziness and disequilibrium, and may also affect emotional functioning, particularly noradrenergically modulated states of anxiety. Perceptual functions can be assessed to determine the extent of central nervous system involvement in vestibular symptoms and to provide greater confidence when vestibular dysfunction is to be excluded. The ability to detect central vestibular dysfunction will significantly enhance our response to the dizziness and balance symptoms that are a common source of distress for Veterans.

  1. Selective retromastoid vestibular neurectomy for intractable Ménière's disease: A technical note

    Directory of Open Access Journals (Sweden)

    Cho-Shun Li

    2015-03-01

    Conclusion: Sectioning of vestibular fibers was performed along the cochleovestibular cleavage landmark on the cochlear nerve where the overlapping zone was located, allowing for a safe and adequate vestibular neurectomy, while most of the cochlear fibers were spared.

  2. Vestibular dysfunction in patients with chronic pain or underlying neurologic disorders

    National Research Council Canada - National Science Library

    Gilbert, John W; Vogt, Manuel; Windsor, Robert E; Mick, Gregory E; Richardson, Gay B; Storey, Benjamin B; Herder, Stephanie L; Ledford, Susan; Abrams, Dee A; Theobald, Mary Katherine; Cunningham, Dana; Kelly, Louise; Herring, Kimberly V; Maddox, Michael L

    2014-01-01

    Individuals with vestibular dysfunction are at increased risk for falling. In addition, vestibular dysfunction is associated with chronic pain, which could present a serious public health concern as approximately 43...

  3. Nonphosphorylated neurofilament protein is expressed by scattered neurons in the vestibular and precerebellar brainstem

    OpenAIRE

    Baizer, Joan S.

    2009-01-01

    Vestibular information is essential for the control of posture, balance, and eye movements. The vestibular nerve projects to the four nuclei of the vestibular nuclear complex (VNC), as well as to several additional brainstem nuclei and the cerebellum. We have found that expression of the calcium-binding proteins calretinin (CR) and calbindin (CB), and the synthetic enzyme for nitric oxide synthase (nNOS) define subdivisions of the medial vestibular nucleus (MVe) and the nucleus prepositus (Pr...

  4. Sensorintegrative dysfunction underlying vestibular disorders after traumatic brain injury: A review

    OpenAIRE

    Laura M. Franke, PhD; William C. Walker, MD; David X. Cifu, MD; Alfred L. Ochs, PhD; Henry L. Lew, MD, PhD

    2012-01-01

    Vestibular symptoms are persistent and problematic sequelae of blast exposure. Several lines of evidence suggest that these symptoms often stem from injury to the central nervous system. Current methods of assessing the vestibular system have described vestibular deficits that follow traumatic brain injury and differentiate blunt and blast trauma but have not examined the full range of vestibular functions that depend on the cerebral structures above the midbrain. Damage to the central vestib...

  5. Vestibular Modulation of Sympathetic Nerve Activity to Muscle and Skin in Humans

    OpenAIRE

    Hammam, Elie; Vaughan G Macefield

    2017-01-01

    We review the existence of vestibulosympathetic reflexes in humans. While several methods to activate the human vestibular apparatus have been used, galvanic vestibular stimulation (GVS) is a means of selectively modulating vestibular afferent activity via electrodes over the mastoid processes, causing robust vestibular illusions of side-to-side movement. Sinusoidal GVS (sGVS) causes partial entrainment of sympathetic outflow to muscle and skin. Modulation of muscle sympathetic nerve activity...

  6. [Anatomy and physiology of the vestibular system: review of the literature].

    Science.gov (United States)

    Sakka, L; Vitte, E

    2004-10-01

    The vestibular system is a complex system involving not only posterior labyrinth but also central structures such as cerebellum, striatum, thalamus, frontal and prefrontal cortex to assure balance, movements and walking. Information reaching the vestibular complex are not purely vestibular but also from visual, somatosensory and cerebellar origins. The equilibrium is also a complex physiological function needing concordance of vestibular, visual and somatosensory information or either central compensation after an injury but also an integrity of the central nervous system.

  7. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Amir Abbas Ebrahimi

    2018-01-01

    Full Text Available The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys with the profound sensorineural hearing loss (PTA>90 dB. They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP. For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT was completed pre- and post-intervention with SPS (Synapsys, Marseille, France. Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS, vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05. The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

  8. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction.

    Science.gov (United States)

    Ebrahimi, Amir Abbas; Jamshidi, Ali Ashraf; Movallali, Guita; Rahgozar, Mehdi; Haghgoo, Hojjat Allah

    2017-11-01

    The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys) with the profound sensorineural hearing loss (PTA>90 dB). They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP). For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT) was completed pre- and post-intervention with SPS (Synapsys, Marseille, France). Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS), vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05). The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

  9. Clinical romberg testing does not detect vestibular disease.

    Science.gov (United States)

    Longridge, Neil S; Mallinson, Arthur I

    2010-07-01

    To evaluate the effectiveness of tandem Romberg and tandem walking testing at detecting vestibular disease and to increase the difficulty of these standard screening assessments in an attempt to try and make them more effective in the clinical office setting. A prospective study in a tertiary and quaternary care neuro-otology clinic comparing performance on tandem Romberg and tandem walking between patients with vestibular disease and controls matched for age and sex. Making the tandem Romberg test and tandem walking tests more difficult for patients was not helpful because it also made the tests more difficult to perform for controls with no symptoms of vestibular disease. When comparing a young and an old cohort, there was a significant difference in performance. Our techniques of sharpening and sensitizing tandem Romberg and tandem walking tests were not useful at delineating vestibular disease, and age itself may be a confound that mimics the effects of balance system disease. The tandem Romberg and tandem walking tests, despite being in widespread clinical use as office screening tests, may not be effective at determining the presence of newly developed vestibular disease.

  10. Vestibular evoked myogenic potentials in patients with ankylosing spondylitis.

    Science.gov (United States)

    Özgür, Abdulkadir; Serdaroğlu Beyazal, Münevver; Terzi, Suat; Coşkun, Zerrin Özergin; Dursun, Engin

    2016-10-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease with unknown etiology. Although sacroiliac joint involvement is the classic sign along with the formed immune mediators, it may result in immune-mediated inner ear disease and may cause damage to the audiovestibular system. Vestibular evoked myogenic potentials (VEMP) is a clinical reflex test used in the diagnosis of vestibular diseases and is performed by recording and evaluating the muscle potentials resulting from the stimulation of the vestibular system with different stimuli. The aim of this study is to evaluate the cervical VEMP test results in AS patients without vestibular symptoms. Thirty-three patients with AS and a control group of 30 healthy volunteers with similar demographic characteristics were evaluated in the study. VEMP wave latency, P13-N23 wave amplitude, and VEMP asymmetry ratio (VAR) values were compared between the groups. The relationship between clinical and laboratory findings of the AS patients and VEMP data were also investigated. Compared with healthy people, this study shows the response rate of patients with ankylosing spondylitis was reduced in the VEMP test, and P13-N23 wave amplitude showed a decrease in AS patients who had VEMP response (p ankylosing spondylitis. The data obtained from this study suggest that AS may lead to decreased sensitivity of the vestibular system.

  11. Internal models and neural computation in the vestibular system.

    Science.gov (United States)

    Green, Andrea M; Angelaki, Dora E

    2010-01-01

    The vestibular system is vital for motor control and spatial self-motion perception. Afferents from the otolith organs and the semicircular canals converge with optokinetic, somatosensory and motor-related signals in the vestibular nuclei, which are reciprocally interconnected with the vestibulocerebellar cortex and deep cerebellar nuclei. Here, we review the properties of the many cell types in the vestibular nuclei, as well as some fundamental computations implemented within this brainstem-cerebellar circuitry. These include the sensorimotor transformations for reflex generation, the neural computations for inertial motion estimation, the distinction between active and passive head movements, as well as the integration of vestibular and proprioceptive information for body motion estimation. A common theme in the solution to such computational problems is the concept of internal models and their neural implementation. Recent studies have shed new insights into important organizational principles that closely resemble those proposed for other sensorimotor systems, where their neural basis has often been more difficult to identify. As such, the vestibular system provides an excellent model to explore common neural processing strategies relevant both for reflexive and for goal-directed, voluntary movement as well as perception.

  12. Impaired math achievement in patients with acute vestibular neuritis.

    Science.gov (United States)

    Moser, Ivan; Vibert, Dominique; Caversaccio, Marco D; Mast, Fred W

    2017-12-01

    Broad cognitive difficulties have been reported in patients with peripheral vestibular deficit, especially in the domain of spatial cognition. Processing and manipulating numbers relies on the ability to use the inherent spatial features of numbers. It is thus conceivable that patients with acute peripheral vestibular deficit show impaired numerical cognition. Using the number Stroop task and a short math achievement test, we tested 20 patients with acute vestibular neuritis and 20 healthy, age-matched controls. On the one hand, patients showed normal congruency and distance effects in the number Stroop task, which is indicative of normal number magnitude processing. On the other hand, patients scored lower than healthy controls in the math achievement test. We provide evidence that the lower performance cannot be explained by either differences in prior math knowledge (i.e., education) or slower processing speed. Our results suggest that peripheral vestibular deficit negatively affects numerical cognition in terms of the efficient manipulation of numbers. We discuss the role of executive functions in math performance and argue that previously reported executive deficits in patients with peripheral vestibular deficit provide a plausible explanation for the lower math achievement scores. In light of the handicapping effects of impaired numerical cognition in daily living, it is crucial to further investigate the mechanisms that cause mathematical deficits in acute PVD and eventually develop adequate means for cognitive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Visual-vestibular processing deficits in mild traumatic brain injury.

    Science.gov (United States)

    Wright, W G; Tierney, R T; McDevitt, J

    2017-01-01

    The search for reliable and valid signs and symptoms of mild traumatic brain injury (mTBI), commonly synonymous with concussion, has lead to a growing body of evidence that individuals with long-lasting, unremitting impairments often experience visual and vestibular symptoms, such as dizziness, postural and gait disturbances. Investigate the role of visual-vestibular processing deficits following concussion. A number of clinically accepted vestibular, oculomotor, and balance assessments as well as a novel virtual reality (VR)-based balance assessment device were used to assess adults with post-acute concussion (n = 14) in comparison to a healthy age-matched cohort (n = 58). Significant between-group differences were found with the VR-based balance device (p = 0.001), with dynamic visual motion emerging as the most discriminating balance condition. The symptom reports collected after performing the oculomotor and vestibular tests: rapid alternating horizontal eye saccades, optokinetic stimulation, and gaze stabilization, were all sensitive to health status (p vestibular tasks most closely linked to spatial and self-motion perception had the greatest discriminatory outcomes. The current findings suggest that mesencephalic and parieto-occipital centers and pathways may be involved in concussion.

  14. Binding body and self in visuo-vestibular conflicts.

    Science.gov (United States)

    Macauda, Gianluca; Bertolini, Giovanni; Palla, Antonella; Straumann, Dominik; Brugger, Peter; Lenggenhager, Bigna

    2015-03-01

    Maintenance of the bodily self relies on the accurate integration of multisensory inputs in which visuo-vestibular cue integration is thought to play an essential role. Here, we tested in healthy volunteers how conflicting visuo-vestibular bodily input might impact on body self-coherence in a full body illusion set-up. Natural passive vestibular stimulation was provided on a motion platform, while visual input was manipulated using virtual reality equipment. Explicit (questionnaire) and implicit (skin temperature) measures were employed to assess illusory self-identification with either a mannequin or a control object. Questionnaire results pointed to a relatively small illusion, but hand skin temperature, plausibly an index of illusory body ownership, showed the predicted drop specifically in the condition when participants saw the mannequin moving in congruence with them. We argue that this implicit measure was accessible to visuo-vestibular modulation of the sense of self, possibly mediated by shared neural processes in the insula involved in vestibular and interoceptive signalling, thermoregulation and multisensory integration. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  15. The role of stereo vision in visual-vestibular integration.

    Science.gov (United States)

    Butler, John S; Campos, Jennifer L; Bülthoff, Heinrich H; Smith, Stuart T

    2011-01-01

    Self-motion through an environment stimulates several sensory systems, including the visual system and the vestibular system. Recent work in heading estimation has demonstrated that visual and vestibular cues are typically integrated in a statistically optimal manner, consistent with Maximum Likelihood Estimation predictions. However, there has been some indication that cue integration may be affected by characteristics of the visual stimulus. Therefore, the current experiment evaluated whether presenting optic flow stimuli stereoscopically, or presenting both eyes with the same image (binocularly) affects combined visual-vestibular heading estimates. Participants performed a two-interval forced-choice task in which they were asked which of two presented movements was more rightward. They were presented with either visual cues alone, vestibular cues alone or both cues combined. Measures of reliability were obtained for both binocular and stereoscopic conditions. Group level analyses demonstrated that when stereoscopic information was available there was clear evidence of optimal integration, yet when only binocular information was available weaker evidence of cue integration was observed. Exploratory individual analyses demonstrated that for the stereoscopic condition 90% of participants exhibited optimal integration, whereas for the binocular condition only 60% of participants exhibited results consistent with optimal integration. Overall, these findings suggest that stereo vision may be important for self-motion perception, particularly under combined visual-vestibular conditions.

  16. Evaluation of diagnostic tests of the otolith organs and their application in various vestibular pathologies

    NARCIS (Netherlands)

    Winters, S.M.

    2014-01-01

    Current vestibular testing is limited. The general function of the vestibular system on both sides of the head can be tested, and one part of the peripheral vestibular organ, the horizontal semicircular canal, can be tested unilaterally. However, recently a test for the function of the otolith

  17. Vestibular vertigo and ataxia in emergency neurology

    Directory of Open Access Journals (Sweden)

    Natalia Vladimirovna Aptikeeva

    2013-01-01

    Full Text Available Patients with vestibular vertigo (VV are commonly referred to hospital, as emergently indicated, which makes the urgent establishment of the cause of VV relevant. One hundred and ninety-eight patients (86 men; mean age, 55.6±13.7 years and 112 women; mean age, 69.1±9.2 years with VV who had been admitted to hospital for suspected stroke were examined. Ischemic stroke in the vertebrobasilar system (VBS was diagnosed in only 28 (32.5% men and 22 (19.6% women; transient ischemic attack in VBS was seen in 10 (12.2% men and 6 (5.6% women; other diseases were identified in the remaining cases. VBS stroke was noted to be hyperdiagnosed in the patients with VV; whether itis expedient to apply a standardized approach to the problem of vertigo and unstable equilibrium and to attract a multidisciplinary team to examine patients in the admission room of a multidisciplinary hospital is discussed.

  18. Does spectacle use lead to vestibular suppression?

    Science.gov (United States)

    Thakar, A

    2016-11-01

    Laboratory experiments indicate that changes in retinal image size result in adaptive recalibration or suppression of the vestibulo-ocular reflex. Myopia correction with spectacles or contact lenses also leads to retinal image size changes, and may bring about similar vestibulo-ocular reflex alterations. A hypothesis-generating preliminary investigation was conducted. In this cross-sectional study, findings of electronystagmography including bithermal caloric testing were compared between 17 volunteer myopes using spectacles or contact lenses and 17 volunteer emmetropes (with no refractive error). Bilateral hypoactive caloric responses were demonstrated in 6 of 11 spectacle users, in 1 of 6 contact lens users and in 1 of 17 emmetropes. Hypoactive caloric responses were significantly more likely in spectacle users than in emmetropes (p spectacles have vestibulo-ocular reflex suppression, as demonstrated by the caloric test. This has implications for the interpretation of electronystagmography and videonystagmography results, and highlights spectacle use as a possible cause of vestibular impairment. Further corroboration of these findings is warranted, with more precise and direct vestibulo-ocular reflex tests such as rotational tests and the head impulse test.

  19. Extraterrestrial vestibular research, a new partial field of medical research into the human vestibular apparatus.

    Science.gov (United States)

    Pichler, H J

    1967-01-01

    The first otologic professorial chair in the world was established by Politzer in Vienna as long ago as 1861. In 1914 an assistant of the 1st Vienna Ear Clinic with Politzer as its head, Barany, was awarded the Nobel Prize for Medicine for his fundamental investigations into the organ of equilibration and for his discovery of the caloric sensitivity of the semicircular canals. Since that time Barany is regarded as the founder of the physiology of the vestibular apparatus. During the period 1959 to 1963 a new conception of fundamental research into the vestibule was demanded and elaborated in Vienna with the postulate that, in all theoretical deliberations and practical experience, one should take into consideration that our experiments into the vestibule do not take place on a static platform but rather on a diversely moving one, namely the surface of the earth. This led to new findings in the field of research into the otolith apparatus. In 1962 it was discovered that the gravitation of the sun at the distance of earth-sun represents a supraliminal stimulus, namely both in the aphelion as well as in the perihelion position of the earth. In 1965 it was suggested in Vienna that a new branch of research into the vestibule should be established on an international level, the so-called extraterrestrial vestibular research. The importance of this new branch of research is discussed for all problems of orientation of human beings in space.

  20. BETAHISTINE DIHYDROCHLORIDE IN CANINE PERIPHERAL VESTIBULAR SYNDROME DICLORIDRATO DE BETAISTINA NA SÍNDROME VESTIBULAR PERIFÉRICA CANINA

    Directory of Open Access Journals (Sweden)

    Tatiana Champion

    2010-04-01

    Full Text Available Vestibular disease is a common syndrome in small animals that  may resulst of central or peripheral disease. The pathophysiology of peripheral vestibular syndrome is unknown, however it can be related to an abnormal dynamic of endolymphatic fluid or neuritis of the vestibular portion of the VIII cranial nerve.  The recovery of neurological sings is slow and, in chronic cases, the neurological deficits can be irreversible. In veterinary medicine, thera are few medical options to treat this condition, however, in Medicine, betahistine dihydrochloride is used to treat peripheral vestibular disorders. These drug  was used in four dogs with vestibular syndrome. The results showed clinical improvement in 7 to 10 days of treatment and completed recovery in 20 to 30 days, followed by the cure. One year after the treatment, the dogs did not have recurrence of the syndrome. This report shows the use of betahistine dihydrochloride in dogs with peripheral vestibular syndrome, with rapid clinical recover, without laboratorial abnormalities or recurrence of the clinical signs .The results encourage the use of betahistine dihydrochloride in the treatment of  peripheral vestibular disorders in small animals.

    KEY WORDS: Betahistine, dog, vestibular syndrome.
    A síndrome vestibular periférica é uma condição clínica comum em cães. Várias doenças podem causar essa síndrome. Entretanto, sua patofisiologia ainda é pouco conhecida. As alterações clínicas geralmente são autolimitantes, a recuperação pode ser longa e, em casos crônicos, os déficits neurológicos podem ser irreversíveis. Em medicina veterinária, há poucas opções terapêuticas. Na Medicina, o dicloridrato de betaístina é amplamente utilizado. Essa medicação foi empregada em seis cães com síndrome vestibular periférica. Os resultados mostraram melhora clínica com sete a dez dias de tratamento e recuperação quase completa entre vinte e trinta dias. Este

  1. Importancia de la semiología del dolor en el diagnóstico de un proceso inflamatorio pulpar

    Directory of Open Access Journals (Sweden)

    Andrés 0 Pérez Ruiz

    2011-09-01

    Full Text Available El dolor es un síntoma de extraordinaria importancia en la práctica estomatológica y particularmente en lo concerniente a las alteraciones de la pulpa dentaria. Con el objetivo de profundizar en el conocimiento de las fases por las que atraviesa un proceso inflamatorio pulpar, que permiten predecir sus manifestaciones dolorosas, se realizó una revisión bibliográfica sobre el tema con un enfoque multidisciplinario y básico-clínico. Se utilizó el método documental para el análisis y tratamiento de la información ofrecida por las fuentes teóricas. El sitio en Internet Google fue empleado como fundamental motor de búsqueda y Lilacs, Hinari, Medline y PubMed fueron las bases de datos más revisadas. La clasificación del estado de inflamación pulpar, que atiende a eventos histopatológicos que no se pueden visualizar, resulta más difícil. Se podría lograr mayor precisión en un diagnóstico basado en el curso que sigue el dolor, de acuerdo a la magnitud del compromiso inflamatorio y apoyado en la rica semiología que se puede obtener si se sigue la trayectoria de las variables del estímulo nociceptivo. El incremento y profundización de los conocimientos en este campo contribuiyó significativamente a un mejor diagnóstico y tratamiento de los procesos inflamatorios pulpares.

  2. Impact of Physical Activity on Frailty Status and How to Start a Semiological Approach to Muscular System

    Directory of Open Access Journals (Sweden)

    Maximiliano Smietniansky

    2015-12-01

    Full Text Available Introduction: The world population is aging, and this demographic fact is associated with an increased prevalence of sedentary lifestyles, sarcopenia and frailty; all of them with impact on health status. Biologic reserve determination in the elderly with comorbidity poses a challenge for medical activities. Frailty is an increasingly used concept in the geriatric medicine literature, which refers to an impairment in biologic reserve. There is a close and multidirectional relationship between physical activity, the muscular system function, and a fit status; decline in this dimensions is associated with poor outcomes. The aim of this article is to make a narrative review on the relationship between physical activity, sarcopenia and frailty syndrome. Results: The low level of physical activity, sarcopenia and frailty, are important predictors for development of disability, poor quality of life, falls, hospitalizations and all causes mortality. For clinical practice we propose a semiological approach based on measurement of muscle performance, mass and also level of physical activity, as a feasible way to determine the biologic reserve. This evidence shows us that the evaluation of muscle mass and performance, provides important prognostic information because the deterioration of these variables is associated with poor clinical outcomes in older adults followed up in multiple cohorts. Conclusions: Low activity is a mechanism and at the same time part of the frailty syndrome. The determination of biologic reserve is important because it allows the prognostic stratification of the patient and constitutes an opportunity for intervention. The clinician should be aware of the clinical tools that evaluate muscular system and level of physical activity, because they place us closer to the knowledge of health status.

  3. Looking for complexity in quantitative semiology of frontal and temporal lobe seizures using neuroethology and graph theory.

    Science.gov (United States)

    Bertti, Poliana; Tejada, Julian; Martins, Ana Paula Pinheiro; Dal-Cól, Maria Luiza Cleto; Terra, Vera Cristina; de Oliveira, José Antônio Cortes; Velasco, Tonicarlo Rodrigues; Sakamoto, Américo Ceiki; Garcia-Cairasco, Norberto

    2014-09-01

    Epileptic syndromes and seizures are the expression of complex brain systems. Because no analysis of complexity has been applied to epileptic seizure semiology, our goal was to apply neuroethology and graph analysis to the study of the complexity of behavioral manifestations of epileptic seizures in human frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE). We analyzed the video recordings of 120 seizures of 18 patients with FLE and 28 seizures of 28 patients with TLE. All patients were seizure-free >1 year after surgery (Engel Class I). All patients' behavioral sequences were analyzed by means of a glossary containing all behaviors and analyzed for neuroethology (Ethomatic software). The same series were used for graph analysis (CYTOSCAPE). Behaviors, displayed as nodes, were connected by edges to other nodes according to their temporal sequence of appearance. Using neuroethology analysis, we confirmed data in the literature such as in FLE: brief/frequent seizures, complex motor behaviors, head and eye version, unilateral/bilateral tonic posturing, speech arrest, vocalization, and rapid postictal recovery and in the case of TLE: presence of epigastric aura, lateralized dystonias, impairment of consciousness/speech during ictal and postictal periods, and development of secondary generalization. Using graph analysis metrics of FLE and TLE confirmed data from flowcharts. However, because of the algorithms we used, they highlighted more powerfully the connectivity and complex associations among behaviors in a quite selective manner, depending on the origin of the seizures. The algorithms we used are commonly employed to track brain connectivity from EEG and MRI sources, which makes our study very promising for future studies of complexity in this field. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Normal pressure hydrocephalus after gamma knife radiosurgery for vestibular schwannoma

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    Mohammed T

    2010-01-01

    Full Text Available Vestibular schwannomas are not uncommon, and gamma knife radiosurgery is one of the treatment options for symptomatic tumors. Hydrocephalus is a complication of gamma knife treatment of vestibular schwannoma, though the mechanism of the development of hydrocephalus remains controversial. We present an unusual case of normal pressure hydrocephalus (NPH after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of the hydrocephalus. This is probably the first case of NPH post radiosurgery with normal cerebrospinal fluid protein. Communicating hydrocephalus should be treated with placement of shunt while non-communicating hydrocephalus can be treated with third ventriculostomy. Frequent monitoring and early intervention post radiosurgery is highly recommended to prevent irreversible cerebral damage.

  5. Visual gravitational motion and the vestibular system in humans.

    Science.gov (United States)

    Lacquaniti, Francesco; Bosco, Gianfranco; Indovina, Iole; La Scaleia, Barbara; Maffei, Vincenzo; Moscatelli, Alessandro; Zago, Myrka

    2013-12-26

    The visual system is poorly sensitive to arbitrary accelerations, but accurately detects the effects of gravity on a target motion. Here we review behavioral and neuroimaging data about the neural mechanisms for dealing with object motion and egomotion under gravity. The results from several experiments show that the visual estimates of a target motion under gravity depend on the combination of a prior of gravity effects with on-line visual signals on target position and velocity. These estimates are affected by vestibular inputs, and are encoded in a visual-vestibular network whose core regions lie within or around the Sylvian fissure, and are represented by the posterior insula/retroinsula/temporo-parietal junction. This network responds both to target motions coherent with gravity and to vestibular caloric stimulation in human fMRI studies. Transient inactivation of the temporo-parietal junction selectively disrupts the interception of targets accelerated by gravity.

  6. Visual gravitational motion and the vestibular system in humans

    Directory of Open Access Journals (Sweden)

    Francesco eLacquaniti

    2013-12-01

    Full Text Available The visual system is poorly sensitive to arbitrary accelerations, but accurately detects the effects of gravity on a target motion. Here we review behavioral and neuroimaging data about the neural mechanisms for dealing with object motion and egomotion under gravity. The results from several experiments show that the visual estimates of a target motion under gravity depend on the combination of a prior of gravity effects with on-line visual signals on target position and velocity. These estimates are affected by vestibular inputs, and are encoded in a visual-vestibular network whose core regions lie within or around the Sylvian fissure, and are represented by the posterior insula/retroinsula/temporo-parietal junction. This network responds both to target motions coherent with gravity and to vestibular caloric stimulation in human fMRI studies. Transient inactivation of the temporo-parietal junction selectively disrupts the interception of targets accelerated by gravity.

  7. Síndrome vestibular em canídeos

    OpenAIRE

    Ferreira, Ricardo Filipe da Silva

    2009-01-01

    Dissertação de Mestrado Integrado em Medicina Veterinária A síndrome vestibular é uma apresentação neurológica relativamente comum em Medicina Veterinária. É definida como o conjunto de sinais clínicos associados a uma doença do sistema vestibular. A função do sistema vestibular é traduzir as forças de gravidade e movimento em sinais neurológicos utilizados pelo encéfalo para a determinação da posição da cabeça no espaço, e para a coordenação dos movimentos da cabeça com os ...

  8. The phosphorylation status of merlin in sporadic vestibular Schwannomas.

    Science.gov (United States)

    Wang, Zhaoyan; Lu, Yanjun; Tang, Juanjuan; Wang, Haojie; Wu, Hao

    2009-04-01

    The events leading to Schwannomas development are still largely unknown. Some studies have demonstrated that merlin acts as a tumor suppressor by blocking Ras-mediated signaling. In this study, we analyze the clinical and biological behaviors of seven randomly selected sporadic vestibular Schwannomas removed from the patients. We find that merlin was commonly lost in these Schwannomas, due to loss of merlin expression or phosphorylation status of merlin expression. Heightened CDKs/cyclins signal transduction concomitant with loss of p27 was well correlated with loss of functional merlin in Schwannomas. More, we show that phosphorylated merlin Schwannomas exhibited increased Ras/Rac/PAK signal transduction. That was in agreement with the severe clinical behaviors, i.e., phosphorylation status of merlin increased tumor size in sporadic vestibular Schwannomas. These results led us to suggest that phosphorylated merlin, a kind of type of mutation merlin, is involved in tumorigenesis of sporadic vestibular Schwannomas.

  9. An electronic prosthesis mimicking the dynamic vestibular function

    Science.gov (United States)

    Shkel, Andrei M.

    2006-03-01

    This paper reports our progress toward development of a unilateral vestibular prosthesis. The sensing element of the prosthesis is a custom designed one-axis MEMS gyroscope. Similarly to the natural semicircular canal, the microscopic gyroscope senses angular motion of the head and generates voltages proportional to the corresponding angular accelerations. Then, voltages are sent to the pulse generating unit where angular motion is translated into voltage pulses. The voltage pulses are converted into current pulses and are delivered through specially designed electrodes, conditioned to stimulate the corresponding vestibular nerve branch. Our preliminary experimental evaluations of the prosthesis on a rate table indicate that the device's output matches the average firing rate of vestibular neurons to those in animal models reported in the literature. The proposed design is scalable; the sensing unit, pulse generator, and the current source can be potentially implemented on a single chip using integrated MEMS technology.

  10. Migraine patients consistently show abnormal vestibular bedside tests

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2015-01-01

    Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

  11. The effects of aging on clinical vestibular evaluations

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    Maxime eMaheu

    2015-09-01

    Full Text Available Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cVEMP and oVEMP, then the caloric and vHIT methods for semi-circular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semi-circular canals function.

  12. The vein of the vestibular aqueduct with potential pathologic perspectives

    DEFF Research Database (Denmark)

    Friis, Morten; Sørensen, Mads Sølvsten; Qvortrup, Klaus

    2008-01-01

    HYPOTHESIS: Pathologic changes around the vein of the vestibular aqueduct (VVA) may cause obstruction to the flow of blood toward the sigmoid sinus. Furthermore, a distal obstruction of this vessel may be responsible for a development of a retrograde flow of blood with concomitant drainage...... of endolymphatic sac (ES) substances to the inner ear. BACKGROUND: The VVA is responsible for the venous drainage of the vestibular apparatus and endolymphatic duct and ES. Previous studies have linked the VVA to Ménière's disease. The aim of the present article was a 3-dimensional perspective study of the VVA...... with its adjacent anatomic structures. METHODS: In 14 rats, the VVA was examined by 3-dimensional reconstruction of 2-microm serial sections, corrosion cast technique, and scanning electron microscopy. RESULTS: From the external aperture of the vestibular aqueduct, the VVA is interposed between the ES...

  13. Effects of vestibular rehabilitation in the elderly complaining of dizziness

    Directory of Open Access Journals (Sweden)

    Andréa Paz-Oliveira

    2014-08-01

    Full Text Available Changes of body balance are among the most common complaints of the elderly. Vestibular rehabilitation is one of the most effective methods in the recovery of the body balance. The objective to investigate the effects of vestibular rehabilitation in body balance of a group of elderly people with dizziness complain through dizziness handicap inventory. The sample was comprised of 10 seniors (6 women and 4 men with mean age of 68.9 years. The elderly complaining of dizziness showed high score in the DHI in the physical, functional and emotional aspects in the condition pre-VR and these values decreased after vestibular rehabilitation program. Complaints of dizziness also decreased after the implementation of the programmee.  

  14. Does betahistine treatment have additional benefits to vestibular rehabilitation?

    Science.gov (United States)

    Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, Tayfun

    2010-08-01

    The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.

  15. Visual-vestibular conflict induced by virtual reality in humans.

    Science.gov (United States)

    Akiduki, Hironori; Nishiike, Suetaka; Watanabe, Hiroshi; Matsuoka, Katsunori; Kubo, Takeshi; Takeda, Noriaki

    2003-04-17

    Conflicting inputs from visual and vestibular afferents produce motion sickness and postural instability. However, the relationship of visual and vestibular inputs to each other remains obscure. In this study, we examined the development of subjective sickness- and balance-related symptoms and objective equilibrium ataxia induced by visual-vestibular conflict (VVC) stimulation using virtual reality. The subjective symptoms evaluated by Graybiel's and Hamilton's criteria got gradually worse during the VVC. The objective postural instability was not observed during the VVC, but it occurred immediately after the VVC. There was a time lag between the subjective symptoms and objective ataxia induced by VVC. Our study suggests that the VVC inputs are processed in different pathways causing subjective autonomic symptoms and postural instability in humans.

  16. Signal processing in the vestibular system during active versus passive head movements.

    Science.gov (United States)

    Cullen, Kathleen E; Roy, Jefferson E

    2004-05-01

    In everyday life, vestibular receptors are activated by both self-generated and externally applied head movements. Traditionally, it has been assumed that the vestibular system reliably encodes head-in-space motion throughout our daily activities and that subsequent processing by upstream cerebellar and cortical pathways is required to transform this information into the reference frames required for voluntary behaviors. However, recent studies have radically changed the way we view the vestibular system. In particular, the results of recent single-unit studies in head-unrestrained monkeys have shown that the vestibular system provides the CNS with more than an estimate of head motion. This review first considers how head-in-space velocity is processed at the level of the vestibular afferents and vestibular nuclei during active versus passive head movements. While vestibular information appears to be similarly processed by vestibular afferents during passive and active motion, it is differentially processed at the level of the vestibular nuclei. For example, one class of neurons in vestibular nuclei, which receives direct inputs from semicircular canal afferents, is substantially less responsive to active head movements than to passively applied head rotations. The projection patterns of these neurons strongly suggest that they are involved in generating head-stabilization responses as well as shaping vestibular information for the computation of spatial orientation. In contrast, a second class of neurons in the vestibular nuclei that mediate the vestibuloocular reflex process vestibular information in a manner that depends principally on the subject's current gaze strategy rather than whether the head movement was self-generated or externally applied. The implications of these results are then discussed in relation to the status of vestibular reflexes (i.e., the vestibuloocular, vestibulocollic, and cervicoocular reflexes) and implications for higher

  17. Plasticity during vestibular compensation: the role of saccades

    Directory of Open Access Journals (Sweden)

    Hamish Gavin MacDougall

    2012-02-01

    Full Text Available This paper is focussed on one major aspect of compensation: the recent behavioural findings concerning oculomotor responses in human vestibular compensation and their possible implications for recovery after unilateral vestibular loss (UVL. New measurement techniques have provided new insights into how patients recover after UVL and have given clues for vestibular rehabilitation. Prior to this it has not been possible to quantify the level of function of all the peripheral vestibular sense organs. Now it is. By using vestibular-evoked myogenic potentials to measure utricular and saccular function and by new video head impulse testing to measure semicircular canal function to natural values of head accelerations. With these new video procedures it is now possible to measure both slow phase eye velocity and also saccades during natural head movements. The present evidence is that there is little or no recovery of slow phase eye velocity responses to natural head accelerations. It is doubtful as to whether the modest changes in slow phase eye velocity to small angular accelerations are functionally effective during compensation. On the other hand it is now clear that saccades can play a very important role in helping patients compensate and return to a normal lifestyle. Preliminary evidence suggests that different patterns of saccadic response may predict how well patients recover. It may be possible to train patients to produce more effective saccadic patterns in the first days after their unilateral loss. Some patients do learn new strategies, new behaviours, to conceal their inadequate VOR but when those strategies are prevented from operating by using passive, unpredictable, high acceleration natural head movements, as in the head impulse test, their vestibular loss can be demonstrated. It is those very strategies which the tests exclude, which may be the cause of their successful compensation.

  18. [Localization of nitric oxide synthase in the chicken vestibular system].

    Science.gov (United States)

    Nie, Guohui; Wang, Jibao

    2002-08-01

    To locate nitric oxide synthase (NOS) in the chicken vestibular system. The frozen section were processed for NADPH-d histochemistry in a solution containing NADPH and nitroblue tetnazolium (NBT) to demonstrate NOS positive reactivity. NOS positive staining, black-blue in color, was seen at the nerve ending, nerve fibers of the utricul and saculla and ampiculium. Ganglion cells had different activity. The shape of the cells seems to be round or oral. Collectively, data indicate the presence of active NOS in these tissue and suggest modulation of vestibular neurotransmission by nitric oxide.

  19. Vestibular rehabilitation in elderly patients with benign paroxysmal positional vertigo

    OpenAIRE

    Resende Carolina R.; Taguchi Carlos K.; Almeida Juliane G. de; Fujita Reginaldo R.

    2003-01-01

    A Vertigem Posicional Paroxística Benigna (VPPB) é um distúrbio vestibular no qual os pacientes relatam breves momentos de vertigem e/ou leve instabilidade postural, ocasionados por uma mudança brusca na movimentação cefálica ou corporal. OBJETIVO: Verificar o benefício da reabilitação vestibular, realizada em grupo, em pacientes idosos portadores de VPPB. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram selecionados aleatoriamente 16 pacientes portadores de VPPB, todos medicado...

  20. Sensitization as a Basic Principle of Vestibular Adaptation to Microgravity

    Science.gov (United States)

    Horn, Eberhard R.

    2008-06-01

    The analysis of basic mechanisms of physiological adaptation to weightlessness suffers (1) on the rare flight opportunities, and (2) on the collection of data with a rough time resolution. The comparative approach using data from animal and human research might be helpful to overcome these problems even for human research. The advantage of the comparative approach became obvious for vestibular adaptation to microgravity. Neuroanatomical, neurophysiological, behavioural and psychophysical studies in snails, fish, amphibian, rodents, monkey and men clearly revealed vestibular sensitization as a basic mechanism of adaptation to weightlessness.