1/13. Visual-vestibular habituation and balance training for motion sickness.BACKGROUND AND PURPOSE: This case report describes physical therapy for motion sickness in a 34-year-old woman. The purpose of the report is twofold: (1) to provide an overview of the literature regarding motion sickness syndrome, causal factors, and rationale for treatment and (2) to describe the evaluation and treatment of a patient with motion sickness. CASE DESCRIPTION AND OUTCOMES: The patient initially had moderate to severe visually induced motion sickness, which affected her functional abilities and prevented her from working. Following 10 weeks of a primarily home-based program of visual-vestibular habituation and balance training, her symptoms were alleviated and she could resume all work-related activities. DISCUSSION: Although motion sickness affects nearly one third of all people who travel by land, sea, or air, little documentation exists regarding prevention or management.- - - - - - - - - - ranking = 1keywords = ear (Clic here for more details about this article) |
2/13. vertigo in virtual reality with haptics: case report.A researcher was working with a desktop virtual environment system. The system was displaying vector fields of a cyclonic weather system, and the system incorporated a haptic display of the forces in the cyclonic field. As the subject viewed the rotating cyclone field, they would move a handle "through" the representation of the moving winds and "feel" the forces buffeting the handle as it moved. Stopping after using the system for about 10 min, the user experienced an immediate sensation of postural instability for several minutes. Several hours later, there was the onset of vertigo with head turns. This vertigo lasted several hours and was accompanied with nausea and motion illusions that exacerbated by head movements. Symptoms persisted mildly the next day and were still present the third and fourth day, but by then were only provoked by head movements. There were no accompanying symptoms or history to suggest an inner ear disorder. physical examination of inner ear and associated neurologic function was normal. No other users of this system have reported similar symptoms. This case suggests that some individuals may be susceptible to the interaction of displays with motion and movement forces and as a result experience motion illusions. Operators of such systems should be aware of this potential and minimize exposure if vertigo occurs.- - - - - - - - - - ranking = 332.40668947932keywords = inner ear, inner, ear (Clic here for more details about this article) |
3/13. Neurotologic issues.Progress has been made in the diagnosis and treatment of inner ear disorders. Autoimmune inner ear disorders and Meniere's disease (MD), the prototype inner ear disease, are highlighted in this review of current knowledge and contemporary dietary, medical, surgical, and vestibular rehabilitation therapy. A number of other peripheral vestibular disorders are presented and contrasted with MD.- - - - - - - - - - ranking = 497.86003421898keywords = inner ear, inner, ear (Clic here for more details about this article) |
4/13. Drop attacks secondary to superior canal dehiscence syndrome.Two patients with unprovoked drop attacks were found to have dehiscence of the superior semicircular canal on CT of the temporal bone. Both had conductive hearing loss, preservation of stapedius reflex, and abnormal vestibular evoked myogenic potentials. Neither had sound- or pressure-induced nystagmus. Repair of the dehiscence in one case stopped the drop attacks, supporting a causal relationship between the dehiscence and the drop attacks.- - - - - - - - - - ranking = 0.5keywords = ear (Clic here for more details about this article) |
5/13. Dramatic favorable responses of children with learning disabilities or dyslexia and attention deficit disorder to antimotion sickness medications: four case reports.Responses of four learning disabled children who showed dramatic improvements to one or more antimotion-sickness-antihistamines and -stimulants are described qualitatively. These cases were selected from a prior quantitative study in which three antihistamines (meclizine, cyclizine, dimenhydrinate) and three stimulants (pemoline, methylphenidate, dextroamphetamine) were tested in variable combinations (using a specific clinical method) for favorable responses by 100 children characterized by diagnostic evidence of learning disabilities and cerebellar-vestibular dysfunctioning. Pending validation in double-blind controlled studies, these qualitative results suggest that the "cerebellar-vestibular (CV) stabilizing" antimotion-sickness medications, piracetam included, and their combinations may be shown to be therapeutically useful in treating children with learning disabilities or dyslexia and attention deficit disorder.- - - - - - - - - - ranking = 3.5keywords = ear (Clic here for more details about this article) |
6/13. Mal de debarquement presenting in the Emergency Department.Mal de debarquement (MDD) is a common, benign, and self-limited syndrome suffered by many people after disembarkation from an oceangoing vessel. It is characterized by a continuing sensation of being on an unsteady pitching and rolling deck, even after a return to solid ground. Symptoms typically dissipate over several hours or days, but can linger for weeks. There is no effective treatment for MDD, no work-up is required, and patients can be reassured that the symptoms are transient. We present a case of MDD in a previously healthy 22-year-old male, and discuss the approach to MDD in the emergency department setting.- - - - - - - - - - ranking = 0.5keywords = ear (Clic here for more details about this article) |
7/13. Scopolamine withdrawal syndrome.As travel by air and ship becomes increasingly popular, more and more travelers are using transdermal scopolamine to avoid motion sickness. In fact, it has become almost fashionable for ocean travelers to sit on the sun deck with a patch behind the ear. This article describes withdrawal symptoms in a patient who used transdermal scopolamine beyond the recommended 3 days.- - - - - - - - - - ranking = 0.5keywords = ear (Clic here for more details about this article) |
8/13. Control of simulator sickness in an AH-64 aviator.An active 33-year-old Army AH-64 aviator with simulator sickness refractory to routine preventive measures was successfully managed with transdermal scopolamine. Although adaptation is the ultimate means for control of simulator sickness, the use of anti-motion sickness medication, specifically transdermal scopolamine, may be a useful adjuvant in selected aviators.- - - - - - - - - - ranking = 0.5keywords = ear (Clic here for more details about this article) |
9/13. Persistent mal de debarquement syndrome: a motion-induced subjective disorder of balance.Six patients with a distinct syndrome of persistent sensations of imbalance are presented. Common features included onset following a period of motion exposure, symptoms lasting months to years, mild unsteadiness and anxiety, minimal relief from antivertiginous medication, and normal neurologic and quantitative vestibulo-ocular examinations. One patient experienced recurrent episodes. Mal de debarquement refers to sensations of motion experienced on return to stable land after adaptation to motion lasting from hours to days in normal individuals. The presented patients exemplify a syndrome of persistent mal de debarquement. The entity is found in a relatively small number of dizzy patients. Persistent mal de debarquement is discussed in the context of what is known about long-term vestibulo-ocular adaptation to alterations of visual or vestibular environments.- - - - - - - - - - ranking = 0.5keywords = ear (Clic here for more details about this article) |
10/13. Remote cerebral hemisphere symptoms from surgically treated patients with posterior fossa brain tumors; vascular factors: a basis for a theory concerning space sickness.Three case histories of patients with large tumors in the posterior fossa who were operated on in a sitting position subsequently developed 1 or more symptoms referable to the temporoparietooccipital regions of the brain 24 to 48 hours postoperatively. Initially, it was believed that such symptoms were due to a stimulation of the association pathways causing firing of remote association areas (See Ch. 4). Subsequent studies of the rotation of blood vessels of the brain in the developing embryo and a review of the anatomical location of the arteries supplying the temporoparietooccipital region led to the conclusion that some compromise of the posterior cerebral artery was responsible for the symptoms. The symptomatology in these brain tumor patients was not unlike that seen in the cosmonauts and astronauts in space flight, designated as "motion sickness" in the space literature. A suggestion was made as to clarification of the definitions. This author advocated that the term "motion sickness" be confined to those symptoms of dizziness, nausea, and vomiting, due to involvement of the peripheral end organ, the inner ear. "Space sickness" might include these symptoms but also might have the addition of disorientation or the inversion of image in space and formed or unformed hallucinations. These relate to the temporoparietooccipital area, the midtemporal, and the occipital regions. In such instances, there must be central involvement or a stimulation of this interpretive cortex of the brain. The remote symptoms from the supratentorial cotex were believed to be due to hypoxia related to the posterior cerebral artery compromise, resulting in delayed "luxury perfusion" and the development of local lactic acidosis. Transaxial transmission of force with an uncal tentorial herniation causing compression of the posterior cerebral artery was suggested as a mechanism responsible for the vascular compression.- - - - - - - - - - ranking = 165.95334473966keywords = inner ear, inner, ear (Clic here for more details about this article) |
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