1/18. Familial progressive vestibulocochlear dysfunction caused by a COCH mutation (DFNA9).OBJECTIVE: To describe the decline of vestibulocochlear function in a man with vestibulocochlear dysfunction caused by a Pro51Ser mutation within the COCH gene on chromosome 14q12-13 (DFNA9). methods: A follow-up of more than 15 years was performed in a single case. Clinical investigations were supplemented by oculomotor, vestibular, and auditory tests. RESULTS: A 50-year-old man had had progressive sensorineural hearing loss and dysequilibrium for 15 years; he had been asymptomatic at the age of 35 years. He suffered from instability in the dark, head movement-dependent oscillopsia, paroxysmal positional vertigo, and vertigo with and without nausea. Hearing impairment started unilaterally, predominantly in the high frequencies. He also reported tinnitus. Disease progressed to severe bilateral high-frequency hearing impairment and vestibular areflexia. Fluctuation of vestibulocochlear function was documented and mentioned by the patient. CONCLUSIONS: Our patient proved to suffer from an autosomal dominant vestibulocochlear disorder caused by a COCH gene mutation. The remarkable medical history has some features in common with meniere disease; however, there are also different clinical and neurophysiological features. In the family, phenotypic variability is present.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
2/18. Childhood vertigo: a case report and review of the literature.vertigo is a relatively uncommon pediatric complaint, with correct diagnosis made even more challenging by the patient's inherent difficulty in describing his or her symptoms. confusion may exist among vertigo, dizziness, dysequilibrium, ataxia, pre-syncope or syncope, and seizure activity by both the pediatric patient and his or her family. A complete history and physical examination, as well as appropriate ancillary studies, may assist in clarifying the diagnosis. This paper attempts, via case report and literature review, to discuss the various etiologies of acute vertigo in the pediatric population, provide diagnostic clues, and evaluate some of the available diagnostic modalities.- - - - - - - - - - ranking = 3keywords = vertigo (Clic here for more details about this article) |
3/18. A case of isolated nodulus infarction presenting as a vestibular neuritis.We reported a patient with cerebellar infarction who presented with purely isolated vertigo, ipsilesional spontaneous nystagmus, and contralesional axial lateropulsion without usual symptoms or signs of cerebellar dysfunction. An MRI of the brain showed a small left cerebellar infarct selectively involving the nodulus. A pure vestibular syndrome in our patient may be explained by ipsilateral involvement of nodulo-vestibular inhibitory projection to vestibular nucleus. Clinicians should be aware of the possibility of a nodulus infarction in patient with acute vestibular syndrome, even if the pattern of nystagmus and lateropulsion is typical of a vestibular neuritis.- - - - - - - - - - ranking = 0.5keywords = vertigo (Clic here for more details about this article) |
4/18. Hemorrhagic acoustic schwannoma: radiological and histopathological findings.A 49-year-old man on anticoagulation treatment with phenprocoumon presented with acute right sided 7th and 8th cranial nerve palsy, acute hearing loss, headache, vertigo, and vomiting. CT and MRI revealed a cerebellopontine angle tumor 15mm in diameter and acute intratumoral hematoma. A cellular schwannoma composed predominantly of Antoni A tissue with dilated thin-walled vessels, surrounded by old hemorrhage with hemosiderin-laden macrophages was found histologically.- - - - - - - - - - ranking = 0.5keywords = vertigo (Clic here for more details about this article) |
5/18. Drop attacks and vertical vertigo after transtympanic gentamicin: diagnosis and management.Drop attacks represent a significant problem during the natural course of Meniere's disease. They are characterized by a sudden fall to the ground without loss of consciousness. diagnosis is clinical and based on the typical description of the patient. Involvement of vertical canal is possible during Meniere's disease and also after gentamicin application. Treatment of drop attacks is still a matter of discussion; most cases have a benign course with spontaneous remission and no treatment is necessary. In severe cases, aggressive treatment (surgical or pharmacological) is necessary. A case of drop attack associated with vertical vertigo is presented. Vestibular tests were performed in order to assess the involvement of inner ear. Caloric test and ice water test reveal no response. vestibular evoked myogenic potentials are present even after high doses of gentamicin. Drop attacks and vertical vertigo can occur after transtympanic gentamicin and can be well managed with high doses of local gentamicin.- - - - - - - - - - ranking = 3keywords = vertigo (Clic here for more details about this article) |
6/18. The retrolabyrinthine approach and vascular loop.Several researchers have made progress toward determining the cause of hemifacial spasm, tinnitus, and episodic vertigo. During the past 5 years, we have encountered a vascular loop in six of 36 patients who were undergoing retrolabyrinthine vestibular neurectomy for recurrent disequilibrium and vertigo. In five of these six patients, disequilibrium improved after neurectomy. This report describes the clinical symptomatology and the results of preoperative cochleovestibular testing for those patients found intraoperatively to have a vascular loop and suspected neurovascular compression syndrome. Audiograms, although varied, characteristically did not demonstrate the low-frequency sensorineural hearing loss characteristic of Meniere's disease. No preoperative marker, with the single exception of computed tomography pneumocisternography, dependably predicted the presence of a vascular loop.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
7/18. vestibular neuronitis in childhood.Over a 14-year period commencing in 1973, we followed 177 children less than 12 years old suffering from vertigo and/or disequilibrium. In 35 of 177 patients, the vertigo-like condition was due to peripheral causes: 10 sudden deafness, six vestibular neuronitis, three benign paroxysmal positional vertigo and three Meniere's disease. In this paper, two cases of pediatric vestibular neuronitis will be reported in detail. All six patients with vestibular neuronitis were boys, and the affected sides were equally distributed in the group. The patients recovered within two to four weeks, a prognosis which is better than that observed in adults. With regard to directional nystagmus, the gaze was bilateral in five patients and vertical in two. They showed neuro-otologic findings that suggest not only unilateral dysfunction but also bilateral disorders or partial lesions on the central vestibular system. Consequently, in the hope that the study of vertigo in childhood may provide additional clues to the pathogenesis of the disease in adults, we would like to consider two cases of pediatric cases of vestibular neuronitis.- - - - - - - - - - ranking = 2keywords = vertigo (Clic here for more details about this article) |
8/18. vertigo caused by basilar artery compression of the eighth nerve.Vascular compression syndromes in the posterior cranial fossa have become well described clinical entities, especially for the fifth and seventh cranial nerves. Jannetta has proposed vascular compression of the eighth nerve as the etiology of hearing loss, tinnitus, and vertigo in some patients. The case that follows illustrates a clear-cut example of vestibular symptoms arising from vascular compression of the eighth nerve. The patient involved had disabling peripheral vertigo refractory to medical management. magnetic resonance imaging documented a tortuous basilar artery compressing the eighth nerve on the involved side. This was confirmed at surgery, and a selective section of the vestibular nerve provided complete relief of disabling symptoms and preservation of hearing. The authors describe the details of this case and the enigma of eighth nerve symptoms due to vascular compression.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
9/18. Middle fossa surgery. Report of 153 cases.The principal indications for the middle cranial fossa approach to the petrous apex and internal auditory canal are section of the vestibular nerves in vertigo, management of lesions of the labyrinthine segment of the facial nerve, and removal of mass lesions of the internal auditory canal. We report 153 cases of pathosis of the temporal bone and related structures for which this approach was used.- - - - - - - - - - ranking = 0.5keywords = vertigo (Clic here for more details about this article) |
10/18. dizziness in childhood.dizziness in childhood is not an infrequent symptom. Accurate history taking and close co-operation between otologist, paediatrician and neurologist are necessary in the approach to the dizzy child. Most cases of childhood dizziness settle in time and investigations should be carefully selected; those with severe and persistent dizziness or ataxia should be thoroughly investigated including: EEG, ENG, calorics and CT scan. The conditions causing dizziness in children are discussed and are illustrated with case histories from our series of 27 children. dizziness of unknown aetiology, serous otitis media and benign paroxysmal vertigo were the most common diagnostic labels applied to our patients. Treatment is rarely necessary but dimenhydrinate or a labyrinthine sedative in those with troublesome vertigo, or the adjustment of the medical regime in those epileptics on phenytoin, may be beneficial. Surgical intervention is only required in those with an operable lesion.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
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