1/16. Downbeat nystagmus caused by thiamine deficiency: an unusual presentation of CNS localization of large cell anaplastic CD 30-positive non-Hodgkin's lymphoma.A 24-year-old woman with a large cell anaplastic CD 30-positive T-cell non-Hodgkin's lymphoma (NHL) developed downbeat nystagmus, anisocoria, and oscillopsia. Prior to overt cerebral invasion by NHL, she had a thiamine deficiency with very low thiamine concentrations in the CSF, probably caused by protracted vomiting and increased vitamin B1 consumption by intrathecal tumor cells. We believe that her neurologic symptoms were caused -- at least partly -- by thiamine deficiency, as she reacted well to thiamine supplementation at the beginning of treatment.- - - - - - - - - - ranking = 1keywords = nystagmus (Clic here for more details about this article) |
2/16. multiple system atrophy manifested as dizziness and imbalance: a report of two cases.multiple system atrophy (MSA) is a progressive neurodegenerative disease of undetermined origin that occasionally manifests as dizziness and imbalance. It is not often considered in clinical situations, especially not by neuro-otological consultants. Hence, we report our recent experience with two cases of MSA. One is that of a 62-year-old man with MSA with a predominant cerebellar feature, and the other is that of a 72-year-old man with MSA with a predominant parkinsonian feature. The results of the syncopic study correlated with orthostatic hypotension. The neuro-otological study in both patients revealed an abnormal eye tracking test, abnormal optokinetic nystagmus test and loss of visual suppression in the caloric nystagmus. These indicate that the central vestibular system, e.g., the cerebellum or brain stem, is affected by MSA, contributing to dizziness and imbalance. Therefore, diagnosis of MSA should be kept in mind by neuro-otological consultants when dealing with patients with dizziness and imbalance, especially when this is accompanied by orthostatic hypotension.- - - - - - - - - - ranking = 0.4keywords = nystagmus (Clic here for more details about this article) |
3/16. Incomplete oculomotor nerve palsy caused by an unruptured internal carotid-anterior choroidal artery aneurysm--case report--.A 59-year-old woman visited our institute with the chief complaint of dizziness which persisted whenever she tried to focus on objects. She had not experienced apparent double vision and had no history of intracranial bleeding. Neurological examination revealed no abnormality except for exotropia at the mid-position and at upper gaze. cerebral angiography revealed that the intracranial portion of the left internal carotid artery ran more horizontally and also identified an unruptured left internal carotid-anterior choroidal artery (IC-AChA) aneurysm of 3.0 mm diameter. The aneurysm at the origin of the AChA was confirmed during surgery. The proximal lateral wall of the aneurysm was in contact with the oculomotor nerve. This contact was released after complete obliteration of the aneurysm. The exotropia resolved 3 months later. oculomotor nerve palsy usually indicates the presence of internal carotid-posterior communicating artery (IC-PcomA) aneurysm. Since sacrifice of the AChA will result in severe neurological deficits, accurate neuroimaging information is needed prior to the operation. Conventional angiography and/or three-dimensional computed tomography angiography should be performed to ascertain whether the aneurysm is an IC-PcomA or IC-AChA aneurysm, even if some neurosurgeons insist that conventional angiography is not always needed before surgery for an unruptured aneurysm.- - - - - - - - - - ranking = 5.7241823418886E-5keywords = horizontal (Clic here for more details about this article) |
4/16. 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 = 0.2keywords = nystagmus (Clic here for more details about this article) |
5/16. rehabilitation exercise for treatment of vestibular disorder: a case study.vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV). The symptoms started a day after falling from a bus, where she injured her head. Otherwise her medical history was unremarkable. She was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises (i.e., laying on the left side from sitting on the bed, while the head rotated 45 degrees to the right, waiting for about one minute; twice a day on gradual basis, not laying on the side all the way, but to use enough pillows to lay about at 60 degrees). Four weeks from the start of physical therapy, the patient was free of symptoms, even when her neck was in the extended position.- - - - - - - - - - ranking = 5.7241823418886E-5keywords = horizontal (Clic here for more details about this article) |
6/16. Positional nystagmus of central origin.Audiometric, electrophysiologic, and radiographic findings for a 68-year-old male with an "imbalance" concern are presented. This paper has a two-fold purpose: (1) to present an unusual electronystagmography case study and (2) to highlight the importance of test conditions in lesion localization. The specific disease pathophysiology remains obscure. Repeated hearing tests documented a known hearing impairment with worsening word-recognition ability of the right ear. An initial electronystagmographic exam was normal except for a mild ageotropic direction-changing positional nystagmus with eyes open and fixed. No repeatable click-evoked auditory brainstem response waveforms could be collected. A magnetic resonance imaging of the brain documents diffuse ischemic white matter disease. A repeated vestibular examination some months later supports the initial findings. The case illustrates the importance of following diagnostic protocol, of repeated measures, and of using both a visual fixation and a nonfixation condition for select electronystagmographic subtests.- - - - - - - - - - ranking = 1keywords = nystagmus (Clic here for more details about this article) |
7/16. Aseptic meningoencephalitis presenting with bilateral vestibular ataxia: a case report.Bilateral vestibular dysfunction is a rare condition, of which peripheral disorders are most common, whereas central disorders are extremely rare. A 35-year-old woman developed fever, headache, dizziness, convulsion, and disturbance of consciousness at the same time. MRI findings were normal. Based on the neurological findings and laboratory abnormalities, she was diagnosed as having aseptic meningoencephalitis. Steroid pulse therapy successfully ameliorated her encephalitis sign. However, isolated bilateral vestibular ataxia and dizziness, together with severe decrease of Caloric nystagmus, became apparent and lasted for the following 3 months, without cerebellar/brainstem involvement.- - - - - - - - - - ranking = 0.2keywords = nystagmus (Clic here for more details about this article) |
8/16. Optokinetic suppression of aberrant vestibular reactions: an observation.It has long been known that optokinetic nystagmus may be modified by vestibular inputs. We have suppressed an aberrant vestibular response and associated gastrointestinal sensations by use of an optokinetic stimulus simultaneous to the positional stimulus in a patient with paroxysmal positional vertigo. This single subject study utilized several optokinetic conditions, and patterned its stimulus presentations to control for visual fixation and vestibular habituation. Objective recordings of eye movements (ENG) were made simultaneously with subjective evaluation of "dizziness" on a simple magnitude estimation scale.- - - - - - - - - - ranking = 0.2keywords = nystagmus (Clic here for more details about this article) |
9/16. Clinical features of cisplatin vestibulotoxicity and hearing loss.patients treated with cisplatin were observed in an otoneurological study with special reference to cochlear and vestibular toxicity. Toxicity-related symptoms appeared to be almost all transient. As with leukopenia, hearing loss and dizziness often occurred after several weeks of administration. In the equilibrium examinations, some abnormal findings such as spontaneous nystagmus and positional nystagmus were seen. caloric tests and body sway tests detected abnormal findings in the early stages of cisplatin-related vestibulotoxicity.- - - - - - - - - - ranking = 0.4keywords = nystagmus (Clic here for more details about this article) |
10/16. Voluntary nystagmus masquerading as Tullio's Phenomenon.Nystagmoid eye movements elicited by humming loudly was initially misdiagnosed as Tullio's phenomenon (abnormal acoustical stimulation of the vestibular apparatus owing to labyrinthine fistula). Further workup lead to a final diagnosis of a form of voluntary nystagmus characterized in some reports as "hysterical mystagmus". Some of the characteristics of this example of voluntary nystagmus differed from generally accepted descriptions.- - - - - - - - - - ranking = 1.2keywords = nystagmus (Clic here for more details about this article) |
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