Kind Of Vertigo Research Articles

Transitional nystagmus in a Bow Hunter\u2019s Syndrome case report

BackgroundBow Hunter’s Syndrome (BHS) is known as one of cervical diseases which causes vertigo, but the details of its vertigo, especially nystagmus and eye movement, are still incompletely understood. This time, we reported the first case of BHS with a nystagmus chart with video record of transitional nystagmus.Case presentationThe patient, a 47-year-old female, complained of vertigo caused by head rotation. When she turned her head leftward, leftward nystagmus appeared, and this was followed by dullness of the right arm. After her head was returned to the central position, downbeat nystagmus appeared, which changed to rightward nystagmus. She was diagnosed with BHS by her symptoms and images. We recorded a nystagmus video and nystagmus chart of this transitional nystagmus including downbeat nystagmus. Her vertigo was cured by the modification of a prescription for her past medical history: hypertension.ConclusionThe vertigo of BHS accompanies nystagmus. In this present case, the transitional nystagmus was observed, and it occurred toward the healthy side. Then the nystagmus direction was changed to the affected side via downbeat nystagmus. This is the first report with both a nystagmus chart with video of BHS. Nowadays, various kinds of vertigo induced by neck movement are known. BHS is a rare disease among vertigo diseases, but we should consider it as a different diagnosis of vertigo patients. A precise interview and proper examination are required to make the final diagnosis.

Risk factors of primary benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common kind of vertigo, which can be divided into idiopathic and secondary types. Head trauma, surgery, and inner ear diseases may induce the secondary BPPV, but the etiology and pathogenesis of idiopathic BPPV is still unknown. Recent studies indicate that multiple factors are associated with idiopathic BPPV; in this article we will review the risk factors of idiopathic BPPV. Key words: Benign paroxysmal positional vertigo; Risk factors

Inner Ear Blood Flow in the Rat after Unilateral Arterial Occlusion in the Vertebrobasilar Arterial System

It is generally accepted that certain kinds of vertigo and hearing disturbances are caused by blood flow insufficiency in the vertebrobasilar arterial system. Using the microsphere method we investigated whether unilateral vertebral artery or unilateral posterior inferior cerebellar artery occlusion could cause an imbalance between right and left inner ear blood flow in rats. We also studied the differential vulnerability between blood flow in the cochlea and in the ampullae of the three semicircular canals. We counted the numbers of microspheres distributed to the cochlea (CO) and microspheres distributed to three ampullae of semicircular canals (SC) under a microscope with the surface preparation method. The results were as follows: i ) no imbalances were observed between bilateral CO or SC even in animals with arterial occlusion, and ii ) the CO/SCs of animals with arterial occlusion were not significantly different from that of the control animals. These findings suggest that total inner ear blood flow over a certain period of time was even between the ears bilaterally even in animals with arterial occlusion. The blood flow in the ampullae of the three semicircular canals was not more or less affected by arterial occlusion than the blood flow in the cochlea.

一側椎骨動脈閉塞時の内耳血流の左右差についての検討 マイクロスフィアー法

It is well known that some kinds of vertigo or hearing disturbances are caused by impairment of vertebro-basilar circulation. It is important to determine whether unilateral vertebral artery (VA) occlusion causes an imbalance between bilateral inner ear blood flow. In this study, we investigated the influence of unilateral VA occlusion and hypotension on bilateral inner ear blood flow in rats. Using the microsphere surface methods, we measured blood flow of the cochlea and three semicircular ampullae. In control animals, the differences between blood flow in the right and left cochleae and semicircular ampullae were not significant. In animals with VA occlusion and hypotension, the differences were not significant either. In addition to these findings, we discuss the possibility of imbalance between bilateral inner ear blood flows caused by VA occlusion with consideration of previous reports.

Relevance of function tests in the diagnosis of vestibular disorders.

The diagnostic value or relevance of a vestibular function test is dependent on the whole clinical and functional context of each particular case. It is not the ability to show 'abnormality' in a high number of patients complaining of whatever kind of vertigo, that indicates the relevance of a function test. Neither is relevance of a test based upon the possibility that this test can re-categorize some patients in the same way as has been done by other tests. Each test evaluates some particular functional aspect and this is very different from one test to another. A test is more relevant, i.e. indicates more abnormality when the type of vertigo caused by the dysfunction is also considered. These statements are confirmed by experience in peripheral vestibular disorders, especially benign paroxysmal positional vertigo (BPPV). A paroxysmal positional nystagmus (ppn) (nystagmus and vertigo elicited by movements and manoeuvres) is linked to the problem of provoked vertigo and gives a confirmation of this vertigo by reproducing it in some manoeuvres. Some inconstancy in the reproduction of this ppn may cause difficulties in diagnosis. Caloric tests are the clue for diagnosis of sudden unilateral loss (so-called neuronitis), whereas they give only complementary information for patients with BPPV. Posturography adds information in all categories concerning the standing position and can be interesting in the scope of rehabilitation treatment. The findings of a retrospective study in patients with BPPV (n = 95), compared with patients with Ménière's disease (n = 89) and others with sudden unilateral loss syndrome (n = 48), illustrate these concepts.

Bilateral Inner Ear Blood Folw in Rats with Unilateral Vertebral Artery Occulusion

It is well known that some kinds of vertigo and some hearing problems are caused by impairment of the vertebro-basilar circulation. The influence of unilateral vertebral artery (VA) occlution on bilateral inner ear blood flow was studied in rats by the laser Doppler method. After tracheotomy, both cochleas were exposed through a ventral approach for the measurement of cochlear blood flow (CBF). One VA was occluded by photochemically induced thrombosis. The right femoral artery was cannulated for continuous measurement of systemic blood pressure (BP). BP and CBF showed little change after unilateral VA occlu-sion alone. However, subsequent hypotension induced by venesection not only reduced CBF, but also caused bilateral imbalance between the CBF reduction rates. CBF changed independently of BP, indicating the existence of a local CBF regulation system.

Pathological Study of Temporal Bones of Patients with a History of "Vertigo" and of the Cochleae of SHR Rats with "Vertigo"

The temporal bones of 24 aged cadavers were examined histologically during the last five years. In 18 cases there was a history of vertigo. The Distension of Reissner's membrane was present in 26 of the 29 cochleae examined from those with vertigo and in 5 of the 9 cochleae of the controls. The degree of hydrops in the cochleae of those with a history of vertigo was severer than that in the cochleae of the controls. The temporal bones of two SHR rats with a kind of vertigo were also examined histologically. The cochlear structure of the affected side was destroyed and replaced by fibrotic cells in one rat. In one turn of the cochlea on this side, a mass of coagulated blood and fibrosis was observed in the same region, presumably caused by intracochlear bleeding due to hypertension. Ultrastructural studies are needed to clarify those pathological findings.

"Vertigo" in Old People's Home and the Pathological Study of SHR Rats Suffering from "Vertigo"

Questionnaires were sent to homes for the elderly in Shimane prefecture, inquiring about the incidence of vertigo, its characteristics, duration and associated symptoms. Otological examination of 20 patients revealed probable Meniere's disease in 10.The medulla oblongata and temporal bones of 6 SHR rats with a kind of vertigo were examined. These SHR rats tilted their heads to one side, and when held, they circled around their tails. Their systolic blood pressures were 200-300 mmHg. In two rats, degenerating neurons which stained deeply with Luxol-Fast blue were observed in the reticular formation of the medulla oblongata. In the temporal bones of all 6 rats, the cochlear structures of the affected side were destroyed and replaced by fibrotic cells. Further study is needed to evaluate these pathological findings.

Freaks: Myths and Images of the Secret Self (review)

Reviewed by: Freaks: Myths and Images of the Secret Self John Cech Leslie Fiedler . Freaks: Myths and Images of the Secret Self. Simon and Schuster, $12.95 cloth, $5.95 paper. Leslie Fiedler's Freaks: Myths and Images of the Secret Self (Simon and Schuster, $12.95 cloth, $5.95 paper) is a particularly relevant book, given the fascinated and, at times, obsessive interest in the monstrous, the alien, the mutant, deformed, and odd —that whole body of strange enigmatic cross-overs from the unconscious, the shadow side of "normal." Fiedler is at his probing, provocative best here, peeling back the layers of rational explanation and defense that are used to cover these powerful and disturbing images of the monster, or, as Fiedler chooses to call the figure in his book, the "freak." The freak can come in a range of symbolic and physical forms, from the imagined creatures of fantasy, myth, or "natural history" to the twisted shapes of actual human beings. Fiedler's point is that freaks speak to our deepest fantasies and fears. They belong to the "secret self" we barely acknowledge when we stare, often with a mixture of wonder and dread, at these real or imagined, nightmarish breaks with order —the order we take for granted in nature, society, or our identities. The monster is the "not us," and yet it is an essential part of our definition of who we are. In its most ancient sense, the monster is "a portent, an omen, a showing forth"; in a sense, it is a demonstration of what is hidden away from view in each of us. For Fiedler, the present study actually began when he was a child, remembering a trip to the side show and watching the Siamese Twins there. As an adult, he gives words to the substance of that intuitive, early connection he made and, he believes, all of us make between the monstrous and ourselves: Confronting them, I could feel the final horror evoked by Freaks stir to life: a kind of vertigo like that experienced by Narcissus when he beheld his image in the reflecting waters and plunged to his death. In joined twins the confusion of the self and the other, substance and shadow, ego and other is more terrifyingly confounded than it is when the child first perceives face to face in the mirror an image moving as he moves, though clearly in another world. In that case, at least there are only two participants, the perceiver and the perceived; but standing before Siamese Twins, the beholder sees them looking not only at each other, but - both at once - at him. And for an instant it may seem to him that he is a third brother, bound to the pair before him by an invisible bond; so that the distinction between audience and exhibit, we and them, normal and Freak, is revealed as an illusion, desperately, perhaps even necessarily, defended, but untenable in the end. Children encounter the monster first in their own dream experience and then later in fairy tales, myth, fantasy, and other popular media such as comic books, television shows, and horror movies. Rather than censor monsters, Fiedler believes that kids are "in need of . . . fantasies to project dreams of revenge on the adult world, and to immunize themselves against the real loss and terror by frightening themselves with what they [know] to be fictions." The monster organizes the chaos of a child's emotions; and, through engaging the monster, he masters or channels his normal psychological "distress." Thus, primal fears of being devoured, for instance, are embodied in the many traditional stories about giants or "in the flesh" by circus fat ladies or side show geeks. The image of the giant has its roots deep in the ancient myths of the cannibalistic father, Saturn or Cronus; and the archetype continues to surface in recent children's books like Arthur Yorinks' and Richard Egielski's Sid and Sol (Farrar, Straus & Giroux $6.95) and Alison Sage's and Gian Calvi's The Ogre's Banquet (Doubleday, $5.95). Both treat the giant humorously, making him more the buffoon, more the victim of self-devouring vanity than...