DOCSLIB.ORG

Correlation Between Vestibulo-Ocular Reflex and Optokinetic

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Correlation Between Vestibulo-Ocular Reflex and Optokinetic ACTA OTORHINOLARYNGOL ITAL 26, 20-24, 2006 ORIGINAL PAPER Correlation between vestibulo-ocular reflex and optokinetic afternystagmus in normal subjects and in patients with vestibular system disorders Correlazioni tra il riflesso vestibolo-oculare e il nistagmo post-otticocinetico nei soggetti normali e in pazienti con patologia del sistema vestibolare M. DELLEPIANE, M.C. MEDICINA, L. BARETTINI, A.C. MURA1 Otorhinolaryngology Clinic, University of Genova; 1 Otorhinolaryngology Unit, Galliera Hospital, Genova, Italy Key words Parole chiave Vestibular disorders • Diagnosis • Vestibulo-ocular reflex Disordini vestibolari • Diagnosi • Riflesso vestibulo-ocu- • Optokinetic afternystagmus lare • Post-nistagmo otticocinetico Summary Riassunto Optokinetic afternystagmus follows optokinetic nystagmus as Il post-nistagmo otticocinetico (OKAN1) compare dopo il an expression of the central velocity storage integrator dis- nistagmo otticocinetico (OKN), è dovuto alla scarica di strut- charge and its fast phase is beating in the same direction as ture nervose responsabili dell’accumulo di velocità (velocity the previous optokinetic nystagmus. We investigated the cor- storage) e la sua fase rapida batte nella stessa direzione del relation between vestibulo-ocular reflex and optokinetic precedente OKN. Abbiamo studiato la correlazione tra il rif- afternystagmus in normal subjects and in patients with bilat- lesso vestibolo-oculare (VOR) e il post-nistagmo otticocinetico eral vestibular disorders. The aim of this study was to deter- in soggetti normali e in pazienti con alterata reflessia vestibo- mine the possible role of optokinetic afternystagmus as a lare bilaterale allo scopo di verificare l’utilità diagnostica del- diagnostic test for identifying functional vestibular disorders. l’OKAN nella valutazione della funzionalità vestibolare. I The subjects were examined by electronystagmography and soggetti sono stati esaminati con metodo elettronistagmografi- vestibulo-ocular reflex, optokinetic nystagmus stare type as co, seduti su una sedia rotatoria entro un cilindro che può well as optokinetic afternystagmus were recorded. They were ruotare indipendentemente o sinergicamente alla sedia stessa, restrained in a rotatory drum chair, both the chair and the per lo studio del VOR, dell’OKN di tipo stare e dell’OKAN1. drum could be rotated, independently or coupled. For Lo studio del VOR è stato effettuato sul nistagmo post-rotato- vestibulo-ocular reflex analysis, we studied post-rotatory- rio dopo Stop-test da una velocità di 90°/sec.; l’OKN è stato nystagmus from a velocity of 90°s. Optokinetic nystagmus studiato con una velocità di rotazione del cilindro di 30°/sec. was recorded at a drum velocity of 30°s and the registration per 60 sec. e l’osservazione è stata protratta al buio, dopo lo continued in total darkness, after the illumination was spegnimento della luce, per la valutazione dell’OKAN1. Abbi- switched off, to study optokinetic afternystagmus. We con- amo preso in considerazione il gain del VOR, il gain dell’OKN sidered vestibulo-ocular reflex and optokinetic nystagmus e la costante di tempo (ct), definita come il tempo necessario gain, vestibulo-ocular reflex and optokinetic afternystagmus perché la velocità angolare della fase lenta diminuisca sino al constant of time (tc) defined as the time necessary for the 37% del suo valore originale. Dai risultati emerge che il gain slow phase eye velocity to be reduced to 37% of its initial e la ct del VOR risultano variare significativamente solo nei value. Results demonstrated that vestibulo-ocular reflex gain soggetti con diminuita reflettività vestibolare, mentre il gain and ct showed a significant difference only in patients with dell’OKN è significativamente maggiore solo in presenza di reduced vestibular reflexia, while optokinetic nystagmus gain aumentata reflettività, come pure la ct del VOR; invece la ct was greater only in patients with increased reflexia; optoki- dell’OKAN1 varia significativamente solo nei pazienti con netic afternystagmus ct was different from the control group iporeflessia vestibolare. In conclusione, sebbene la ct del VOR only in patients with hyporeflexia. In conclusion, our results e dell’OKAN1 abbiano un analogo comportamento per lo suggest that vestibulo-ocular reflex and optokinetic afternys- meno nei soggetti con diminuita reflettività vestibolare e pos- tagmus ct are clinically more useful than the gain alone in sano essere considerati un indice clinico più affidabile rispet- testing vestibular disorders with hyporeflexia. On the other to al gain, riteniamo più utile ai fini diagnostici un nuovo hand, we propose a new mathematical and statistical metodo per lo studio del nistagmo basato su un’analisi matem- approach to study the temporal evolution of more parame- atica e statistica di più parametri analizzati nella loro ters of the nystagmus. evoluzione temporale. 20 VESTIBULO-OCULAR REFLEX AND OPTOKINETIC AFTER NYSTAGMUS Introduction amination. A specific diagnosis was made in 25 cas- es and included chronic otitis in 3 patients, of trau- Primary optokinetic afternystagmus (OKAN) fol- matic aetiology in 4 cases, previous exposure to lows the optokinetic nystagmus (OKN), which is known ototoxic drugs in 10, vertebrobasilar insuffi- triggered by image slip on the retina when visual ciency and/ or cerebellar pathology in 8. stimulus is terminated by complete darkness. As a control group for ENG data, 20 healthy adults During the optokinetic stimulation, activity related to were identified. slow phase eye velocity (SPEV) in the subcortical Three groups of subjects were enrolled in the study. pathways is stored by the central velocity storage in- Group 1: 20 healthy adults (12 male, 8 female, aged tegrator 1-3, which discharges, generating OKAN1 24 to 27 years, mean 25.2). None had a history of with fast phases beating in the same direction as the past or present neurological, ophthalmologic, otolog- previous OKN 4. ic, systemic, or traumatic disease that could poten- OKAN1 is sometimes followed by a secondary opto- tially have affected results. kinetic afternystagmus (OKAN2) moving in the op- Group 2: 18 patients (11 male, 7 female; aged 22 to posite direction 4. The meaning of this reversal phase 70 years, mean 53) with bilateral vestibular hyper- is still obscure although it has been suggested to be reflexia. caused by central nervous system (CNS) adaptation Group 3: 20 patients (10 male, 10 female; aged 30 to to the optokinetic stimulus 5 6. 76 years, mean 48) with bilateral peripheral hypore- The relevance of the vestibular system, on the gene- flexia. sis of the OKAN, is supported by several studies. Pe- ripheral vestibular lesions may cause a loss of sym- APPARATUS metry in the primary and secondary OKAN with a Subjects were restrained in an electrically operated decrease in the strengths expressed by the gain and drum chair (Tönnies GmbH & Co., Wurzburg, Ger- duration 7-9. many). The chair rotated about the axis of a sur- Moreover, optokinetic after-response, in such cases, rounding cylindrical drum, 20 m diameter and 1.90 m is asymmetric with the OKAN1 beating toward the in height. On the inner wall of the drum were 32 ver- pathologic ear being significantly weaker than the tical black stripes, 9.32 cm in width and at an angle OKAN1 beating toward the healthy ear 7-10. of 5°,61 each were painted on a white background. It has been suggested that the appearance of direc- The moving pattern filled the entire visual field. Both tional asymmetry and/or a reduced time constant of the chair and the drum could be rotated (indepen- optokinetic afternystagmus (OKAN tc) might be a dently or coupled) at computer-controlled velocities. clinical index of vestibular imbalance 11 12. To test this With the illumination switched off, the drum ensured hypothesis, we studied changes both in the gain of total darkness for isolated testing of the VOR with the vestibulo-ocular reflex (VOR) and OKN and in eyes open. the time constants of the VOR and OKAN in patients Horizontal eye movements were recorded by surface with vestibular system disorders. The study design electrodes located on the outer edge and printed us- allowed information to be obtained concerning the ing a polygraph (Tönnies GmbH & Co., Wurzburg, clinical relevance of the OKAN tc. Germany) with a paper speed of 5 mm/s. Data were introduced and then analyzed by Lab- View 4.0 software (National Instruments, Austin, Materials and Methods TX, USA). SUBJECTS PROCEDURE A total of 38 subjects (21 male, 17 female, age range For VOR analysis, subjects were rotated at a veloci- 22-76 years, mean 51), with vestibular disorders who ty of 90° s reached by subliminal acceleration in 190 showed a bilateral vestibulopathy were submitted to s and then maintained for 30 s. This was done both electronystagmographic examination. Of these, 23 clockwise and counterclockwise. presented combined vestibular loss and uni- or bilat- After 30 s of rotation at 90° s the seat was stopped eral auditory loss. None showed spontaneous nystag- and nystagmus were recorded in total darkness. mus or had taken sedating medications within 48 We studied the OKN stare type. The drum was rotat- hours before testing. ed at a velocity of 30° s for 60 s both clockwise and Clinical history included chronic persistent or recur- counterclockwise. After each stimulation, the illumi- rent dizziness in 24 cases, associated with vertigo nation was switched off for nystagmus recording. and neurological signs in 4 other subjects and only Subjects were asked to look at stripes on the internal neurological symptoms in another 2 patients. The re- wall of the drum but without fixing. maining 8 subjects did not complain of vestibular A pause of 300 s was taken between stimulations. symptoms from 6 to 20 months, at the time of the ex- Calibration of eye movements was performed en- 21 M. DELLEPIANE ET AL. couraging subjects to follow a light moved across the visual field (1 mm = 10°). ANALYSIS For the analysis of recordings, gain and tc were ob- tained both manually and by means of computerized analysis.
Load more

Recommended publications
  • TRAUMATIC BRAIN INJURY Experts Speculate That Perhaps Just As Many – Or More - Hit Their Heads and Never Have It Checked Out
    8/1/2019 ‘’POST-CONCUSSION SYNDROME AND VISUAL-VESTIBULAR INTEGRATION DISCLOSURE POLICY DYSFUNCTION” It is the policy of our office, Vincent R. Vicci Jr., O.D., P.A., to state that I have no formal affiliation with other practices, offices, hospitals with the exception of being a staff consultant to the Kessler Institute SEPTEMBER – 2019 for Rehabilitation from which I receive no direct compensation. I have no affiliation with any pharmaceutical company or any company that distributes supplies or instrumentation to doctors and providers of vision care services. I have no copyrighted information, supplies or instrumentation that will be utilized in this presentation. All NEURO-OPTOMETRIC REHABILITATION information supplied during this presentation is based solely upon well established and accepted principles and clinical expertise in the areas LEVEL II EDUCATION discussed. Footnoted materials are presented with all handouts and Power Point presentations. Presentations are prepared and delivered with a high degree of professional conduct to all appropriate VINCENT R. VICCI JR., O.D. participants without discrimination against learners on the basis of gender, age, socioeconomic or ethnic background, sexual orientation WESTFIELD, N.J. or disability. VINCENT R. VICCI JR., O.D., D.P.N.A.P, F.N.O.R.A. • Distinguished Practitioner: National Academies of Practice • Fellow: Neuro-Optometric Rehabilitation Association • Staff consultant - Vision Care Clinics – Kessler Institute for Rehabilitation (West Orange, Saddle Brook, Chester, N.J.) • Consultant: Hartwyck at Oak Tree – J.F.K. Rehabilitation Institute • Seton Hall U.: M.S.O.T. program / yearly guest lecturer • Kean University: O.T. program / yearly guest lecturer • Past President / Co-Founder: Neuro-Optometric Rehabilitation Association (NORA) • Member: O.E.P., N.J.S.O.P, A.O.A.
    [Show full text]
  • Catch One of These Radiology Management Program Webinars
    PROVIDERNews Catch One of These Radiology Management Program Webinars Providers who weren’t able to attend the Radiology Management Program overviews held at our recent Mountain State Provider Workshops will have more opportunities to learn this important information. Twelve webinar sessions have been scheduled in November and December to allow providers to hear tips for how to prepare for the program. Representatives from National Imaging Associates, Inc. (NIA) will conduct two 90-minute sessions on each of the following dates: ® Nov. 16, 2010, 8 a.m. and noon ® Nov. 17, 2010, 8 a.m. and noon ® Dec. 7, 2010, 8 a.m. and noon ® Dec. 8, 2010, 8 a.m. and noon ® Dec. 14, 2010, 8 a.m. and noon ® Dec. 15, 2010, 8 a.m. and noon Registration is required. Please click here to access the registration form. (Continued on page 2) Inside This Edition: Radiology Management Program 2 Prescription Drug Benefit Management Moving 10 Paperless EOB and EFT 2 Watch Your Mail for News about FreedomBlueSM NaviNet® Verification Process 3 PPO and BlueRxSM PDP Changes 11 Mountain State Automates Electronic Changes for Service Benefit Plan FEP Members 11 Professional Claim Adjustments Requests 4 National Consumer Cost Tool Initiative 13 Mountain State to Revise COB Process 6 Mountain State to Update Its List of Procedures Coverage for Certain OTC Medications 6 Requiring Authorization 13 October 2010 Medicare Advantage News 7 Contracting/Reimbursement Update 14 Need help getting ready for ICD-10? 8 Please Note Important Holiday Observances 16 HIPAA News 9 Welcome to Our Newest Groups 16 Procedure Codes Relevant to Dental Services 10 Medical Policy Updates 17 PROVIDERNews Catch One of These Radiology Management Program Webinars (Continued from page 1) You will need a computer with Internet access to view the educational materials presented during the webinar.
    [Show full text]
  • Assessment and Management of Infantile Nystagmus Syndrome
    perim Ex en l & ta a l ic O p in l h t C h f Journal of Clinical & Experimental a o l m l a o n l r o Atilla, J Clin Exp Ophthalmol 2016, 7:2 g u y o J Ophthalmology 10.4172/2155-9570.1000550 ISSN: 2155-9570 DOI: Review Article Open Access Assessment and Management of Infantile Nystagmus Syndrome Huban Atilla* Department of Ophthalmology, Faculty of Medicine, Ankara University, Turkey *Corresponding author: Huban Atilla, Department of Ophthalmology, Faculty of Medicine, Ankara University, Turkey, Tel: +90 312 4462345; E-mail: [email protected] Received date: March 08, 2016; Accepted date: April 26, 2016; Published date: April 29, 2016 Copyright: © 2016 Atilla H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract This article is a review of infantile nystagmus syndrome, presenting with an overview of the physiological nystagmus and the etiology, symptoms, clinical evaluation and treatment options. Keywords: Nystagmus syndrome; Physiologic nystagmus phases; active following of the stimulus results in poor correspondence between eye position and stimulus position. At higher velocity targets Introduction (greater than 100 deg/sec) optokinetic nystagmus can no longer be evoked. Unlike simple foveal smooth pursuit, OKN appears to have Nystagmus is a rhythmic, involuntary oscillation of one or both both foveal and peripheral retinal components [3]. Slow phase of the eyes. There are various classifications of nystagmus according to the nystagmus is for following the target and the fast phase is for re- age of onset, etiology, waveform and other characteristics.
    [Show full text]
  • Retina Dnb Ophthalmology Question Bank
    DNB Ophthalmology Question Bank Retina and Vitreous 1999-2019 Dr. Krati Gupta Dr. Saurabh Deshmukh www.eyelearn.in RETINA, VITREOUS AND CHOROID A. Retinal vascular disorders 1. Anatomy 2. Diabetic retinopathy a) NPDR b) PDR c) Macular edema 3. Retinal vein occlusion a) BRVO b) CRVO 4. Retinal artery occlusion a) CRAO b) OIS 5. Hypertensive retinopathy 6. Pregnancy related hypertensive retinopathy 7. ROP 8. Coats disease 9. Eales disease 10. Radiation retinopathy B. Acquired macular disorders 1. Anatomy 2. Investigations a) Macular function tests b) FFA c) ICG d) OCT e) OCTA 3. Macular degeneration a) ARMD b) CNVM c) IPCV 4. Vitreomacular interface disorders a) ERM b) Macular hole 5. CSR 6. Submacular hemorrhage 7. Macular surgeries 8. Other macular disorders C. Hereditary Fundus Dystrophies 1. Anatomy a) RPE b) Rods and cones 2. Investigations a) VEP b) ERG c) EOG d) Electronystagmometry 3. RP 4. Retinoschisis 5. Bionic eye D. Retinal Detachment 1. Anatomy Dr. Krati Gupta | Dr. Saurabh Deshmukh 2. Investigations a) USG 3. Peripheral retinal degenerations 4. Retinal tears and breaks 5. GRT 6. Retinal Detachment a) RRD b) TRD c) ERD 7. Retinal detachment surgery a) Vitrectomy b) Scleral buckle c) SRF Drainage 8. Vitreous substitutes a) Air b) Gas c) Silicon Oil d) PFCL E. Drugs and LASER 1. Intravitreal drugs a) Steroids b) Anti- VEGF agents 2. Retinal LASERS a) Retinal Micropulsed LASER b) PDT c) TTT F. Vitreous and choroid 1. Vitreous a) Vitreous hemorrhage b) Terson’s syndrome c) PHPV Asteroid hyalosis 2. Choroid a) Choroidal coloboma b) Choroidal effusion G.
    [Show full text]
  • Optical Coherence Tomography in Age-Related Macular Degeneration 1St Edition Principles 1
    OPTICAL COHERENCE TOMOGRAPHY IN AGE- RELATED MACULAR DEGENERATION 1ST EDITION DOWNLOAD FREE Gabriel Coscas | 9783662505618 | | | | | Atlas of Retinal OCT: Optical Coherence Tomography Fluoroscopy Dental panoramic radiography X-ray motion analysis. Lay summary — Los Angeles Times September 4, White light is an example of a broadband source with lower power. OCT is based on low-coherence interferometry. October Any light that is outside the short coherence length will not interfere. An imaging approach to temporal OCT was developed by Claude Boccara's team in[24] with an acquisition of the images without beam scanning. Light with broad bandwidths can be generated by using superluminescent diodes or lasers with extremely short pulses femtosecond lasers. Bibcode : OExpr. April Learn how and when to remove this template message. Substances Angiogenesis Inhibitors. Synthetic array heterodyne detection offers another approach to this problem without the need for high dispersion. Free Shipping Free global shipping No minimum order. Therefore, translating one arm of the interferometer has two functions; depth scanning and a Doppler-shifted optical carrier are accomplished by pathlength variation. Optic Neuropathies and Papilledema 6. American Journal of Ophthalmology. We are always looking for ways to improve customer experience on Elsevier. Optical Coherence Tomography in Age-Related Macular Degeneration 1st edition Principles 1. Optical Coherence Tomography in Age-Related Macular Degeneration 1st edition Clinics. A wide range of fundus imaging modalities are now available, and this book explains the respective value of each technique. Intravascular OCT has been investigated for use in neurovascular applications, too, including imaging for guiding endovascular treatment of ischemic stroke and brain aneurysms.
    [Show full text]
  • Glaucoma Symposium
    PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY 2015 VICTORIA CONFERENCE July 16 - 19, 2015 Inn at Laurel Point Victoria, B.C. CANADA COPE EVENT #109358 Date Speaker Title COPE Verification Thursday, Dry Eye Etiology and Diagnosis 45687 1 hour July 16, Terry Burris, MD (1 hr) 2015 AS Therapeutic Dry Eye: Current and Future 45701 1 hour Terry Burns, MD Treatment Options (1 hr) AS Therapeutic Danica Marrelli, VEGF Inhibitors in Eye Care 36496 1 hour OD (1 hr) PS Therapeutic Curtis Baxstrom, Prism Applications in Acquired 43108 1 hour OD Brain Injury (1 hr) NO Tad 45456 1 hour Diabetes Potpourri (1 hr) Buckingham, OD SD Therapeutic Glaucoma Case Analysis Friday, Danica Marrelli, Everyday Challenges for the 40184 2 hours July 17 OD Primary Care Optometrist (2 hrs) GL Therapeutic Corneal Degenerations 45688 1 hour Terry Burris, MD (1 hr) AS Therapeutic Tad Pharmaceutical Injections for 45631 1 hour Buckingham, OD Optometrists (1 hr) IS Therapeutic 2015 Update on Corneal 45690 1 hour Terry Burris, MD Procedures Surgery (1 hr) PO Therapeutic Total hours offered: 10 Total hours earned: Name License # Mailing Address ______ Please retain a copy of this stamped form as verification of hours earned. Please be advised that your individual state board makes the final determination of applicable hours. For more information, contact Pacific University College of Optometry, 2043 College Way . Forest Grove, OR 97116 . 503-352-2202 1 of 156 2 of 156 PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY 2015 VICTORIA CONFERENCE July 16 - 19, 2015 Inn at Laurel Point Victoria,
    [Show full text]
  • Nystagmus and Ocular Oscillations in Infancy and Childhood Richard W
    9 Nystagmus and Ocular Oscillations in Infancy and Childhood Richard W. Hertle ye care practitioners may be among the first to evaluate Einfants and children with involuntary ocular movements. Pediatric ophthalmologists may, in fact, see more patients with nystagmus than any other specialist because of the frequent association of nystagmus with strabismus.9,16,20,42,54,61,75 Nystag- mus may be covered less frequently in literature and research because there is less we understand or can do about it, compared to strabismus or other childhood eye diseases. HISTORICAL PERSPECTIVE Nystagmus is a rhythmic, involuntary oscillation of one or both eyes. The term comes from the Greek word “nystagmos,” to nod, drowsiness and from “nystazein,” to doze; probably akin to Lithuanian “snusti,” also to doze. Using the information obtained from a complete history, physical examination, and radiographic and oculographic evaluations, more than 40 types of nystagmus can be distinguished (Table 9-1). Some forms of nystagmus are physiological whereas others are pathological. Although the nystagmus is typically described by its more easily observable fast (jerk) phase, the salient clinical and pathological feature is the presence of a slow phase in one or both directions. Clinical descriptions of nystagmus are usually based on the direc- tion of the fast phase and are termed horizontal, vertical, or rotary, or any combination of these (Fig. 9-1). The nystagmus may be conjugate or dysconjugate, indicating whether the eyes move 289 290 handbook of pediatric neuro-ophthalmology TABLE 9-1. Nystagmus Types as Identified by History, Physical Examination, and Ocular Motility Recordings. 1.
    [Show full text]
  • The Influence of Visual Vertigo and Vestibulopathy on Oculomotor
    Journal of Vestibular Research 24 (2014) 305–311 305 DOI 10.3233/VES-140519 IOS Press The influence of visual vertigo and vestibulopathy on oculomotor responses Oz Zura,∗, Ruth Dicksteinb, Elizabeth Dannenbaumc,EliCarmelid and Joyce Fungc,e aDepartment of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel bPhysical Therapy Services, Flieman Geriatric Rehabilitation Hospital, Haifa, Israel cFeil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Research Site of the Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada dPhysical Therapy Department, Haifa University, Social Welfare and Health Sciences, Haifa, Israel eSchool of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada Received 9 May 2013 Accepted 28 March 2014 Abstract. OBJECTIVE: Dynamic visual inputs can cause visual vertigo (VV) in patients with vestibulopathy, leading to dizziness and falls. This study investigated the influence of VV on oculomotor responses. METHODS: In this cross-sectional, single-blind study, with experimental and control groups, 8 individuals with vestibulopathy and VV, 10 with vestibulopathy and no VV, and 10 healthy controls participated. Oculomotor responses were examined with 2- dimensional video-oculography. Participants were exposed to dynamic visual inputs of vertical stripes sweeping across a screen at 20 deg/sec, while seated or in Romberg stance, with and without a fixed target. Responses were quantified by optokinetic nystagmus frequency (OKNf) and gain (OKNg). RESULTS: Seated with no target, VV participants had higher OKNf than controls (37 ± 9vs.24± 9 peaks/sec; P<0.05). In Romberg stance with no target, they had higher OKNf than controls (41 ± 9vs.28± 10 peaks/sec; P<0.05).
    [Show full text]
  • Diagnostic Tests for Vestibular Problems
    The inner ear’s vestibular organs and the Electronystagmography (ENG) refers to a associated nerves and brain centers form group of tests or test battery, and uses a complex system that serves many small electrodes placed over the skin functions and can be affected by a around the eyes during testing. number of outside systems. A thorough Videonystagmography (VNG) refers to evaluation of the inner ear may therefore the same test battery run using goggles require several different kinds of tests. with video cameras to monitor the eyes. Doctors use information from a person’s Both the video cameras and the medical history and findings from a electrodes can measure eye movements physical examination as a basis for to evaluate signs of vestibular ordering diagnostic tests to assess the dysfunction or neurological problems. vestibular system function and to rule out Generally these tests are performed in a alternative causes of symptoms. Most room that is dark or with low lighting. people tolerate these tests well. However, The examiner asks random questions that sometimes the tests are fatiguing and can are meant to occupy the person being result in temporary unsteadiness. tested and keep them alert. ENG/VNG tests are the most common set of tests administered to people with dizziness, vertigo, and/ or imbalance. The vestibular and visual systems are Parts of the ENG/VNG test battery connected to each other and to the evaluate the movement of the eyes as muscles in the eyes and neck that help they follow different visual targets. Other maintain good balance. Head movements parts of the ENG/VNG observe eye or other stimulation of the inner ear movements as the head is placed in sends signals through the nervous different positions.
    [Show full text]
  • Evaluation of Vestibular and Oculomotor Functions in Individuals
    https://doi.org/10.1590/0004-282X20180154 ARTICLE Evaluation of vestibular and oculomotor functions in individuals with dizziness after stroke Avaliação das funções vestibular e oculomotora em indivíduos com tontura após acidente vascular encefálico Bianca Nunes Pimentel1, Valdete Alves Valentins dos Santos Filha1 ABSTRACT Changes in postural balance and visual complaints are frequent consequences of stroke. We aimed to investigate the symptoms and the vestibular and oculomotor functions of patients with dizziness post ischemic and hemorrhagic stroke and compare the results among them. Methods: Fifty patients with dizziness after stroke were evaluated through a clinical anamnesis and computerized vector electronystagmography: calibration of ocular movements, spontaneous nystagmus, semi-spontaneous nystagmus, pendular tracking, optokinetic nystagmus, rotary chair testing, and the caloric test. Results: All patients complained of dizziness, especially imbalance. Ischemic stroke in the carotid territory was the prevalent type. Visual complaints were reported by 56% of the sample and were related to abnormalities in oculomotor and caloric tests. Conclusion: The occurrence of visual symptoms was related to some abnormalities in the vector electronystagmography tests, being more frequent in cases of stroke in the vertebrobasilar system, and with oscillopsia and reduced visual acuity as symptoms. Keywords: Stroke; dizziness; vestibular function tests; vision disorders. RESUMO Alterações no equilíbrio postural são consequências frequentes no acidente vascular cerebral (AVC). O objetivo deste estudo foi investigar os sintomas e as funções vestibular e oculomotora de sujeitos com tontura após AVC isquêmico e hemorrágico, comparando seus resultados. Métodos: Foram avaliados 50 sujeitos com tontura após AVC, por meio de anamnese clínica e vectoeletronistagmografia computadorizada (VENG): calibração dos movimentos oculares; nistagmo espontâneo e semi-espontâneo; rastreio pendular; nistagmo optocinético; prova rotatória pendular decrescente e prova calórica com estímulo a ar.
    [Show full text]
  • Study of Electronystagmography in the Diagnosis and Efficacy of Follow-Up After Treatment, in Patients with Vertigo of Peripheral Origin
    International Journal of Otorhinolaryngology and Head and Neck Surgery Zorengpuii et al. Int J Otorhinolaryngol Head Neck Surg. 2019 Nov;5(6):1481-1485 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20194558 Original Research Article Study of electronystagmography in the diagnosis and efficacy of follow-up after treatment, in patients with vertigo of peripheral origin Zorengpuii1, Lalnuntluangi Khiangte2*, Naveen P.3 1Department of Otorhinolaryngology, State Referral Hospital, Falkawn, Aizawl, Mizoram, India 2Department of Ophthalmology, State Referral Hospital, Falkawn, Aizawl, Mizoram, India 3 Department of Physiology, Zoram Medical College, Falkawn, Aizawl, Mizoram, India Received: 13 September 2019 Revised: 02 October 2019 Accepted: 03 October 2019 *Correspondence: Dr. Lalnuntluangi Khiangte, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Vertigo is a symptom of multisystemic disorders of various etiological factors with different clinical manifestations. The disorders causing the symptom may be of peripheral or central origin, and accurate diagnosis of the underlying pathology is warranted for effective treatment. Balance is a complex sensorimotor task involving accurate and redundant sensory input from the visual, vestibular and proprioceptive systems, central nervous system integration of the sensory signals and the generation of the appropriate motor commands and adequate musculoskeletal capabilities to perform the motor tasks involved in occulomotor and posture control.
    [Show full text]
  • Electronystagmographic Study O Onystagmographic Study of The
    Original Article Electronystagmographic study of the vertigo patients Shaila Somani 1* , Siddartha Oswal 2, Shivaji Patil 3, Sham Somani 4, Jayesh Rane 5 Akshay Wachasundar 6 1Associate Professor, 2,5,6 Junior Resident, 3Professor, 4Professor and HOD, Department of ENT, MIMSR Medical College & Y.C.R. H ospital, Vishwanathampuram, Ambe jogai Road, Latur, 413512 Maharashtra, INDIA. Email: [email protected] Abstract Introduction: The word “vertigo” comes from the Latin word “vertigo” - to run, the suffix “ - igo” = a condition of turning about). Vertigo is defined as the sensation of movement of self or environment. One of the most common presenting complaints patients bring to their family physicians and ENT surgeons is dizziness. In day -to-day ENT practice, incidence of dizziness is reported to be 10 -15 %. Aims and Objectives: To Study Electronystagmog raphic of the Vertigo Patients. Material and Methods: This is a perspective study which was conducted in the Department of Otorhinolaryngology, tertiary care center. This study was done in tertiary care and Medical college. Data collection-18 months from January 2014 to June 2015.Data analysis-6 months from Jul y 2015 to December 2015.Sample size included patients who presented with primary complaints of vertigo in our Otorhinolaryngology OPD. Sample size was 73 patients. All cases attending the ENT OPD with the vertigo , Patients with dizziness and vertigo , All age groups Both males and females included into study. Result: On non-caloric ENG test 3 patients showed smooth pursuit nystagmus abnormality on pendulum test and 3 showed asymmetric Opt kinetic test, 26 patients showed abnormal on positional test on 3 posit ions suggestive of BPPV.
    [Show full text]