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A video-oculographic study of acute vestibular syndromes.

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Title: A video-oculographic study of acute vestibular syndromes.
Authors: Roberts, H. N., McGuigan, S., Infeld, B., Sultana, R. V., Gerraty, R. P.
Source: Acta Neurologica Scandinavica. Oct2016, Vol. 134 Issue 4, p258-264. 7p.
Subjects: Vestibular apparatus diseases, Vestibulo-ocular reflex, Eye movements, Vestibular nerve, Hospital emergency services, Medical research, Diagnosis
Abstract: Objectives To quantitate the vestibulo-ocular reflex ( VOR) gain in patients with acute vestibular neuritis ( VN) and repeat this daily using a portable video head impulse test device to assess vestibular recovery in the acute stage of VN. Materials and methods We enrolled adults with symptoms and signs of VN presenting to the emergency department within 48 h of symptom onset. We recorded the eye movement response to rapid head impulses using the ICS Impulse™ video head impulse test device on each day of their hospital admission. Results There were eight patients (75% men, aged 35-85 years) who had marked variation in their initial vestibulo-ocular reflex gains. Three patients had vestibulo-ocular reflex gains in the normal range initially, despite having physical signs of VN. Two patients had initial contralesional gains below the normal range, associated with markedly reduced ipsilesional gains. Most patients' vestibulo-ocular reflex gains increased during admission, but four patients' ipsilesional gains remained in the abnormal range. Patients with lower vestibulo-ocular reflex gains were less likely to improve into the normal range. No patient with initially abnormal VOR gain recovered normal vestibulo-ocular reflex gain along with resolution of physical signs. Conclusion Early video head impulse testing in the emergency department and each day of admission is feasible and well tolerated. There is marked variation in VOR gain in patients with symptoms and signs of VN, and low initial VOR gains are a predictor for low VOR gains on subsequent days. Improvement in VOR gains was seen in most patients. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: A video-oculographic study of acute vestibular syndromes.
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  Data: <searchLink fieldCode="AR" term="%22Roberts%2C+H%2E+N%2E%22">Roberts, H. N.</searchLink><br /><searchLink fieldCode="AR" term="%22McGuigan%2C+S%2E%22">McGuigan, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Infeld%2C+B%2E%22">Infeld, B.</searchLink><br /><searchLink fieldCode="AR" term="%22Sultana%2C+R%2E+V%2E%22">Sultana, R. V.</searchLink><br /><searchLink fieldCode="AR" term="%22Gerraty%2C+R%2E+P%2E%22">Gerraty, R. P.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Oct2016, Vol. 134 Issue 4, p258-264. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Vestibular+apparatus+diseases%22">Vestibular apparatus diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Vestibulo-ocular+reflex%22">Vestibulo-ocular reflex</searchLink><br /><searchLink fieldCode="DE" term="%22Eye+movements%22">Eye movements</searchLink><br /><searchLink fieldCode="DE" term="%22Vestibular+nerve%22">Vestibular nerve</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+research%22">Medical research</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
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  Data: Objectives To quantitate the vestibulo-ocular reflex ( VOR) gain in patients with acute vestibular neuritis ( VN) and repeat this daily using a portable video head impulse test device to assess vestibular recovery in the acute stage of VN. Materials and methods We enrolled adults with symptoms and signs of VN presenting to the emergency department within 48 h of symptom onset. We recorded the eye movement response to rapid head impulses using the ICS Impulse™ video head impulse test device on each day of their hospital admission. Results There were eight patients (75% men, aged 35-85 years) who had marked variation in their initial vestibulo-ocular reflex gains. Three patients had vestibulo-ocular reflex gains in the normal range initially, despite having physical signs of VN. Two patients had initial contralesional gains below the normal range, associated with markedly reduced ipsilesional gains. Most patients' vestibulo-ocular reflex gains increased during admission, but four patients' ipsilesional gains remained in the abnormal range. Patients with lower vestibulo-ocular reflex gains were less likely to improve into the normal range. No patient with initially abnormal VOR gain recovered normal vestibulo-ocular reflex gain along with resolution of physical signs. Conclusion Early video head impulse testing in the emergency department and each day of admission is feasible and well tolerated. There is marked variation in VOR gain in patients with symptoms and signs of VN, and low initial VOR gains are a predictor for low VOR gains on subsequent days. Improvement in VOR gains was seen in most patients. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Oct2016
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