Factors That Impact the Long-Term Outcome of Postconcussive Dizziness Among Post-9/11 Veterans.

Purpose: The primary aim of this study was to examine the factors associated with long-term outcomes of postconcussive disruptive dizziness in Veterans of the post-9/11 wars.

Method: For this observational cohort study, the Neurobehavioral Symptom Inventory-Vestibular subscale (NSI-V) score was used as an outcome measure for dizziness in 987 post-9/11 Veterans who indicated disruptive dizziness at an initial Veterans Health Administration Comprehensive Traumatic Brain Injury Evaluation (CTBIE). An NSI-V change score was calculated as the difference in the scores obtained at the initial CTBIE and on a subsequent survey.

Vestibular and balance function in veterans with chronic dizziness associated with mild traumatic brain injury and blast exposure.

The purpose of this study was to examine vestibular and balance function in individuals with chronic dizziness associated with mTBI/blast. A prospective case-control study design was used to examine ocular motor, vestibular function, and postural stability in veterans with symptoms of dizziness and/or imbalance following an mTBI or blast exposure ( = 77) and a healthy control group ( = 32). Significant group differences were observed for saccadic accuracy, VOR gain during slow harmonic acceleration at 0.

Disruptive Dizziness Among Post-9/11 Veterans With Deployment-Related Traumatic Brain Injury.

Objective: To identify disruption due to dizziness symptoms following deployment-related traumatic brain injury (TBI) and factors associated with receiving diagnoses for these symptoms.

Setting: Administrative medical record data from the Department of Veterans Affairs (VA).

Participants: Post-9/11 veterans with at least 3 years of VA care who reported at least occasional disruption due to dizziness symptoms on the comprehensive TBI evaluation.

Effects of Noise Exposure on the Vestibular System: A Systematic Review.

Despite our understanding of the impact of noise-induced damage to the auditory system, much less is known about the impact of noise exposure on the vestibular system. In this article, we review the anatomical, physiological, and functional evidence for noise-induced damage to peripheral and central vestibular structures. Morphological studies in several animal models have demonstrated cellular damage throughout the peripheral vestibular system and particularly in the otolith organs; however, there is a paucity of data on the effect of noise exposure on human vestibular end organs.

Association of Traumatic Brain Injury With Vestibular Dysfunction and Dizziness in Post-9/11 Veterans.

Objective: To describe the prevalence and impact of vestibular dysfunction and nonspecific dizziness diagnoses and explore their associations with traumatic brain injury (TBI) severity, mechanism, and postconcussive comorbidities among post-9/11 veterans.

Setting: Administrative medical record data from the US Departments of Defense and Veterans Affairs (VA).

Participants: Post-9/11 veterans with at least 3 years of VA care.

Sensory dysfunction and traumatic brain injury severity among deployed post-9/11 veterans: a chronic effects of neurotrauma consortium study.

Objectives: To describe the prevalence of sensory dysfunction (i.e. auditory, visual, vestibular, chemosensory and multiple sensory problems) and explore associations with traumatic brain injury (TBI) severity and injury mechanism among deployed Post-9/11 Veterans.

Vestibular consequences of mild traumatic brain injury and blast exposure: a review.

The purpose of this article is to review relevant literature on the effect of mild traumatic brain injury (mTBI) and blast injury on the vestibular system. Dizziness and imbalance are common sequelae associated with mTBI, and in some individuals, these symptoms may last for six months or longer. In war-related injuries, mTBI is often associated with blast exposure.

A Benign Paroxysmal Positional Vertigo Triage Clinic.

Purpose: The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic.

Method: A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic.

Results: The BPPV triage clinic had a hit rate of 39%.

Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans.

Background: The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV and treatment efficacy have not been reported in a cohort of veterans with BPPV.

Vestibular, balance, microvascular and white matter neuroimaging characteristics of blast injuries and mild traumatic brain injury: Four case reports.

Background: Case reports are presented on four Veterans, aged 29-46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry and neuroimaging procedures were used to characterize their injuries.

Vestibular Assessment and Rehabilitation: Ten-Year Survey Trends of Audiologists' Opinions and Practice.

Background: The past decade has yielded changes in the education and training of audiologists and technological advancements that have become widely available for clinical balance function testing. It is unclear if recent advancements in vestibular instrumentation or the transition to an AuD degree have affected audiologists' vestibular clinical practice or opinions.

Purpose: The purpose of this study was to examine predominant opinions and practices for vestibular assessment (VA) and vestibular rehabilitation (VR) over the past decade and between master's- and AuD-level audiologists.

Video Head Impulse Testing (vHIT) and the Assessment of Horizontal Semicircular Canal Function.

Background: Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been developed to provide an objective assessment to the clinical test.

International guidelines for the clinical application of cervical vestibular evoked myogenic potentials: an expert consensus report.

Background: Cervical vestibular evoked myogenic potentials (cVEMPs) are electromyogram responses evoked by high-level acoustic stimuli recorded from the tonically contracting sternocleidomastoid (SCM) muscle, and have been accepted as a measure of saccular and inferior vestibular nerve function. As more laboratories are publishing cVEMP data, there is a wider range of recording methods and interpretation, which may be confusing and limit comparisons across laboratories.

Objective: To recommend minimum requirements and guidelines for the recording and interpretation of cVEMPs in the clinic and for diagnostic purposes.

The effect of noise exposure on the cervical vestibular evoked myogenic potential.

Objective: The purpose of this study was to investigate the effects of noise exposure on the cervical vestibular evoked myogenic potential (cVEMP) in individuals with asymmetric noise-induced sensorineural hearing loss (NIHL).

Design: A cross-sectional observational study was used to compare cVEMP characteristics in 43 individuals with a history of noise exposure greater in one ear (e.g.

Effects of stimulus and recording parameters on the air conduction ocular vestibular evoked myogenic potential.

Background: Vestibular evoked myogenic potentials (VEMPs) have been recorded from the sternocleidomastoid muscle (cervical VEMP or cVEMP) and more recently from the eye muscles (ocular VEMP or oVEMP) in response to air conduction and bone conduction stimuli. Both cVEMPs and oVEMPs are mediated by the otoliths and thereby provide diagnostic information that is complementary to videonystagmography and rotational chair tests. In contrast to the air conduction cVEMP, which originates from the saccule/inferior vestibular nerve, recent evidence suggests the possibility that the air conduction oVEMP may be mediated by the utricle/superior vestibular nerve.

Normative data for the subjective visual vertical test during centrifugation.

Background: The otoliths act as gravito-inertial force sensors and contribute to the perception of spatial orientation. The perception of gravitational vertical can be assessed by asking a subject to adjust a light bar to the vertical. Prior to clinical use of the SVV (subjective visual vertical) test, normative data and test-retest reliability must be established.

Head injury and blast exposure: vestibular consequences.

Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented.

The effect of age on the vestibular evoked myogenic potential and sternocleidomastoid muscle tonic electromyogram level.

Objective: Cervical vestibular evoked myogenic potentials (cVEMPs) are short-latency electromyogram (EMG) evoked by high-level acoustic stimuli recorded from the activated sternocleidomastoid muscle and used to evaluate otolith organ function. The purpose of this study was to investigate the effects of aging on the cVEMP and on the sternocleidomastoid muscle EMG level.

Design: A cross-sectional observational study was used to investigate differences in cVEMP and sternocleidomastoid muscle EMG level in a group of 24 younger and 24 older individuals.

Monothermal caloric screening test performance: a relative operating characteristic curve analysis.

Objective: The objective of the present study was to evaluate the performance of the monothermal caloric screening test in a large sample of patients.

Design: A retrospective analysis of the medical records of 1002 consecutive patients who had undergone vestibular assessment at the Mayo Clinic during the years 1989 and 1990 was conducted. Patients with incomplete alternate binaural bithermal (ABB) caloric testing, congenital or periodic alternating nystagmus, or bilateral vestibular loss were excluded from the study.

The influence of voluntary tonic EMG level on the vestibular-evoked myogenic potential.

Vestibular-evoked myogenic potentials (VEMPs) are proposed as a reliable test to supplement the current vestibular test battery by providing diagnostic information about saccular and/or inferior vestibular nerve function. VEMPs are short-latency electromyograms (EMGs) evoked by high-level acoustic stimuli and recorded from surface electrodes over the tonically contracted sternocleidomastoid muscle. VEMP amplitude is influenced by the EMG level, which must be controlled.

Validity and reliability of the Motion Sensitivity Test.

The Motion Sensitivity Test (MST) is a clinical protocol designed to measure motion-provoked dizziness during a series of 16 quick changes to head or body positions. The MST has been used as a guide for developing an exercise program for patients with motion-provoked dizziness and as a treatment outcome measure to monitor the effectiveness of vestibular rehabilitation therapy. This study determined validity, test-retest reliability, and interrater reliability of the MST.

The effects of click and tone-burst stimulus parameters on the vestibular evoked myogenic potential (VEMP).

Vestibular evoked myogenic potentials (VEMP) are short latency electromyograms (EMG) evoked by high-level acoustic stimuli and recorded from surface electrodes over the tonically contracted sternocleidomastoid (SCM) muscle and are presumed to originate in the saccule. The present experiments examined the effects of click and tone-burst level and stimulus frequency on the latency, amplitude, and threshold of the VEMP in subjects with normal hearing sensitivity and no history of vestibular disease. VEMPs were recorded in all subjects using 100 dB nHL click stimuli.