Clinical features of secondary BPPV: A nation-wide multicenter study.

BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, and its prevalence is substantial. While primary BPPV has been well studied, the understanding of secondary BPPV is still limited.ObjectiveTo investigate the prevalence and clinical characteristics of secondary BPPV in a national multicenter retrospective analysis.

Update on Clinical Physiology and Pathomechanisms for Vestibulo-Autonomic Interplay.

The vestibulo-autonomic interaction refers to the neural interplay between the vestibular and autonomic systems. In particular, the vestibular system plays an active role in adjusting blood distribution during movement and changes in posture, thereby complementing the baroreflex. This review summarizes recent clinical evidence highlighting the interaction between the vestibular and autonomic systems, including altered vestibular-evoked myogenic potentials in patients with postural orthostatic tachycardia syndrome, orthostatic hypotension, and neurodegenerative disorders.

Optic neuropathy as an early manifestation of granulomatosis with polyangiitis: a case report and literature review.

Introduction: Ophthalmic involvement occurs in up to 40% of patients with granulomatosis with polyangiitis (GPA), usually confined to the anterior segment. Herein, we describe patients presenting with optic neuropathy as an early manifestation of GPA, without other signs of ocular or adnexa involvement.

Methods: We report a case of isolated optic neuropathy without other ocular or adnexal involvement and examine the reported clinical features of 17 additional patients through a literature review.

Diagnostic Errors in the Acutely Dizzy Patient-Lessons Learned.

Acute vertigo or dizziness is a frequent presentation to the emergency department (ED), making up between 2.1% and 4.4% of all consultations.

Investigating the changes in volumes of the limbic system and hypothalamic-subnuclei in patients with depression.

Background: Depression is consistently linked to changes in the hypothalamus, HPA axis, and limbic system, though the specific substructures involved remain unclear. This study aims to explore the relationship between depression and the volumes of specific nuclei within these brain regions. Understanding these connections could provide deeper insights into the biological mechanisms underlying depression.

Selective otolithic dysfunction in patients presenting with acute spontaneous vertigo: consideration based on MRI.

Objective: Acute unilateral peripheral vestibulopathy or vestibular neuritis (AUPV/VN) manifests as acute onset vertigo, often accompanied by nausea, vomiting, and moderate gait instability. It is suspected when vestibular hypofunction is documented on video-head impulse (video-HITs) and caloric tests in the presence of contralesionally beating horizontal-torsional nystagmus. Herein, we report patients presenting with acute vestibular syndrome (AVS) showing selective otolithic dysfunction in the presence of normal caloric and video-HITs and abnormal enhancement of the peripheral vestibular structures on MRI.

Blood Pressure Variability and Ocular Vestibular-Evoked Myogenic Potentials Are Independently Associated With Orthostatic Hypotension.

Background And Purpose: We delineated the association between otolithic dysfunction and blood pressure (BP) variability.

Methods: We prospectively recruited 145 consecutive patients (age=71 [59-79] years, median [interquartile range]; 76 females) with orthostatic intolerance between December 2021 and December 2023 at a tertiary hospital in South Korea. Each patient underwent evaluations of cervical and ocular vestibular-evoked myogenic potentials (oVEMPs), 24-h noninvasive ambulatory BP monitoring (ABPM), and a head-up tilt-table test using the Finometer device.

Protective Effect of Memantine on Cisplatin-Induced Ototoxicity: An In Vitro Study.

Hypothesis: Memantine, an N -methyl- d -aspartate receptor antagonist, is widely used to treat Alzheimer's disease and has been found to have potential neuroprotective effects. In this study, we evaluated the protective effects of memantine against cisplatin-induced ototoxicity.

Background: Cisplatin is a widely used anticancer drug for various cancers; however, its use is limited by its side effects, including ototoxicity.

Ocular Vestibular-Evoked Myogenic Potential Assists in the Differentiation of Multiple System Atrophy From Parkinson's Disease.

Objective: Vestibular-evoked myogenic potentials (VEMPs) can help in assessing otolithic neural pathway in the brainstem, which may also contribute to the cardiovascular autonomic function. Parkinson's disease (PD) is associated with altered VEMP responses; however, the associations between VEMP abnormalities and multiple system atrophy (MSA) remain unknown. Therefore, we compared the extent of otolith dysfunction using ocular (oVEMP) and cervical VEMPs between patients with MSA and PD.

Four-hour-delayed 3D-FLAIR MRIs in patients with acute unilateral peripheral vestibulopathy.

Objective: Conventionally, MRI aids in differentiating acute unilateral peripheral vestibulopathy/vestibular neuritis (AUPV/VN) from mimickers. Meanwhile, the diagnostic utility of MRIs dedicated to the inner ear remains to be elucidated for diagnosing AUPV/VN.

Methods: We prospectively recruited 53 patients with AUPV/VN (mean age ± SD = 60 ± 15 years, 29 men).

Neck rigidity: a pitfall for video head-impulse tests in Parkinson's disease.

Video head impulse tests (video-HITs) are commonly used for vestibular evaluation; however, the results can be contaminated by various artifacts, including technical errors, recording problems, and participant factors. Although video-HITs can be used in patients with Parkinson's disease (PD), the effect of neck rigidity has not been systematically investigated. This study aimed to investigate the effect of neck rigidity on video-HIT results in patients with PD.

Expanding Clinical Spectrum of Anti-GQ1b Antibody Syndrome: A Review.

Importance: The discovery of the anti-GQ1b antibody has expanded the nosology of classic Miller Fisher syndrome to include Bickerstaff brainstem encephalitis, Guillain-Barré syndrome with ophthalmoplegia, and acute ophthalmoplegia without ataxia, which have been brought under the umbrella term anti-GQ1b antibody syndrome. It seems timely to define the phenotypes of anti-GQ1b antibody syndrome for the proper diagnosis of this syndrome with diverse clinical presentations. This review summarizes these syndromes and introduces recently identified subtypes.

Ocular motor and vestibular dysfunction in central nervous system lymphoma.

Background And Purpose: Diagnosis of lymphoma involving the central nervous system (CNS) is challenging. This study aimed to explore the abnormal vestibular and ocular motor findings in CNS lymphoma.

Methods: A retrospective search of the medical records identified 30 patients with CNS lymphoma presenting ocular motor and vestibular abnormalities from four neurology clinics of university hospitals in South Korea (22 men, age range 14-81 years, mean 60.

Evolution of Vestibular Findings During and Between the Attacks of Meniere Disease: Update.

Purpose Of Review: The diagnosis of Meniere disease (MD) has based on characteristics of vertigo and findings of audiologic evaluation. This review focuses on the recent findings of the evolution of vestibular function and their underlying physiology during and between the attacks of MD and thus aims to help identify this common disorder with many faces according to the phase.

Recent Findings: During the attacks, the direction of spontaneous nystagmus changes over time, beating initially toward the affected ear (irritative nystagmus), then toward the healthy ear (paretic nystagmus), and finally back toward the affected ear again (recovery nystagmus).

Scale for Ocular Motor Disorders in Ataxia (SODA) in Patients with Multiple System Atrophy.

A clinical scale fully dedicated to evaluating ocular motor abnormalities is required for now. We investigated the utility of a recently developed Scale for Ocular motor Disorders in Ataxia (SODA) in patients with multiple system atrophy (MSA). We prospectively assessed SODA in consecutive patients with MSA between August 2021 and August 2023 at the Korea University Medical Center.

The semicircular canal function is preserved with little impact on falls in patients with mild Parkinson's disease.

Introduction: Postural instability is a cardinal symptom of Parkinson's disease (PD), which suggests the vestibular system may be affected in PD. This study aimed to determine whether vestibular dysfunction is associated with the risk of falls in PD.

Methods: We prospectively recruited patients with de-novo PD at a tertiary medical center between December 2019 and March 2023.

Recurrence and long-term outcomes of Tolosa-Hunt syndrome.

Background And Purpose: Tolosa-Hunt Syndrome (THS) is a rare disorder, and detailed clinical information and treatment outcomes have yet to be fully elucidated. This study aims to investigate the clinical features and factors associated with the treatment outcomes of THS, as defined by the established diagnostic criteria.

Methods: This study retrospectively recruited 91 patients with a diagnosis of THS from 2003 to 2020.

Effects of pupil size in video head-impulse tests.

The results of video head impulse tests (video-HITs) may be confounded by data artifacts of various origins, including pupil size and eyelid obstruction of the pupil. This study aimed to determine the effect of these factors on the results of video-HITs. We simulated ptosis by adopting pharmacological dilatation of the pupil in 21 healthy participants (11 women; age 24-58 years).