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Title: A video-oculographic study of acute vestibular syndromes.
Epworth Authors: McGuigan, Sean
Infeld, Bernard
Sultana, Ron
Gerraty, Richard
Other Authors: Roberts, H. N.
Keywords: Video-Oculography
Acute Vestibular Neuritis
Vestibular System
Vestibulo-ocular Reflex
Vestibular Neuritis
Vestibular Neuronitis
Vestibular Recovery
Eye Movement Response
Rapid Head Impulses
ICS Impulse
Video Head Impulse Test Device
Video Head Impulse Test
Vestibular Dysfunction
Neurosciences Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Oct-2016
Publisher: Wiley
Citation: Acta Neurol Scand. 2016 Oct;134(4):258-64.
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.
DOI: 10.1111/ane.12536
PubMed URL:
ISSN: 1600-0404
Journal Title: Acta Neurologica Scandinavica
Type: Journal Article
Affiliated Organisations: Department of Medicine, Monash University, Melbourne, Vic., Australia.
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Emergency Care
Head & Neck

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