Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (5): 56-60.doi: 10.6040/j.issn.1673-3770.1.2020.077

Previous Articles     Next Articles

Study of the relationship of dizziness and vertigo sensations with the nystagmus intensity

  

  • Received:2020-08-06 Published:2020-11-17

Abstract: Objective To explore the relationship between dizziness-vertigo and nystagmus intensity, according to the nystagmus accompanied by dizziness and/or vertigo during caloric test. Methods The relationship between dizziness and vertigo sensations and nystagmus intensity was analyzed in 399 patients with peripheral vestibular disorders,who underwent routine caloric test. The nystagmus intensity is as an index, accompanied by dizziness and/or vertigo sensations induced during caloric test. Results Warm and cold stimulation induced dizziness and vertigo and associated nystagmus overall analysis, the intensity of nystagmus was always greater than that of dizziness when vertigo occurred. The nystagmus thresholds for dizziness and vertigo induced by warm and cold air stimulation in the left ears were 4.2°/s and 5.9°/s for cold, 4.2°/s and 8°/s for warm, in the right ears were 4.6°/s and 6.2°/s for cold, 5.3°/s and 6.5°/s for warm, respectively. Three hundred ninety nine patients were subjected to alternating warm and cold stimulation in both ears for a total of 1596 times, which induced dizziness 513 times(32.14%), of which 312 times only dizziness and 201 times vertigo ten seconds after dizziness. Vertigo was induced 906 times(56.77%), of which 705 occurred directly without transitioning from dizziness to vertigo, and another 201 times vertigo occurred after ten seconds of dizziness; 378(23.68%)times did not induce dizziness and vertigo. Conclusions Vertigo corresponds to a higher nystagmus intensity threshold than dizziness, with patients showing dizziness when the nystagmus is weak and vertigo when it is stronger. Warm and cold air stimulation induced nystagmus intensity from weak to strong, and from dizziness to vertigo sensations induced at the same time, suggesting that the symptoms of dizziness and vertigo are related to the asymmetric between the two vestibular tension.

Key words: Vertigo, Dizziness, Nystagmus, Caloric test, Slow phase velocity

CLC Number: 

  • R764
[1] Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the international classification of vestibular disorders[J]. Neurol Clin, 2015, 33(3): 541-550, vii. doi:10.1016/j.ncl.2015.04.010.
[2] Bisdorff A, Von Brevern M, Lempert T, et al. Classification of vestibular symptoms: towards an international classification of vestibular disorders[J]. J Vestib Res, 2009, 19(1/2): 1-13. doi:10.3233/ves-2009-0343.
[3] Alexandre R.Bisdorff, Jeffrey P.Staab, David E.Newman-Toker, 等. 前庭疾病国际分类概述[J]. 神经损伤与功能重建, 2019, 14(2): 55-60. doi:10.16780/j.cnki.sjssgncj.2019.02.001. BISDORFF AR, STAAB JP, NEWMANTOKER DE, et al. Overview of the international classification of vestibular disorders[J]. Neural Injury and Functional Reconstruction, 2019, 14(2): 55-60. doi:10.16780/j.cnki.sjssgncj.2019.02.001.
[4] 吴子明, 张素珍. 前庭症状国际分类与解析[J]. 中华耳科学杂志, 2015, 13(1): 187-189. doi:10.3969/j.issn.1672-2922.2015.01.39.
[5] Baloh RW, Halmagyi GM, Zee DS. The history and future of neuro-otology[J]. Continuum(Minneap Minn). 2012,18(5 Neuro-otology):1001-1015. doi:10.1212/01.CON.0000418371.49605.19.
[6] Herdman S.J.T.R. Vestibular Rehabilitation[M]. Davis Company, Philadelphia, Pennsylvania, 2007:234.
[7] Lee J, Choi B, Noh H, et al. Nystagmus in Ramsay Hunt syndrome with or without dizziness[J]. Neurol Sci, 2020. doi:10.1007/s10072-020-04536-w.
[8] Newman-Toker DE, Cannon LM, Stofferahn ME, et al. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting[J]. Mayo Clin Proc, 2007, 82(11): 1329-1340. doi:10.4065/82.11.1329.
[9] Newman-Toker DE, Dy FJ, Stanton VA, et al. How often is dizziness from primary cardiovascular disease true vertigo? A systematic review[J]. J Gen Intern Med, 2008, 23(12): 2087-2094. doi:10.1007/s11606-008-0801-z.
[10] Mijovic T, Remillard A, Zaia EH, et al. A closer look at subjective caloric sensations: Is there more to Vertigo than spinning?[J]. J Vestib Res, 2018, 27(5/6): 271-277. doi:10.3233/VES-170624.
[11] Qiu PH. The statistical evaluation of medical tests for classification and prediction[J]. J Am Stat Assoc, 2005, 100(470): 705. doi:10.1198/jasa.2005.s19.
[12] Dieterich M, Bense S, Stephan T, et al. fMRI signal increases and decreases in cortical areas during small-field optokinetic stimulation and central fixation[J]. Exp Brain Res, 2003, 148(1): 117-127. doi:10.1007/s00221-002-1267-6.
[13] Brandt T, Dieterich M. Vestibular syndromes in the roll plane: topographic diagnosis from brainstem to cortex[J]. Ann Neurol, 1994, 36(3): 337-347. doi:10.1002/ana.410360304.
[14] Chiarovano E, Vidal PP, Magnani C, et al. Absence of rotation perception during warm water caloric irrigation in some seniors with postural instability[J]. Front Neurol, 2016, 7: 4. doi:10.3389/fneur.2016.00004.
[1] XU Jia, LI Xin, CHEN Wenjing, GAO Juanjuan, LU Xingxing, YI Haijin. Short-term and long-term outcomes of endolymphatic sac decompression with instillation of local steroids for intractable Meniere's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 17-21.
[2] ZHANG Yaoyao,WANG Haitao. The application of MRI technology with intratympanic gadolinium injection in the diagnosis and treatment of Meniere's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 101-107.
[3] LI Jiawei, LIU Xiaoyang, YANG Xingyu, SUN Xiaoming, LI Xidan. Effect of repetitive transcranial magnetic stimulation on chronic vestibular syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 7-10.
[4] JIANG Lina, YU Qianru, YU Jie, GUAN Benling, LU Yu, YU Shudong. Anxiety and depression in patients with common types of vertigo [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 1-5.
[5] . Diagnosis and management of peripheral vestibular diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 1-6.
[6] . A new grade of vestibular function abnormality in Menieres disease: a pilot study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 14-19.
[7] . Clinical value of vestibular evoked myogenic potential to predict prognosis of unilateral idiopathic sudden sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 27-32.
[8] . Therapeutic effectiveness of 75 cases of retrolabyrinthine vestibular neurectomy for intractable Menieres disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 46-50.
[9] . Abnormality rate of vestibular evoked myogenic potentials in patients with primary and recurrent benign paroxysmal positional vertigo: a clinical observation [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 51-55.
[10] Vestibular rehabilitation training is important for treating vestibular diseases and improving vertigo symptoms. However, the large number of patients, the lack of venues and rehabilitation specialists, and medical expenses have limited its application at all levels in hospitals. With the development of smartphones and the mobile internet, home-based rehabilitation and remote guidance have become possible. Therefore, we developed a remote vestibular rehabilitation training guidance platform to be accessed with smartphones and the mobile internet. The platform design is based on the Browser/Server mode structure; it has IOS and Android versions and supports wireless access smartphone terminals. The platform facilitates a more convenient, smooth, and effective remote guidance for vestibular rehabilitation function exercises, curative effect evaluations, and follow-up; this improves efficiency and compliance as well as reduces the technical barriers, site restrictions, and labor costs of vestibular rehabilitation. This paper introduces the functional design, related technology realization, and the operational effect of the platform.. Development and application of a vestibular rehabilitation training guidance platform [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 78-81.
[11] Sudden sensorineural hearing loss(SSNHL)is defined as a decease in hearing ≥30 dB HL affecting at least three consecutive frequencies with no identifiable cause within 72 h. A possible cause is inner ear hemorrhage. However, detecting inner ear hemorrhage is difficult with conventional magnetic resonance imaging(MRI)sequences. Some studies showed that the 3-dimensional fluid attenuated inversion recovery(3D-FLAIR)MRI sequence could sensitively detect inner ear hemorrhage in SSNHL patients. In this article, we review the related literature about the clinical application of the 3D-FLAIR MRI sequence to evaluate SSNHL caused by inner ear hemorrhage.. The role of three-dimensional fluid attenuated inversion recovery magnetic resonance imaging in diagnosis of sudden sensorineural hearing loss caused by inner ear hemorrhage [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 97-101.
[12] Labyrinthitis is an infectious disease of the inner ear. Its main clinical manifestations are paroxysmal dizziness, vertigo, and sensorineural hearing loss. This article focuses on the otogenic bacterial labyrinthitis associated with otitis media. According to the pathological manifestations of the inner ear, labyrinthitis can be divided into three types: circumscribed labyrinthitis, serous labyrinthitis, and suppurative labyrinthitis. Circumscribed labyrinthitis, also known as labyrinth fistula, is often complicated by middle ear cholesteatoma, which usually occurs in the horizontal semicircular canal. Serous labyrinthitis is a sterile inflammation in the inner ear caused by bacterial toxins, which often leads to misdiagnosis and misjudgment. Suppurative labyrinthitis is a bacterial infectious inflammation that occurs in the inner ear that often causes severe sensorineural hearing loss and dizziness. At present, otogenic labyrinthitis is no longer rare, although it has not attracted enough attention. This article reviews the different types of otogenic bacterial labyrinthitis in a combination of domestic and foreign literature to provide clinical help for early diagnosis and treatment of patients with this condition.. The progress of otogenic bacterial labyrinthitis research [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 102-107.
[13] Benign paroxysmal positional vertigo(BPPV), the most common peripheral vestibular disease, has a high incidence and prevalence. It mostly occurs at night or during morning awakening, suggesting that it is closely related to sleep characteristics. We reviewed and summarized the relevant literature of the two diseases in recent years. We found that sleep posture was closely related to the occurrence, development, treatment, and prognosis of BPPV, and that different types of sleep disorders also individually affected the occurrence of the disease. This article was aimed to help raise awareness regarding the correlation between the two diseases as well as provide methods and ideas for the diagnosis and treatment.. Research progress on the effect of sleep on benign paroxysmal positional vertigo [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 108-112.
[14] Haijin YI,Shiming YANG. Value the diagnosis and treatment of ear trauma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 1-3.
[15] Jia XU,Haijin YI. Standardized treatment of auricular complications with temporal bone fractures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 4-8.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] LIN Bin,WANGHui-ge . Functional endoscopic sinus surgery, FESS[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 481 -487 .
[2] GONG Lei,SUN Jie,XUE Zi-chao,LI Jing-hua,XUE Wei-guo . DNA analysis of the cell cycle in sino-nasal neoplasm[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 193 -195 .
[3] CHEN Wen-wen . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(5): 472 -472 .
[4] LUAN Jiangang,LIANG Chuanyu,WEN Yanjun,LI Jiong . Construction of RNAi expressing plasmid vector of pSIRENshuttle for EGFR gene silencing[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 4 -8 .
[5] MA Jing, ZHONG Cui-ping . Surgical method for nasopharyngeal fibroangioma encroaching on fossa pterygopalatina: with a report of 5 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 30 -32 .
[6] LIU Qiang-he,LUO Xiang-lin,GENG Wan-ping,CHEN Chen,LEI Xun,LIU Fang-xian,DENG Ming . Age-related spiral ganglion neuron damages and hearing loss in senescence accelerated mice[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 215 -217 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 223 -226 .
[8] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 246 -247 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 250 -252 .
[10] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 260 -262 .