Vertigo: its multisensory syndromes
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
London [u.a.]
Springer
1999
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| Ausgabe: | 2. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXVIII, 503 S. Ill., graph. Darst. |
| ISBN: | 3540199349 |
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| 245 | 1 | 0 | |a Vertigo |b its multisensory syndromes |c Thomas Brandt |
| 250 | |a 2. ed. | ||
| 264 | 1 | |a London [u.a.] |b Springer |c 1999 | |
| 300 | |a XXVIII, 503 S. |b Ill., graph. Darst. | ||
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| 650 | 7 | |a Duizeligheid |2 gtt | |
| 650 | 4 | |a Diagnosis, Differential | |
| 650 | 4 | |a Vertigo | |
| 650 | 4 | |a Vertigo |x diagnosis | |
| 650 | 4 | |a Vertigo |x physiopathology | |
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Datensatz im Suchindex
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| adam_text | Contents
Glossary xxiii
Section A Vertigo: symptoms, syndromes, disorders 1
1 Introduction 3
The vestibular vertigo syndromes 3
Signs and symptoms 4
The mismatch concept 4
The vestibulo-ocular reflex (VOR) 5
Neuronal network of the VOR 7
VOR mediation of perception and postural adjustments 9
Vestibulocollic reflex 10
Vestibulospinal reflexes 10
Vestibular falls 13
Peripheral vestibular falls 14
Vestibular neuritis: contraversive rotational vertigo with
ipsiversive falls 14
Benign paroxysmal positioning vertigo (BPPV): forward falls
produced by canalolithiasis of the posterior semicircular canal .. 15
Meniere s drop attacks (Tumarkin s otolithic crisis) 15
Otolith Tullio phenomenon: contraversive ocular tilt
reaction (OTR) and fall 15
Bilateral vestibulopathy with predominant forward and
backward falls 15
Central vestibular falls 15
Vestibular epilepsy with contraversive vertigo and falls 15
Thalamic astasia with contraversive or ipsiversive falls? 16
Ocular tilt reaction: ipsiversive in caudal, contraversive in
upper brainstem lesions 16
Lateropulsion in Wallenberg s syndrome: ipsiversive falls and
adjustments of perceived vertical 16
Downbeat nystagmus syndrome with backward falls 16
Vestibular autonomic regulation 16
Neuroanatomic substrates 18
References 19
xii Contents
2 Approaching the patient 23
Dizziness and light-headedness 23
Attacks of (rotatory) vertigo, episodic vertigo 23
Sustained (rotatory) vertigo 24
Positional/positioning vertigo 26
Oscillopsia 26
Vertigo associated with auditory dysfunction 27
Dizziness or to-and-fro vertigo and postural imbalance 27
Semicircular canal vertigo and mixed canal-otolith vertigo 28
Otolithic vertigo 29
Paroxysmal vertigo 29
Neuro-ophthalmological and otoneurological evaluation 34
References 47
3 Management of the dizzy patient 49
Antivertiginous and antiemetic drugs 49
Surgical treatment 51
Vestibular exercises and physical therapy for vestibular rehabilitation .. 52
Quantitative effects of balance training on postural sway in
normal subjects 52
Balance training in vestibular disorders 53
Plasticity of the vestibular system: central compensation and
sensory substitution for vestibular deficits 55
Terms and definitions of plasticity and central compensation 55
Vestibular compensation and its multiple mechanisms 56
Transmitters of the vestibulo-ocular reflex and drug-modulated
compensation 58
Substitution of vestibular function 60
References 61
Section B Vestibular nerve and labyrinthine disorders 65
4 Vestibular neuritis 67
The clinical syndrome 67
Vertigo and posture 68
Eye movements 69
Caloric testing 69
MR imaging 70
Natural course 71
High-frequency defect of VOR in permanent peripheral
vestibular lesion 71
Differential diagnosis 72
Aetiology and pathomechanism 73
Pathomechanism 73
Vestibular neuritis - a partial unilateral vestibular loss 73
Viral or vascular aetiology? 75
Historical discussion 75
Arguments for viral aetiology 75
Contents xiii
Site of the lesion 76
Management 76
References 79
5 Meniere s disease 83
The clinical syndrome 83
Attacks 83
Auditory symptoms and signs in the vertigo-free interval 84
Vestibular function in the vertigo-free interval 85
Imaging 85
Differential diagnosis 85
Natural course 85
Aetiology and pathomechanism 86
Endolymphatic hydrops 86
Aetiology 87
Delayed endolymphatic hydrops 88
Vascular hypothesis 88
Psychosomatic hypothesis 89
Pathophysiology of attacks and progressive dysfunction 89
Management 90
Attacks 90
Attack-free interval 91
Intratympanic gentamicin therapy 91
Surgical treatments: nondestructive or destructive 92
Non-destructive 92
Destructive 93
Pragmatic therapy 93
Vestibular drop attacks (Tumarkin s otolithic crisis) 94
References 95
6 Perilymph fistulas (PLF) 99
The clinical syndromes 99
Semicircular canal type of PLF 100
Otolith type of PLF 100
How may a perilymph fistula be identified? 101
Pressure fistula tests 101
Vascular fistula tests 101
Imaging techniques (CT, MRI) 102
Electronystagmography 102
Hearing tests 102
Exploratory tympanotomy 102
Other proposed tests 102
Differential diagnosis 102
Aetiology and pathomechanisms 102
Experimental perilymph/endolymph fistulas and
endolymphatic hydrops 104
Management 105
xiv Contents
Conservative treatment 105
Surgical treatment 106
Tullio phenomenon 106
Experimental history 106
Clinical history 107
Clinical types of Tullio phenomena 107
Otolith Tullio phenomenon 107
Why does otolith Tullio phenomenon manifest with
paroxysmal ocular tilt reaction (OTR)? 108
Vestibulospinal reflexes tested as part of the Tullio phenomenon 108
Management Ill
Fistula of the anterior semicircular canal 112
References 113
7 Peripheral vestibular paroxysmia (disabling positional vertigo) 117
The clinical syndrome 117
Case reports 118
Vertigo 120
Auditory symptoms and tests 120
Other associated symptoms 120
Electronystagmography 121
Subjective visual vertical 121
Posturography 121
Differential diagnosis 121
Aetiology and pathomechanisms 122
Management 122
Uncertainties in the diagnosis and treatment of vestibular
paroxysmia 123
Alternating episodes of vestibular nerve paroxysmia and failure 124
References 125
8 Bilateral vestibulopathy 127
The clinical syndrome 127
Diagnosis 128
Associated symptoms and differential diagnosis 129
Aetiologies and pathomechanisms 129
Idiopathic BVF 132
Spatial orientation: vestibulo-ocular and vestibulospinal reflexes 135
Management 137
References 139
9 Miscellaneous vestibular nerve and labyrinthine disorders 143
Imaging of the labyrinth and vestibular nerve 143
Congenital causes 143
Infectious causes 145
Herpes zoster oticus 146
Acute otitis media 149
Contents xv
Specific infections 151
Cholesteatoma 151
Autoimmune inner ear disorders 151
Cogan s syndrome 154
How to monitor activity in Cogan s syndrome 155
Tumours 155
References 165
Section C Central vestibular disorders 167
10 Vestibular disorders in (frontal) roll plane 175
The clinical syndrome 176
Topographic diagnostic rules 178
Ocular tilt reaction (OTR) 179
Mechanism of OTR 180
OTR and perceived tilt 181
Two types of OTR: the medullary ascending VOR-OTR and the
mesencephalic descending integrator-OTR 181
Aetiology 184
Natural course and management 185
Skew deviation (skew-torsion sign) 185
Skew torsion: a vestibular brainstem sign of topographic
diagnostic value 186
Different types of skew deviation 186
Alternating skew deviation 187
Natural course 188
Perceived vertical (subjective visual vertical) 189
Historical reports on SVV tilts 189
SVV tilt - a vestibular sign? 189
SVV tilt versus room tilt illusion 190
SVV tilts in central vestibular versus peripheral ocular
motor lesions 192
Thalamic and cortical astasia associated with SVV tilts 192
Torsional nystagmus 193
Three-dimensional modelling of static vestibulo-ocular
brainstem syndromes 194
References 195
11 Vestibular disorders in (sagittal) pitch plane 199
Downbeat nystagmus (vestibular downbeat syndrome) 199
The clinical syndrome 199
Nystagmus 200
Oscillopsia and impaired motion perception 200
Postural imbalance 201
Aetiology and pathomechanism 201
Pathomechanism and site of the lesions 201
Aetiology 203
i
xvi Contents !
Management 204
Upbeat nystagmus (vestibular upbeat syndrome) 205
The clinical syndrome 206
Nystagmus 206
Oscillopsia, motion perception, and spatial orientation 206
Postural imbalance 207 .
Aetiology and pathomechanism 207
Pathomechanism and site of the lesions 207
Aetiology 208
Management 209
References 211 i
12 Vestibular disorders in (horizontal) yaw plane 215 !
Horizontal nystagmus as a sign of vestibular tone imbalance
in the yaw plane 215
Combined VOR dysfunction in more than one plane of action 217
References 217 ,
13 Vestibular cortex: its locations, functions, and disorders 219 I
Multiple vestibular cortex areas 219
No primary vestibular cortex 219 j
The parieto-insular vestibular cortex (PIVC) 220
Multimodal sensorimotor vestibular cortex function and dysfunction ... 221
Spatial hemineglect, a cortical vestibular syndrome? 224 (
Paroxysmal room-tilt illusion 224
Self-motion perception: the mechanism of reciprocal inhibitory
visual-vestibular interaction 225
References 230
14 Vestibular epilepsy 233
The vestibular seizure 234
Rotatory seizure ( volvular epilepsy ) 234 ¦
Differential diagnosis 234 ¦
Management 235
Epileptic nystagmus 235
Vestibular versus visual (optokinetic) seizures 237
Vestibulogenic epilepsy 237
References 238
15 Miscellaneous central vestibular disorders 241
Central brainstem/cerebellar lesions mimicking vestibular neuritis
or peripheral vestibular failure 241
Paroxysmal central vertigo 242 ,
Central vestibular falls without vertigo 243
Central vestibular syndromes in multiple sclerosis 244
Vestibular syndromes and brain tumours 244
Metabolic disorders of the vestibular system 245
References 245 f
i
Contents xvii
Section D Positional and positioning vertigo 247
16 Benign paroxysmal positioning vertigo 251
The clinical syndrome 252
Positioning nystagmus 253
Vertigo and posture 254
Natural course 256
Differential diagnosis 256
Pathomechanism and aetiology 257
Pathomechanism 257
Peripheral or central vestibular dysfunction? 257
The traditional view of cupulolithiasis 257
Arguments for canalolithiasis 259
Unilateral mimicking bilateral BPPV 261
Aetiology 264
Management 265
Positional exercises and liberatory manoeuvres 265
Surgical procedures 269
Singular neurectomy 269
Plugging of the posterior semicircular canal 269
Horizontal semicircular canal BPPV (h-BPPV) 269
The clinical syndrome 270
Atypical h-BPPV with apogeotropic positional nystagmus 270
Natural course 271
Aetiology and pathomechanism 271
Transition of canalolithiasis to cupulolithiasis 274
Reversible ipsilateral caloric hypoexcitability 275
Management 278
Anterior semicircular canal BPPV (a-BPPV) 279
References 280
17 Positional nystagmus/vertigo with specific gravity differential
between cupula and endolymph (buoyancy hypothesis) 285
Positional alcohol vertigo/nystagmus (PAN) 286
Positional heavy water nystagmus 287
Positional glycerol nystagmus 287
Positional nystagmus with macroglobulinaemia (Waldenstrom s
disease) 288
References 288
18 Central positional vertigo 291
Positional downbeating nystagmus 291
Central positional nystagmus 292
Central paroxysmal positional/positioning vertigo and
paroxysmal positioning vomiting 293
Transient vertebrobasilar ischaemia 296
Rotational vertebral artery occlusion 296
xviii Contents
Head (neck)-extension vertigo 297
Bending-over vertigo 298
References 298
Section E Vascular vertigo 301
19 Stroke and vertigo 307
Strokes causing peripheral and central vestibular disorders 307
Anterior inferior cerebellar artery and the internal auditory artery 308
Vertebral artery and posterior inferior cerebellar artery 309
Wallenberg s syndrome 309
Basilar artery and paramedian pontine and mesencephalic arteries 312
Vestibular syndromes in roll plane 312
Vestibular syndromes in pitch plane 314
Thalamic infarctions 314
Cortical infarctions 315
Cortical rotational vertigo 318
References 322
20 Migraine and vertigo 325
Migraine 326
The clinical syndrome 326
Aetiology and pathomechanism 326
Management 327
Basilar migraine (BM) and vestibular migraine 329
The clinical syndrome 329
Diagnosis of BM with episodic vertigo ( vestibular migraine ) 332
Pathomechanisms of vertigo, motion sickness and ocular 333
motor deficits
Origin of vertigo in migraine 333
Motion sickness-like symptoms 334
Ocular motor deficits in the symptom-free interval
indicate permanent brainstem or cerebellar dysfunction 335
Benign paroxysmal vertigo in childhood 335
Benign paroxysmal torticollis in infancy 336
Benign recurrent vertigo 337
Dizziness and vertigo as facultative symptoms in migraine
apart from BM 337
Association of migraine with other vertigo disorders? 337
References 338
21 Hyperviscosity syndrome and vertigo 341
The clinical syndrome 341
Aetiology and pathomechanism 341
Management 341
References 342
Contents xix
Section F Traumatic vertigo 343
22 Head and neck injury 347
Traumatic otolith vertigo 349
References 349
23 Vertigo due to barotrauma 351
Alternobaric vertigo 351
Blast injury 352
Decompression sickness 352
Management 352
Round and oval window fistula caused by barotrauma 353
References 354
24 Iatrogenic vestibular disorders 355
Intratympanic gentamicin in Meniere s disease: desired and
undesired effects 355
Quinine: reversible and irreversible side effects 356
Vertebral artery dissection due to chiropractic neck manipulation 356
Surgically induced vestibular dysfunction 356
Iatrogenic benign paroxysmal positioning vertigo 357
Vestibular loss associated with chronic noise-induced hearing loss 357
References 358
Section G Hereditary vestibular disorders and vertigo in childhood ... 361
25 Familial periodic ataxia/vertigo (episodic ataxia) 365
The clinical syndromes 366
Episodic ataxia associated with interictal myokymia (type EA-1) 366
Episodic ataxia associated with interictal nystagmus (type EA-2) 367
Differential diagnoses 369
Aetiology and pathomechanism 370
Episodic ataxia type 1, a potassium channelopathy 370
Episodic ataxia type-2, a cerebral calcium channelopathy 370
Effects of acetazolamide and the pathomechanism of EA 372
Management 372
References 373
26 Vertigo in childhood 375
Benign paroxysmal vertigo of childhood and basilar migraine 376
Motion sickness 376
Vestibular neuritis 376
Meniere s disease 377
Perilymph fistulas 377
Unilateral or bilateral loss of vestibular function 377
Hereditary disorders causing peripheral vestibular failure 378
Central vestibular syndromes 379
References 379
xx Contents
Section H Vertigo, dizziness, and falls in the elderly 383
27 Vertigo, dizziness, and falls in the elderly 385
Physiological ageing of the vestibular system 385
Age-related changes in eye movements and vestibulo-ocular reflexes .. 385
Age-related changes in postural sway and balance 386
Cautious senile gait and highest-level gait disorders 386
Falls in the elderly 388
Dizziness in the elderly 389
References 391
Section I Drugs and vertigo 393
28 Drugs and vertigo 395
Ototoxic agents 395
Cerebellar intoxication 397
Drugs and eye movements 400
References 402
Section J Non-vestibular (sensory) vertigo syndromes 405
29 Visual vertigo: visual control of motion and balance 409
Circularvection and linearvection: optokinetically induced
perception of self-motion 409
Psychophysics of circularvection 411
Visual-vestibular interaction: functional significance of
visual and vestibular cortices 413
Rollvection-tilt: optokinetic graviceptive mismatch 414
Visual pseudo-Coriolis effect and pseudo-Purkinje effect 416
Optokinetic motion sickness 417
Physiological height vertigo and postural balance 418
Physical prevention of physiological height vertigo 422
Licence for workers at heights? 422
The visual cliff phenomenon 422
Vision and posture 423
Moving visual scenes 424
Visual acuity 424
Near vision and eye-object distance 425
Visual control of fore-aft versus lateral body sway 426
Visual stabilisation in the dark 426
Flicker illumination 426
Visual field 427
Eye movements, oculomotor disorders, and postural balance 428
Nystagmus with oscillopsia impairs balance 428
Extraocular muscle paresis impairs locomotion and balance 429
Oscillopsia 430
Oscillopsia is smaller than retinal image slip: deficient
vestibulo-ocular reflex 431
Contents xxi
Acquired ocular oscillations with oscillopsia 432
Physiological impairment of motion perception with moving eyes 433
Normal (physiological) inhibitory interactions between
self-motion and object-motion perception 435
Pathological (adaptive?) binocular impairment of motion
perception caused by monocular external eye muscle paresis 435
Oscillopsia and motion perception in congenital nystagmus 435
References 436
30 Somatosensory vertigo 441
Cervical vertigo 441
Functional significance of neck afferents and neck reflexes 442
Spatial orientation 442
Neck reflexes 443
Cervico-ocular reflex 443
Central pathways 443
Ataxia and nystagmus in experimental cervical vertigo 444
Clinical evidence for cervical vertigo? 444
Hypothetical mechanisms 445
Differential diagnosis 446
Arthrokinetic nystagmus and self-motion sensation 446
Other forms of nystagmus induced by non-vestibular stimulation .... 447
Postural imbalance with sensory polyneuropathy 447
References 449
Section K Psychogenic vertigo 453
31 Psychiatric disorders and vertigo 455
Organic versus psychiatric morbidity 456
Vestibular dysfunction secondary to psychiatric disorders and
psychiatric disorders secondary to vestibular dysfunction 456
How can psychogenic vertigo be diagnosed? 457
Panic disorder 458
Criteria for panic attack (DSM-IV 1994) 459
Agoraphobia 459
Criteria for agoraphobia 459
Epidemiology 459
Management 460
Acrophobia 460
Psychotherapy for acrophobia and agoraphobia 461
Psychogenic disorders of stance and gait 461
Criteria for psychogenic disorders of stance and gait 462
Management 463
References 466
32 Phobic postural vertigo 469
The clinical syndrome 469
xxii Contents
Aetiology and hypothetical mechanism 470
Hypothetical mechanism: A disturbance of space constancy
due to decoupling of the efference-copy signal? 471
Body sway in PPV 472
PPV: A panic disorder? 473
Differential diagnosis 475
Course and treatment 475
References 478
Section L Physiological vertigo 481
33 Motion sickness 485
The clinical syndrome 485
Nausea and vomiting 485
Labyrinth function and motion sickness 487
The sensory conflict theory (visual-vestibular mismatch) 487
Vestibular hyperexcitability 489
Incidence and susceptibility 490
Management: physical and medical prevention 491
Physical prevention 491
Visual prevention of motion sickness in vehicles 491
Medical prevention 491
Space sickness 492
References 493
Subject Index 497
|
| adam_txt |
Contents
Glossary xxiii
Section A Vertigo: symptoms, syndromes, disorders 1
1 Introduction 3
The "vestibular" vertigo syndromes 3
Signs and symptoms 4
The mismatch concept 4
The vestibulo-ocular reflex (VOR) 5
Neuronal network of the VOR 7
VOR mediation of perception and postural adjustments 9
Vestibulocollic reflex 10
Vestibulospinal reflexes 10
Vestibular falls 13
Peripheral vestibular falls 14
Vestibular neuritis: contraversive rotational vertigo with
ipsiversive falls 14
Benign paroxysmal positioning vertigo (BPPV): forward falls
produced by canalolithiasis of the posterior semicircular canal . 15
Meniere's drop attacks (Tumarkin's otolithic crisis) 15
Otolith Tullio phenomenon: contraversive ocular tilt
reaction (OTR) and fall 15
Bilateral vestibulopathy with predominant forward and
backward falls 15
Central vestibular falls 15
Vestibular epilepsy with contraversive vertigo and falls 15
Thalamic astasia with contraversive or ipsiversive falls? 16
Ocular tilt reaction: ipsiversive in caudal, contraversive in
upper brainstem lesions 16
Lateropulsion in Wallenberg's syndrome: ipsiversive falls and
adjustments of perceived vertical 16
Downbeat nystagmus syndrome with backward falls 16
Vestibular autonomic regulation 16
Neuroanatomic substrates 18
References 19
xii Contents
2 Approaching the patient 23
Dizziness and light-headedness 23
Attacks of (rotatory) vertigo, episodic vertigo 23
Sustained (rotatory) vertigo 24
Positional/positioning vertigo 26
Oscillopsia 26
Vertigo associated with auditory dysfunction 27
Dizziness or to-and-fro vertigo and postural imbalance 27
Semicircular canal vertigo and mixed canal-otolith vertigo 28
Otolithic vertigo 29
Paroxysmal vertigo 29
Neuro-ophthalmological and otoneurological evaluation 34
References 47
3 Management of the dizzy patient 49
Antivertiginous and antiemetic drugs 49
Surgical treatment 51
Vestibular exercises and physical therapy for vestibular rehabilitation . 52
Quantitative effects of balance training on postural sway in
normal subjects 52
Balance training in vestibular disorders 53
Plasticity of the vestibular system: central compensation and
sensory substitution for vestibular deficits 55
Terms and definitions of plasticity and central compensation 55
Vestibular compensation and its multiple mechanisms 56
Transmitters of the vestibulo-ocular reflex and drug-modulated
compensation 58
Substitution of vestibular function 60
References 61
Section B Vestibular nerve and labyrinthine disorders 65
4 Vestibular neuritis 67
The clinical syndrome 67
Vertigo and posture 68
Eye movements 69
Caloric testing 69
MR imaging 70
Natural course 71
High-frequency defect of VOR in permanent peripheral
vestibular lesion 71
Differential diagnosis 72
Aetiology and pathomechanism 73
Pathomechanism 73
Vestibular neuritis - a partial unilateral vestibular loss 73
Viral or vascular aetiology? 75
Historical discussion 75
Arguments for viral aetiology 75
Contents xiii
Site of the lesion 76
Management 76
References 79
5 Meniere's disease 83
The clinical syndrome 83
Attacks 83
Auditory symptoms and signs in the vertigo-free interval 84
Vestibular function in the vertigo-free interval 85
Imaging 85
Differential diagnosis 85
Natural course 85
Aetiology and pathomechanism 86
Endolymphatic hydrops 86
Aetiology 87
Delayed endolymphatic hydrops 88
Vascular hypothesis 88
Psychosomatic hypothesis 89
Pathophysiology of attacks and progressive dysfunction 89
Management 90
Attacks 90
Attack-free interval 91
Intratympanic gentamicin therapy 91
Surgical treatments: nondestructive or destructive 92
Non-destructive 92
Destructive 93
Pragmatic therapy 93
Vestibular drop attacks (Tumarkin's otolithic crisis) 94
References 95
6 Perilymph fistulas (PLF) 99
The clinical syndromes 99
Semicircular canal type of PLF 100
Otolith type of PLF 100
How may a perilymph fistula be identified? 101
Pressure fistula tests 101
Vascular fistula tests 101
Imaging techniques (CT, MRI) 102
Electronystagmography 102
Hearing tests 102
Exploratory tympanotomy 102
Other proposed tests 102
Differential diagnosis 102
Aetiology and pathomechanisms 102
Experimental perilymph/endolymph fistulas and
endolymphatic hydrops 104
Management 105
xiv Contents
Conservative treatment 105
Surgical treatment 106
Tullio phenomenon 106
Experimental history 106
Clinical history 107
Clinical types of Tullio phenomena 107
Otolith Tullio phenomenon 107
Why does otolith Tullio phenomenon manifest with
paroxysmal ocular tilt reaction (OTR)? 108
Vestibulospinal reflexes tested as part of the Tullio phenomenon 108
Management Ill
Fistula of the anterior semicircular canal 112
References 113
7 Peripheral vestibular paroxysmia (disabling positional vertigo) 117
The clinical syndrome 117
Case reports 118
Vertigo 120
Auditory symptoms and tests 120
Other associated symptoms 120
Electronystagmography 121
Subjective visual vertical 121
Posturography 121
Differential diagnosis 121
Aetiology and pathomechanisms 122
Management 122
Uncertainties in the diagnosis and treatment of vestibular
paroxysmia 123
Alternating episodes of vestibular nerve paroxysmia and failure 124
References 125
8 Bilateral vestibulopathy 127
The clinical syndrome 127
Diagnosis 128
Associated symptoms and differential diagnosis 129
Aetiologies and pathomechanisms 129
Idiopathic BVF 132
Spatial orientation: vestibulo-ocular and vestibulospinal reflexes 135
Management 137
References 139
9 Miscellaneous vestibular nerve and labyrinthine disorders 143
Imaging of the labyrinth and vestibular nerve 143
Congenital causes 143
Infectious causes 145
Herpes zoster oticus 146
Acute otitis media 149
Contents xv
Specific infections 151
Cholesteatoma 151
Autoimmune inner ear disorders 151
Cogan's syndrome 154
How to monitor activity in Cogan's syndrome 155
Tumours 155
References 165
Section C Central vestibular disorders 167
10 Vestibular disorders in (frontal) roll plane 175
The clinical syndrome 176
Topographic diagnostic rules 178
Ocular tilt reaction (OTR) 179
Mechanism of OTR 180
OTR and perceived tilt 181
Two types of OTR: the medullary "ascending" VOR-OTR and the
mesencephalic "descending" integrator-OTR 181
Aetiology 184
Natural course and management 185
Skew deviation (skew-torsion sign) 185
Skew torsion: a vestibular brainstem sign of topographic
diagnostic value 186
Different types of skew deviation 186
Alternating skew deviation 187
Natural course 188
Perceived vertical (subjective visual vertical) 189
Historical reports on SVV tilts 189
SVV tilt - a vestibular sign? 189
SVV tilt versus room tilt illusion 190
SVV tilts in central vestibular versus peripheral ocular
motor lesions 192
Thalamic and cortical astasia associated with SVV tilts 192
Torsional nystagmus 193
Three-dimensional modelling of static vestibulo-ocular
brainstem syndromes 194
References 195
11 Vestibular disorders in (sagittal) pitch plane 199
Downbeat nystagmus (vestibular downbeat syndrome) 199
The clinical syndrome 199
Nystagmus 200
Oscillopsia and impaired motion perception 200
Postural imbalance 201
Aetiology and pathomechanism 201
Pathomechanism and site of the lesions 201
Aetiology 203
i
xvi Contents !
Management 204
Upbeat nystagmus (vestibular upbeat syndrome) 205
The clinical syndrome 206
Nystagmus 206
Oscillopsia, motion perception, and spatial orientation 206
Postural imbalance 207 .
Aetiology and pathomechanism 207
Pathomechanism and site of the lesions 207
Aetiology 208
Management 209
References 211 i
12 Vestibular disorders in (horizontal) yaw plane 215 !
Horizontal nystagmus as a sign of vestibular tone imbalance
in the yaw plane 215
Combined VOR dysfunction in more than one plane of action 217
References 217 ,
13 Vestibular cortex: its locations, functions, and disorders 219 I
Multiple vestibular cortex areas 219
No primary vestibular cortex 219 j
The parieto-insular vestibular cortex (PIVC) 220
Multimodal sensorimotor vestibular cortex function and dysfunction . 221
Spatial hemineglect, a cortical vestibular syndrome? 224 (
Paroxysmal room-tilt illusion 224
Self-motion perception: the mechanism of reciprocal inhibitory
visual-vestibular interaction 225
References 230
14 Vestibular epilepsy 233
The vestibular seizure 234
Rotatory seizure ("volvular epilepsy") 234 '¦
Differential diagnosis 234 ¦
Management 235
Epileptic nystagmus 235
Vestibular versus visual (optokinetic) seizures 237
"Vestibulogenic epilepsy" 237
References 238
15 Miscellaneous central vestibular disorders 241
Central brainstem/cerebellar lesions mimicking vestibular neuritis
or peripheral vestibular failure 241
Paroxysmal central vertigo 242 ,
Central vestibular falls without vertigo 243
Central vestibular syndromes in multiple sclerosis 244
Vestibular syndromes and brain tumours 244
Metabolic disorders of the vestibular system 245
References 245 f
i
Contents xvii
Section D Positional and positioning vertigo 247
16 Benign paroxysmal positioning vertigo 251
The clinical syndrome 252
Positioning nystagmus 253
Vertigo and posture 254
Natural course 256
Differential diagnosis 256
Pathomechanism and aetiology 257
Pathomechanism 257
Peripheral or central vestibular dysfunction? 257
The traditional view of cupulolithiasis 257
Arguments for canalolithiasis 259
Unilateral mimicking bilateral BPPV 261
Aetiology 264
Management 265
Positional exercises and liberatory manoeuvres 265
Surgical procedures 269
Singular neurectomy 269
Plugging of the posterior semicircular canal 269
Horizontal semicircular canal BPPV (h-BPPV) 269
The clinical syndrome 270
Atypical h-BPPV with apogeotropic positional nystagmus 270
Natural course 271
Aetiology and pathomechanism 271
Transition of canalolithiasis to cupulolithiasis 274
Reversible ipsilateral caloric hypoexcitability 275
Management 278
Anterior semicircular canal BPPV (a-BPPV) 279
References 280
17 Positional nystagmus/vertigo with specific gravity differential
between cupula and endolymph (buoyancy hypothesis) 285
Positional alcohol vertigo/nystagmus (PAN) 286
Positional "heavy water" nystagmus 287
Positional glycerol nystagmus 287
Positional nystagmus with macroglobulinaemia (Waldenstrom's
disease) 288
References 288
18 Central positional vertigo 291
Positional downbeating nystagmus 291
Central positional nystagmus 292
Central paroxysmal positional/positioning vertigo and
paroxysmal positioning vomiting 293
Transient vertebrobasilar ischaemia 296
Rotational vertebral artery occlusion 296
xviii Contents
Head (neck)-extension vertigo 297
Bending-over vertigo 298
References 298
Section E Vascular vertigo 301
19 Stroke and vertigo 307
Strokes causing peripheral and central vestibular disorders 307
Anterior inferior cerebellar artery and the internal auditory artery 308
Vertebral artery and posterior inferior cerebellar artery 309
Wallenberg's syndrome 309
Basilar artery and paramedian pontine and mesencephalic arteries 312
Vestibular syndromes in roll plane 312
Vestibular syndromes in pitch plane 314
Thalamic infarctions 314
Cortical infarctions 315
Cortical rotational vertigo 318
References 322
20 Migraine and vertigo 325
Migraine 326
The clinical syndrome 326
Aetiology and pathomechanism 326
Management 327
Basilar migraine (BM) and "vestibular migraine" 329
The clinical syndrome 329
Diagnosis of BM with episodic vertigo ("vestibular migraine") 332
Pathomechanisms of vertigo, motion sickness and ocular 333
motor deficits
Origin of vertigo in migraine 333
Motion sickness-like symptoms 334
Ocular motor deficits in the symptom-free interval
indicate permanent brainstem or cerebellar dysfunction 335
Benign paroxysmal vertigo in childhood 335
Benign paroxysmal torticollis in infancy 336
Benign recurrent vertigo 337
Dizziness and vertigo as facultative symptoms in migraine
apart from BM 337
Association of migraine with other vertigo disorders? 337
References 338
21 Hyperviscosity syndrome and vertigo 341
The clinical syndrome 341
Aetiology and pathomechanism 341
Management 341
References 342
Contents xix
Section F Traumatic vertigo 343
22 Head and neck injury 347
Traumatic otolith vertigo 349
References 349
23 Vertigo due to barotrauma 351
Alternobaric vertigo 351
Blast injury 352
Decompression sickness 352
Management 352
Round and oval window fistula caused by barotrauma 353
References 354
24 Iatrogenic vestibular disorders 355
Intratympanic gentamicin in Meniere's disease: desired and
undesired effects 355
Quinine: reversible and irreversible side effects 356
Vertebral artery dissection due to chiropractic neck manipulation 356
Surgically induced vestibular dysfunction 356
Iatrogenic benign paroxysmal positioning vertigo 357
Vestibular loss associated with chronic noise-induced hearing loss 357
References 358
Section G Hereditary vestibular disorders and vertigo in childhood . 361
25 Familial periodic ataxia/vertigo (episodic ataxia) 365
The clinical syndromes 366
Episodic ataxia associated with "interictal" myokymia (type EA-1) 366
Episodic ataxia associated with "interictal" nystagmus (type EA-2) 367
Differential diagnoses 369
Aetiology and pathomechanism 370
Episodic ataxia type 1, a potassium channelopathy 370
Episodic ataxia type-2, a cerebral calcium channelopathy 370
Effects of acetazolamide and the pathomechanism of EA 372
Management 372
References 373
26 Vertigo in childhood 375
Benign paroxysmal vertigo of childhood and basilar migraine 376
Motion sickness 376
Vestibular neuritis 376
Meniere's disease 377
Perilymph fistulas 377
Unilateral or bilateral loss of vestibular function 377
Hereditary disorders causing peripheral vestibular failure 378
Central vestibular syndromes 379
References 379
xx Contents
Section H Vertigo, dizziness, and falls in the elderly 383
27 Vertigo, dizziness, and falls in the elderly 385
Physiological ageing of the vestibular system 385
Age-related changes in eye movements and vestibulo-ocular reflexes . 385
Age-related changes in postural sway and balance 386
Cautious senile gait and "highest-level gait disorders" 386
Falls in the elderly 388
Dizziness in the elderly 389
References 391
Section I Drugs and vertigo 393
28 Drugs and vertigo 395
Ototoxic agents 395
Cerebellar intoxication 397
Drugs and eye movements 400
References 402
Section J Non-vestibular (sensory) vertigo syndromes 405
29 Visual vertigo: visual control of motion and balance 409
Circularvection and linearvection: optokinetically induced
perception of self-motion 409
Psychophysics of circularvection 411
Visual-vestibular interaction: functional significance of
visual and vestibular cortices 413
Rollvection-tilt: optokinetic graviceptive mismatch 414
Visual pseudo-Coriolis effect and pseudo-Purkinje effect 416
Optokinetic motion sickness 417
Physiological height vertigo and postural balance 418
Physical prevention of physiological height vertigo 422
Licence for workers at heights? 422
The "visual cliff" phenomenon 422
Vision and posture 423
Moving visual scenes 424
Visual acuity 424
Near vision and eye-object distance 425
Visual control of fore-aft versus lateral body sway 426
Visual stabilisation in the dark 426
Flicker illumination 426
Visual field 427
Eye movements, oculomotor disorders, and postural balance 428
Nystagmus with oscillopsia impairs balance 428
Extraocular muscle paresis impairs locomotion and balance 429
Oscillopsia 430
Oscillopsia is smaller than retinal image slip: deficient
vestibulo-ocular reflex 431
Contents xxi
Acquired ocular oscillations with oscillopsia 432
Physiological impairment of motion perception with moving eyes 433
Normal (physiological) inhibitory interactions between
self-motion and object-motion perception 435
Pathological (adaptive?) binocular impairment of motion
perception caused by monocular external eye muscle paresis 435
Oscillopsia and motion perception in congenital nystagmus 435
References 436
30 Somatosensory vertigo 441
Cervical vertigo 441
Functional significance of neck afferents and neck reflexes 442
Spatial orientation 442
Neck reflexes 443
Cervico-ocular reflex 443
Central pathways 443
Ataxia and nystagmus in experimental cervical vertigo 444
Clinical evidence for cervical vertigo? 444
Hypothetical mechanisms 445
Differential diagnosis 446
Arthrokinetic nystagmus and self-motion sensation 446
Other forms of nystagmus induced by non-vestibular stimulation . 447
Postural imbalance with sensory polyneuropathy 447
References 449
Section K Psychogenic vertigo 453
31 Psychiatric disorders and vertigo 455
Organic versus psychiatric morbidity 456
Vestibular dysfunction secondary to psychiatric disorders and
psychiatric disorders secondary to vestibular dysfunction 456
How can psychogenic vertigo be diagnosed? 457
Panic disorder 458
Criteria for panic attack (DSM-IV 1994) 459
Agoraphobia 459
Criteria for agoraphobia 459
Epidemiology 459
Management 460
Acrophobia 460
Psychotherapy for acrophobia and agoraphobia 461
Psychogenic disorders of stance and gait 461
Criteria for psychogenic disorders of stance and gait 462
Management 463
References 466
32 Phobic postural vertigo 469
The clinical syndrome 469
xxii Contents
Aetiology and hypothetical mechanism 470
Hypothetical mechanism: A disturbance of space constancy
due to decoupling of the efference-copy signal? 471
Body sway in PPV 472
PPV: A panic disorder? 473
Differential diagnosis 475
Course and treatment 475
References 478
Section L Physiological vertigo 481
33 Motion sickness 485
The clinical syndrome 485
Nausea and vomiting 485
Labyrinth function and motion sickness 487
The sensory conflict theory (visual-vestibular mismatch) 487
Vestibular hyperexcitability 489
Incidence and susceptibility 490
Management: physical and medical prevention 491
Physical prevention 491
Visual prevention of motion sickness in vehicles 491
Medical prevention 491
Space sickness 492
References 493
Subject Index 497 |
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| discipline | Medizin |
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| illustrated | Illustrated |
| index_date | 2024-07-02T20:19:22Z |
| indexdate | 2024-07-09T21:13:37Z |
| institution | BVB |
| isbn | 3540199349 |
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| spelling | Brandt, Thomas 1943- Verfasser (DE-588)128513497 aut Vertigo its multisensory syndromes Thomas Brandt 2. ed. London [u.a.] Springer 1999 XXVIII, 503 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Duizeligheid gtt Diagnosis, Differential Vertigo Vertigo diagnosis Vertigo physiopathology Schwindel (DE-588)4053994-5 gnd rswk-swf (DE-588)1071861417 Konferenzschrift gnd-content Schwindel (DE-588)4053994-5 s DE-604 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016415062&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Brandt, Thomas 1943- Vertigo its multisensory syndromes Duizeligheid gtt Diagnosis, Differential Vertigo Vertigo diagnosis Vertigo physiopathology Schwindel (DE-588)4053994-5 gnd |
| subject_GND | (DE-588)4053994-5 (DE-588)1071861417 |
| title | Vertigo its multisensory syndromes |
| title_auth | Vertigo its multisensory syndromes |
| title_exact_search | Vertigo its multisensory syndromes |
| title_exact_search_txtP | Vertigo its multisensory syndromes |
| title_full | Vertigo its multisensory syndromes Thomas Brandt |
| title_fullStr | Vertigo its multisensory syndromes Thomas Brandt |
| title_full_unstemmed | Vertigo its multisensory syndromes Thomas Brandt |
| title_short | Vertigo |
| title_sort | vertigo its multisensory syndromes |
| title_sub | its multisensory syndromes |
| topic | Duizeligheid gtt Diagnosis, Differential Vertigo Vertigo diagnosis Vertigo physiopathology Schwindel (DE-588)4053994-5 gnd |
| topic_facet | Duizeligheid Diagnosis, Differential Vertigo Vertigo diagnosis Vertigo physiopathology Schwindel Konferenzschrift |
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