Journal of Vestibular Research - Volume Pre-press, issue Pre-press

Authors: Pyykkö, Ilmari | Manchaiah, Vinaya | Zou, Jing | Levo, Hilla | Kentala, Erna

Article Type: Research Article

Abstract: The purpose of the present study was to characterize the occurrence of Tumarkin attacks in patients with Ménière’sdisease (MD), and to study its association with reported complaints, severity of consequences, and also self-reported work ability. The study used a cross-sectional design. Data obtained from the Finnish Ménière Federation using an electronic survey was analyzed. 602 people with MD responded to the survey (62% response rate) with a mean age of 56.7 years and a mean duration of the disease 12.4 years. 49% of the respondents experienced Tumarkin attacks, which lasted for a few seconds to a few minutes. There were …significant differences in complaints reported by MD patients with and without Tumarkin attacks. Respondents with Tumarkin attacks experienced various consequences, including tripping, falls, fear, anxiety, problems in dyadic life, and even transient loss of consciousness. Respondents with Tumarkin attacks had more frequently applied for pension than those not having Tumarkin attacks. On an average, respondents with Tumarkin attacks had less self-reported working ability when compared to those without Tumarkin attacks. The current study results suggest various differences in terms of complaints reported, severity of consequences, and the self-reported working ability in MD patients with and without Tumarkin attacks. Hearing healthcare professionals must examine Tumarkin attacks and their consequences in patients with MD during clinical examinations. In addition, the therapy should focus on alleviating the consequences and improving work ability. Show more

Keywords: Vasovagal attack, unconsciousness, vestibular syncope, Tumarkin attacks, drop attacks

DOI: 10.3233/VES-180634

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-12, 2018

Authors: Roller, Robert Alan | Hall, Courtney D.

Article Type: Research Article

Abstract: BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises. OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises. Balance training focused on postural realignment and hip strategy performance during altered visual and somatosensory inputs. METHODS: A retrospective chart review of 159 …patients with vestibular deficits was performed and five outcome measures were analyzed. RESULTS: All outcomes- self-report dizziness and balance function, dynamic gait index, modified clinical test of sensory interaction and balance, and clinical dynamic visual acuity improved significantly and approached or achieved normal scores. CONCLUSIONS: The combination of modified VOR X1 gaze stability exercises, wherein patients achieved high-velocity head movement (240°/s) during short exercise bouts, with “forced use” gait and balance exercises for postural realignment and hip strategy recruitment, achieved 93–99% of normal scores for all five outcomes. These results compare favorably to the outcomes for current VR techniques and warrant further investigation. Show more

Keywords: Vestibular rehabilitation, peripheral vestibular hypofunction, outcomes

DOI: 10.3233/VES-180633

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-9, 2018

Authors: Clément, Gilles | Reschke, Millard F.

Article Type: Research Article

Abstract: BACKGROUND: It has been proposed that individual susceptibility to motion sickness is related to the vestibulo-ocular reflex (VOR) through the activation of the velocity storage mechanism. OBJECTIVE: We investigated whether motion sickness level was related to the gain and phase of the VOR. METHODS: VOR gain and phase were measured in 214 subjects while they rotated in yaw at 0.01 Hz, 0.02 Hz, 0.04 Hz, 0.08 Hz, and 0.16 Hz in darkness, and results were compared to the severity of symptoms the subjects experienced during subsequent tests to provoke motion sickness. These tests included cross-coupled angular accelerations, sudden stops in light …or in dark, off-vertical axis rotation, and parabolic flight. The subjects were grouped according to the motion sickness level reached during these tests (none, low, medium, or high). RESULTS: No correlation was found between the horizontal VOR gain and motion sickness level. However, for the subjects with high motion sickness level, the VOR phase lead was significantly lower during rotation at frequencies ranging from 0.04 Hz to 0.16 Hz (i.e. the VOR time constant was longer) than the other motion sickness groups. CONCLUSION: These results support the theory that the longer the time constant for velocity storage, the more severe the motion sickness. Show more

Keywords: Motion sickness, sensory conflict, vestibular nystagmus, velocity storage

DOI: 10.3233/VES-180632

Citation: Journal of Vestibular Research, vol. Pre-press, no. Pre-press, pp. 1-10, 2018