Journal of Vestibular Research - Volume 33, issue 2

Authors: Gamble, Ryan | Sumner, Petroc | Wilson-Smith, Kevin | Derry-Sumner, Hannah | Rajenderkumar, Deepak | Powell, Georgie

Article Type: Research Article

Abstract: BACKGROUND: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic neuro-vestibular condition characterised by subjective dizziness, non-spinning vertigo, and postural imbalance. Symptoms are typically induced by situations of visuo-vestibular conflict and intense visual-motion. OBJECTIVE: Little research has focused on the lived experiences of people with PPPD. Therefore, our objective was to present an in-depth exploration of patient experiences and sense-making, and the effect of PPPD on psycho-social functioning. METHODS: We conducted semi-structured interviews with 6 people with PPPD, who were recruited from an Audiovestibular department in Wales. We present a case-by-case Interpretive Phenomenological Analysis (IPA) for each participant …and present common themes. RESULTS: Our analysis revealed a range of superordinate and subordinate themes, individualised to each participant, but broadly described under the following headings: dismissal and non-belief, identity loss, dissociative experiences, poor psychological well-being and processes of sense-making. CONCLUSION: The qualitative experiences documented in this study will help clinicians and researchers to better understand the lived experiences of PPPD, how PPPD patients make sense of their symptoms, and the psycho-social impacts of the condition. Show more

Keywords: Persistent Postural-Perceptual Dizziness (PPPD), visual vertigo, qualitative, psycho-social functioning

DOI: 10.3233/VES-220059

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 89-103, 2023

Authors: Emekci, Tuğba | Dündar, Mehmet Akif | Kirazlı, Gülce | İnceoğlu, Feyza | Cengiz, Deniz Uğur | Kilinç, Fatma Men | Karababa, Ercan | Muzaç, Seray | Kaya, Şeyda | Arbağ, Hamdi

Article Type: Research Article

Abstract: BACKGROUND/OBJECTIVE: There exists limited information in the literature on dominant hand preference in relation with vHIT applications. The present study aimed to examine the relationship between the clinician’s dominant use of right- or left-hand and vHIT results. METHODS: A Synapsys vHIT Ulmer device was used in the study. The tests were administered by 3 clinicians experienced in vHIT, 2 of whom were right-handed and 1 left-handed. The test was applied to the 94 participants three times, one week apart. RESULTS: In this study, the correlation between right-handed clinicians and left-handed clinicians was examined, and in all …SCCs, namely RA, LA, RL, LL, RP and LP, a moderate positive significant correlation was found between right-handed1 and right-handed2, between right-handed1 and left-handed, and between right-handed2 and left-handed. CONCLUSIONS: In this study, these findings suggested that measures were reliable across test sessions regardless of hand dominancy (right or left). Based on the vHIT results we obtained with three different right- or left-handed clinicians, the clinician should evaluate the results according to the dominant side. Show more

Keywords: Hand-dominance, left-hand dominance, right-hand dominance, vestibulo-ocular reflex, video head impulse test

DOI: 10.3233/VES-220073

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 105-113, 2023

Authors: Onal, Merih | Aygun, Ahmet | Colpan, Bahar | Karakayaoglu, Harun | Onal, Ozkan

Article Type: Research Article

Abstract: BACKGROUND: Video head impulse test (vHIT) and videonystagmography (VNG) provide significant benefits in evaluating benign paroxysmal positional vertigo (BPPV) and determining the semicircular canal localization of the otoconia. OBJECTIVE: This study aimed to investigate the relationship between vestibular–ocular reflex (VOR) gains measured via vHIT and the slow-phase velocity (SPV) of nystagmus in patients with the posterior semicircular canal (PSCC)-BPPV. METHODS: Sixty-two patients were included in this study and divided into the study (n  = 32, patients with isolated PSCC-BPPV) and control (n  = 30, age- and sex-matched healthy individuals) groups. While VOR gains were measured with vHIT in …both groups and compared between groups, the SPV values of nystagmus observed during the Dix-Hallpike maneuver in the study group were recorded using VNG and compared with the VOR gains of the study group. RESULTS: There were significant differences in posterior canal VOR gains between the study and control groups (p  < 0.001 and p  < 0.01, respectively). Although the affected PSCC had decreased VOR gains versus the control group, it was still within the normal range. However, there was no significant relationship between the VOR gains of the affected PSCC and the SPV of the nystagmus. CONCLUSIONS: vHIT can help detect semicircular canal dysfunction in patients with PSCC-BPPV. The SPV values of nystagmus on VNG during the Dix–Hallpike maneuver do not correlate with the level of VOR gain. Show more

Keywords: Benign paroxysmal positional vertigo, vestibular function tests, head impulse test, vestibulo–ocular reflex, semicircular canals

DOI: 10.3233/VES-220106

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 115-125, 2023

Authors: Ota, Koshi | Nishioka, Daisuke | Katayama, Yusuke | Kitamura, Tetsuhisa | Masui, Jun | Ota, Kanna | Nitta, Masahiko | Matsuoka, Tetsuya | Takasu, Akira

Article Type: Research Article

Abstract: OBJECTIVE: We aimed to identify the proportion of each medical condition or disease contributing to dizziness and their disposition in the Emergency Department (ED). METHODS: This retrospective, descriptive study examined data from the Osaka Emergency Information Research Intelligent Operation Network system in Japan for the period from January 1, 2018 to December 31, 2020. The inclusion criteria were patients with presumptive ICD-10 codes including “dizziness” or “vertigo”. Patient demographics were compared using the χ 2 test and Kruskal-Wallis test. Logistic regression analysis was performed to calculate disposition from ED (emergency admission or discharge) over the 3-year study …period. The adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate analyses. RESULTS: During the 3-year study period, a total of 1,346,457 patients (462,773 in 2018, 468,697 in 2019, and 414,987 in 2020; P  < 0.001), including 53,190 patients with dizziness (18,396 in 2018, 18,649 in 2019, and 16,145 in 2020; P  = 0.058), were identified as having been transported to hospitals by ambulance in Osaka Prefecture. Dizziness and giddiness (R42) was the most common form of dizziness, in 27,075 cases (9,570 in 2018, 9,613 in 2019, and 7,892 in 2020; P  < 0.001; Gender composition showed 10,483 males and 16,592 females.) Vestibular Neuronitis (H81.2) showed significant increase in 2020 compared to the two preceding years (91 in 2018, 119 in 2019, and 130 in 2020, P  = 0.003; including 174 males and 167 females, respectively). Of the 53,190 patients with dizziness, 11,862 (22.3%; 4,323 males, 7,539 females) were admitted to hospital. The odds ratio (OR) for emergency admission for dizziness in 2020 during the COVID-19 pandemic was 0.98 (95% confidence interval (CI), 0.93– 1.03) with reference to 2018. CONCLUSION: Patients with dizziness accounted approximately 4% of ED transportations, with about 20% requiring hospital admission, irrespective of the COVID-19 pandemic. Vestibular neuronitis was significantly increased in 2020. Show more

Keywords: Admission, dizziness, EMS, epidemiology, ORION

DOI: 10.3233/VES-220024

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 127-136, 2023

Authors: Kang, Byung Chul | Kim, TaeKoon | Kwon, Joong Keun

Article Type: Research Article

Abstract: BACKGROUND: Diagnostic criteria of vestibular migraine (VM) by the Bárány classification consists of complex combinations of characteristics of dizziness: episodes, intensity, duration, migraine according to International Classification of Headache Disorders (ICHD), and migraine features accompanying vertigo. The prevalence according to strictly applied Bárány criteria may be much lower than preliminary clincal diagnosis. OBJECTIVE: The purpose of this study is to investigate the prevalence of VM according to strictly applied Bárány criteria among dizzy patients who visited the otolaryngology department. METHODS: The medical records of patients with dizziness from December 2018 to November 2020 were retrospectively searched …using a clinical big data system. The patients completed a questionnaire designed to identify VM according to Bárány classification. Microsoft Excel function formulas were used to identify cases that met the criteria. RESULTS: During the study period, 955 new patients visited the otolaryngology department complaining of dizziness, of which 11.6% were assessed as preliminary clinical diagnosis of VM in outpatient clinic. However, VM according to strictly applied Bárány criteria accounted for only 2.9% of dizzy patients. CONCLUSION: The prevalence of VM according to strictly applied Bárány criteria could be significantly lower than that of preliminary clinical diagnosis in outpatient clinic. Show more

Keywords: Vestibular migraine, vertigo, migraine disorders, Bárány Society, international headache society

DOI: 10.3233/VES-220112

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 137-142, 2023

Authors: Jeong, Junhui | Youk, Tae Mi | Choi, Hyun Seung

Article Type: Research Article

Abstract: BACKGROUND: There have been no comprehensive studies on the incidence of peripheral vestibular disorders based on population-based data for a long-term period. OBJECTIVE: We investigated the incidence of peripheral vestibular disorders using population-based data representing the whole population of South Korea. METHODS: This study used the National Health Insurance Service data in Korea from 2008 to 2020. Peripheral vestibular disorders such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis (VN), and Meniere’s disease (MD) were defined with diagnostic, treatment, or audiovestibular test codes. The annual incidence in total and according to sex, age, and residence was …analyzed. RESULTS: The annual incidence of BPPV, VN, and MD per 100,000 was 51.4, 22.7, and 12.4 in 2008 and 181.1, 62.9, and 50.5 in 2020, respectively. The incidence of each was significantly different by sex (p  < 0.001), age (p  < 0.001), and residence (p  < 0.001), with the highest value in female, people aged 60 years or older, and people who resided in metropolitan cities. CONCLUSIONS: The annual incidence of BPPV, VN, and MD had increasing trends from 2008 through 2020 in South Korea, and all were significantly higher in female, people aged 60 years or older, and people who resided in metropolitan cities. Show more

Keywords: Incidence, peripheral vestibular disorder, peripheral vertigo, benign paroxysmal positional vertigo, vestibular neuritis, Meniere’s disease, population-based study

DOI: 10.3233/VES-220085

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 143-150, 2023

Authors: Gürkov, Robert | Barath, Krisztina | de Foer, Bert | Fukushima, Munehisa | Gluth, Michael | Hornibrook, Jermy | Perez-Fernandez, Nicolas | Pyykkö, Ilmari | Sone, Michihiko | Usami, Shin-Ichi | Wang, Wuqing | Zou, Jing | Naganawa, Shinji

Article Type: Article Commentary

DOI: 10.3233/VES-190662

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 151-157, 2023

Authors: Lopez-Escamez, Jose A. | Attyé, Arnaud

Article Type: Article Commentary

DOI: 10.3233/VES-180663

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 159-162, 2023

Article Type: Retraction

DOI: 10.3233/VES-180662

Citation: Journal of Vestibular Research, vol. 33, no. 2, pp. 163-163, 2023