Post Cochlear Implantation Vertigo : Ictal Nystagmus and Audiovestibular Test Characteristics
Copyright © 2023, Otology & Neurotology, Inc..
OBJECTIVE: To investigate ictal nystagmus and audiovestibular characteristics in episodic spontaneous vertigo after cochlear implantation (CI).
STUDY DESIGN: Retrospective and prospective case series.
PATIENTS: Twenty-one CI patients with episodic spontaneous vertigo after implantation were recruited.
INTERVENTIONS: Patient-initiated home video-oculography recordings were performed during one or more attacks of vertigo, using miniature portable home video-glasses. To assess canal and otolith function, video head-impulse tests (vHITs) and vestibular-evoked myogenic potential tests were conducted.
MAIN OUTCOME MEASURES: Nystagmus slow-phase velocities (SPVs), the presence of horizontal direction-changing nystagmus, and post-CI audiovestibular tests.
RESULTS: Main final diagnoses were post-CI secondary endolymphatic hydrops (48%) and exacerbation of existing Ménière's disease (29%). Symptomatic patients demonstrated high-velocity horizontal ictal-nystagmus (SPV, 44.2°/s and 68.2°/s in post-CI secondary endolymphatic hydrop and Ménière's disease). Direction-changing nystagmus was observed in 80 and 75%. Two were diagnosed with presumed autoimmune inner ear disease (SPV, 6.6°/s and 172.9°/s). One patient was diagnosed with probable vestibular migraine (15.1°/s).VHIT gains were 0.80 ± 0.20 (lateral), 0.70 ± 0.17 (anterior), and 0.62 ± 0.27 (posterior) in the implanted ear, with abnormal values in 33, 35, and 35% of each canal. Bone-conducted cervical and ocular vestibular-evoked myogenic potentials were asymmetric in 52 and 29% of patients (all lateralized to the implanted ear) with mean asymmetry ratios of 51.2 and 35.7%. Reversible reduction in vHIT gain was recorded in three acutely symptomatic patients.
CONCLUSION: High-velocity, direction-changing nystagmus time-locked with vertigo attacks may be observed in post-CI implant vertigo and may indicate endolymphatic hydrops. Fluctuating vHIT gain may be an additional marker of a recurrent peripheral vestibulopathy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology - 45(2023), 1 vom: 01. Jan., Seite 65-74 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kwok, Belinda Y C [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 16.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/MAO.0000000000004037 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Kwok, Belinda Y C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Post Cochlear Implantation Vertigo |b Ictal Nystagmus and Audiovestibular Test Characteristics |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 16.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023, Otology & Neurotology, Inc. | ||
| 520 | |a OBJECTIVE: To investigate ictal nystagmus and audiovestibular characteristics in episodic spontaneous vertigo after cochlear implantation (CI) | ||
| 520 | |a STUDY DESIGN: Retrospective and prospective case series | ||
| 520 | |a PATIENTS: Twenty-one CI patients with episodic spontaneous vertigo after implantation were recruited | ||
| 520 | |a INTERVENTIONS: Patient-initiated home video-oculography recordings were performed during one or more attacks of vertigo, using miniature portable home video-glasses. To assess canal and otolith function, video head-impulse tests (vHITs) and vestibular-evoked myogenic potential tests were conducted | ||
| 520 | |a MAIN OUTCOME MEASURES: Nystagmus slow-phase velocities (SPVs), the presence of horizontal direction-changing nystagmus, and post-CI audiovestibular tests | ||
| 520 | |a RESULTS: Main final diagnoses were post-CI secondary endolymphatic hydrops (48%) and exacerbation of existing Ménière's disease (29%). Symptomatic patients demonstrated high-velocity horizontal ictal-nystagmus (SPV, 44.2°/s and 68.2°/s in post-CI secondary endolymphatic hydrop and Ménière's disease). Direction-changing nystagmus was observed in 80 and 75%. Two were diagnosed with presumed autoimmune inner ear disease (SPV, 6.6°/s and 172.9°/s). One patient was diagnosed with probable vestibular migraine (15.1°/s).VHIT gains were 0.80 ± 0.20 (lateral), 0.70 ± 0.17 (anterior), and 0.62 ± 0.27 (posterior) in the implanted ear, with abnormal values in 33, 35, and 35% of each canal. Bone-conducted cervical and ocular vestibular-evoked myogenic potentials were asymmetric in 52 and 29% of patients (all lateralized to the implanted ear) with mean asymmetry ratios of 51.2 and 35.7%. Reversible reduction in vHIT gain was recorded in three acutely symptomatic patients | ||
| 520 | |a CONCLUSION: High-velocity, direction-changing nystagmus time-locked with vertigo attacks may be observed in post-CI implant vertigo and may indicate endolymphatic hydrops. Fluctuating vHIT gain may be an additional marker of a recurrent peripheral vestibulopathy | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Young, Allison S |e verfasserin |4 aut | |
| 700 | 1 | |a Kong, Jonathan H K |e verfasserin |4 aut | |
| 700 | 1 | |a Birman, Catherine S |e verfasserin |4 aut | |
| 700 | 1 | |a Flanagan, Sean |e verfasserin |4 aut | |
| 700 | 1 | |a Greenberg, Simon L |e verfasserin |4 aut | |
| 700 | 1 | |a Gibson, William P |e verfasserin |4 aut | |
| 700 | 1 | |a Argaet, Emma C |e verfasserin |4 aut | |
| 700 | 1 | |a Fratturo, Luke |e verfasserin |4 aut | |
| 700 | 1 | |a Pogson, Jacob M |e verfasserin |4 aut | |
| 700 | 1 | |a Taylor, Rachael L |e verfasserin |4 aut | |
| 700 | 1 | |a Rosengren, Sally M |e verfasserin |4 aut | |
| 700 | 1 | |a Halmagyi, G Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Welgampola, Miriam S |e verfasserin |4 aut | |
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