61 research outputs found
Temblor ortostĂĄtico como causa de inestabilidad
Orthostatic tremor (OT) is a neurological disease of unknown aetiology. It is defined
by the presence of a 10-20 Hz tremor in the legs while standing still. Symptoms described are
dizziness and instability that diminish if the patient sits down or leans on something; drinking
small amounts of alcohol significantly reduces OT. Due to the dizziness and/or unsteadiness,
these patients are usually referred to the neuro-otology department. We report 4 cases diagnosed
with OT. The diagnosis of OT should be considered for patients with instability. The
clinical history is a key factor to suspect this entity, and the diagnosis is given by the register of
10-20 Hz contractions on limb electromyography. Treatment for this disease consists of medical
treatment; the first option is clonazepam.
© 2011 Elsevier España, S.L. All rights reserved
ExploraciĂłn posturogrĂĄfica de pacientes simuladores
Introduction: An aphysiological pattern in computerized
dynamic posturography (CDP) may be produced by numerous
causes. We analyze the results obtained in this test
by a group of malingering patients.
Patients and method: This study analyzes a particular
group of 7 malingerers, ie patients simulating a false and
unreal equilibrium disorder, without any a priori awareness
of the gain expected from a pathological report. The condition
can only be identified with the very complex postural
disorder known as âcontinuous imbalance.â We analyze the
results of the dynamic posturography test following the
diagnostic criteria described by other authors.
Results: Of the criteria analyzed, we found Cevetteâs to be
the most frequently positive for our study group.
Conclusions: The wide diversity in the criteria used makes
it necessary to apply them together, assuming a high level
of suspicion and great care in the diagnostic process
Resultados de los potenciales evocados miogĂ©nicos vestibulares en el vĂ©rtigo posicional paroxĂstico benigno
Objective: Benign paroxysmal positional vertigo (BPPV)
seems to occur because of otoconia migration into the semicircular
canals or their adherence to the cupula. Although
the origin of these otoconia lies in the macula of the utricle,
vestibular evoked myogenic potentials (VEMPs) can be
used assess saccular function. The aim of this study is to assess
the saccular function in patients diagnosed with BPPV.
Patients and method: Nineteen patients diagnosed with
BPPV of the posterior semicircular canal were included in
this study. Their auditory function and their caloric, rotatory
chair, and VEMP responses were tested. Ipsilateral and
contralateral VEMP thresholds, ipsilateral and contralateral
p13 and n23 latencies at 100 dB, inter-peak amplitude and
the interaural amplitude difference were determined.
Results: We found a lack of VEMP response in 52 % of the
ears with BPPV. When adjusted for bilateral absence, VEMP
response was absent in 20.3 % of ears.
Conclusions: Some patients with idiopathic BPPV show a
degree of saccular dysfunction
Histopathological reaction in the vestibule after cochlear implantation in Macaca fascicularis.
Cochlear implantation surgery (CI) is considered a safe procedure and is the standard treatment for the auditory
rehabilitation in patients with severe-to-profound sensorineural hearing loss. Although the development of
minimally traumatic surgical concepts (MTSC) have enabled the preservation of residual hearing after the implantation, there is scarce literature regarding the vestibular affection following MTCS.
The aim of the study is to analyze histopathologic changes in the vestibule after CI in an animal model (Macaca
fascicularis). Cochlear implantation was performed successfully in 14 ears following MTCS. They were classified
in two groups upon type of electrode array used. Group A (n = 6) with a FLEX 28 electrode array and Group B (n
= 8) with HL14 array. A 6-month follow-up was carried out with periodic objective auditory testing. After their
sacrifice, histological processing and subsequent analysis was carried out. Intracochlear findings, vestibular
presence of fibrosis, obliteration or collapse is analyzed. Saccule and utricle dimensions and neuroepithelium
width is measured.
Cochlear implantation was performed successfully in all 14 ears through a round window approach. Mean
angle of insertion was >270⊠for group A and 180â270⊠for group B. In group A auditory deterioration was
observed in Mf 1A, Mf2A and Mf5A with histopathological signs of scala tympani ossification, saccule collapse
(Mf1A and Mf2A) and cochlear aqueduct obliteration (Mf5A). Besides, signs of endolymphatic sinus dilatation
was seen for Mf2B and Mf5A. Regarding group B, no auditory deterioration was observed. Histopathological
signs of endolymphatic sinus dilatation were seen in Mf 2B and Mf 8B.
In conclusion, the risk of histological damage of the vestibular organs following minimally traumatic surgical
concepts and the soft surgery principles is very low. CI surgery is a safe procedure and it can be done preserving
the vestibular structures
Distortion product otoacoustic emissions in normally hearing subjects.
The finding of active function by the outer hair cells for sound processing prior to neural transduction in the inner hair cells represents the basic mechanism for the generation of Otoacoustic Emissions in the cochlea. Among them the so-called Distortion Product Otoacoustic Emissions represent a tool for an in depth knowledge of the Organ of Corti micromechanics, more advantageous than others, based on their properties, that makes possible an objective frequency-specific study: The response in a group of normally hearing subjects is presented and characterized to ascertain the basic features to be used in further testing of deaf people
Systematic method for morphological reconstruction of the semicircular canals using a fully automatic skeletonization process
We present a novel method to characterize the morphology of semicircular canals of the inner ear. Previous experimental works have a common nexus, the human-operator subjectivity. Although these methods are mostly automatic, they rely on a human decision to determine some particular anatomical positions. We implement a systematic analysis where there is no human subjectivity. Our approach is based on a specific magnetic resonance study done in a group of 20 volunteers. From the raw data, the proposed method defines the centerline of all three semicircular canals through a skeletonization process and computes the angle of the functional pair and other geometrical parameters. This approach allows us to assess the inter-operator effect on other methods. From our results, we conclude that, although an average geometry can be defined, the inner ear anatomy cannot be reduced to a single geometry as seen in previous experimental works. We observed a relevant variability of the geometrical parameters in our cohort of volunteers that hinders this usual simplification
Visual fixation and continuous head rotations have minimal effect on set-point adaptation to magnetic vestibular stimulation
Background: Strong static magnetic fields such as those in an MRI machine can induce sensations of self-motion and nystagmus. The proposed mechanism is a Lorentz force resulting from the interaction between strong static magnetic fields and ionic currents in the inner ear endolymph that causes displacement of the semicircular canal cupulae. Nystagmus persists throughout an individual's exposure to the magnetic field, though its slow-phase velocity partially declines due to adaptation. After leaving the magnetic field an after effect occurs in which the nystagmus and sensations of rotation reverse direction, reflecting the adaptation that occurred while inside the MRI. However, the effects of visual fixation and of head shaking on this early type of vestibular adaptation are unknown. Methods: Three-dimensional infrared video-oculography was performed in six individuals just before, during (5, 20, or 60 min) and after (4, 15, or 20 min) lying supine inside a 7T MRI scanner. Trials began by entering the magnetic field in darkness followed 60 s later, either by light with visual fixation and head still, or by continuous yaw head rotations (2 Hz) in either darkness or light with visual fixation. Subjects were always placed in darkness 10 or 30 s before exiting the bore. In control conditions subjects remained in the dark with the head still for the entire duration. Results: In darkness with head still all subjects developed horizontal nystagmus inside the magnetic field, with slow-phase velocity partially decreasing over time. An after effect followed on exiting the magnet, with nystagmus in the opposite direction. Nystagmus was suppressed during visual fixation; however, after resuming darkness just before exiting the magnet, nystagmus returned with velocity close to the control condition and with a comparable after effect. Similar after effects occurred with continuous yaw head rotations while in the scanner whether in darkness or light. Conclusions: Visual fixation and sustained head shaking either in the dark or with fixation inside a strong static magnetic field have minimal impact on the short-term mechanisms that attempt to null unwanted spontaneous nystagmus when the head is still, so called VOR set-point adaptation. This contrasts with the critical influence of vision and slippage of images on the retina on the dynamic (gain and direction) components of VOR adaptation
Sloan Digital Sky Survey IV: mapping the Milky Way, nearby galaxies, and the distant universe
We describe the Sloan Digital Sky Survey IV (SDSS-IV), a project encompassing three major spectroscopic programs. The Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) is observing hundreds of thousands of Milky Way stars at high resolution and high signal-to-noise ratios in the near-infrared. The Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey is obtaining spatially resolved spectroscopy for thousands of nearby galaxies (median ). The extended Baryon Oscillation Spectroscopic Survey (eBOSS) is mapping the galaxy, quasar, and neutral gas distributions between and 3.5 to constrain cosmology using baryon acoustic oscillations, redshift space distortions, and the shape of the power spectrum. Within eBOSS, we are conducting two major subprograms: the SPectroscopic IDentification of eROSITA Sources (SPIDERS), investigating X-ray AGNs and galaxies in X-ray clusters, and the Time Domain Spectroscopic Survey (TDSS), obtaining spectra of variable sources. All programs use the 2.5 m Sloan Foundation Telescope at the Apache Point Observatory; observations there began in Summer 2014. APOGEE-2 also operates a second near-infrared spectrograph at the 2.5 m du Pont Telescope at Las Campanas Observatory, with observations beginning in early 2017. Observations at both facilities are scheduled to continue through 2020. In keeping with previous SDSS policy, SDSS-IV provides regularly scheduled public data releases; the first one, Data Release 13, was made available in 2016 July
Sloan Digital Sky Survey IV: Mapping the Milky Way, Nearby Galaxies, and the Distant Universe
We describe the Sloan Digital Sky Survey IV (SDSS-IV), a project encompassing three major spectroscopic programs. The Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) is observing hundreds of thousands of Milky Way stars at high resolution and high signal-to-noise ratios in the near-infrared. The Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey is obtaining spatially resolved spectroscopy for thousands of nearby galaxies (median ). The extended Baryon Oscillation Spectroscopic Survey (eBOSS) is mapping the galaxy, quasar, and neutral gas distributions between and 3.5 to constrain cosmology using baryon acoustic oscillations, redshift space distortions, and the shape of the power spectrum. Within eBOSS, we are conducting two major subprograms: the SPectroscopic IDentification of eROSITA Sources (SPIDERS), investigating X-ray AGNs and galaxies in X-ray clusters, and the Time Domain Spectroscopic Survey (TDSS), obtaining spectra of variable sources. All programs use the 2.5 m Sloan Foundation Telescope at the Apache Point Observatory; observations there began in Summer 2014. APOGEE-2 also operates a second near-infrared spectrograph at the 2.5 m du Pont Telescope at Las Campanas Observatory, with observations beginning in early 2017. Observations at both facilities are scheduled to continue through 2020. In keeping with previous SDSS policy, SDSS-IV provides regularly scheduled public data releases; the first one, Data Release 13, was made available in 2016 July
Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic
This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic
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