The Treatment of Peripheral Vestibular Dysfunction Using Caloric Vestibular Stimulation in Patients with Cerebral Hypertensive Crisis

DOI: 10.4236/ijohns.2015.43039   PDF   HTML   XML   2,961 Downloads   3,559 Views   Citations

Abstract

Background: To verify the efficacy of caloric vestibular stimulation in patients with peripheral vestibular dysfunction after cerebral hypertensive crisis. Methods: Enrolled in the study were 60 patients with peripheral vestibular dysfunction caused by a cerebral hypertensive crisis, docu-mented by vestibulometry. Thirty patients underwent standard treatment plus caloric vestibular stimulation, and 30 control group patients received standard treatment alone. Results: After the two-week treatment course, the sensation of vertigo was observed in 40.0% ± 8.9% of treatment group patients compared with 80.0% ± 7.3% of control group patients (t = 3.46; p < 0.001). Spontaneous vestibular somatic reactions were found in 46.7% ± 9.1% of the study treatment group in contrast to 86.7% ± 6.2% of the control group (t = 3.63; p < 0.001). Spontaneous nystagmus was seen in 40.0% ± 8.9% of treatment group patients compared with 93.3% ± 4.6% of control subjects (t = 5.31; p < 0.001). Spontaneous vestibular vegetative reactions were observed in 33.3% ± 8.6% of patients receiving study treatment in contrast to 93.3% ± 4.6% of control group patients (t = 6.16; p < 0.001). Also, 53.3% ± 9.1% of study treatment group patients showed asymmetry of labyrinths compared with 86.7% ± 6.2% of patients from the control group (t = 3.03; p < 0.001). Conclusion: Caloric vestibular stimulation was shown to be an effective treatment for peripheral vestibular dysfunction in patients with cerebral hypertensive crisis. During the 14-day treatment of cerebral hypertensive crisis, complete labyrinthine function recovery occurred in 46.7% of treatment group patients who underwent caloric vestibular stimulation as opposed to 13.3% of control group patients who received standard treatment alone.

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Gomza, Y. and Mösges, R. (2015) The Treatment of Peripheral Vestibular Dysfunction Using Caloric Vestibular Stimulation in Patients with Cerebral Hypertensive Crisis. International Journal of Otolaryngology and Head & Neck Surgery, 4, 229-235. doi: 10.4236/ijohns.2015.43039.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Benoudiba, F., Toulgoat, F. and Sarrazin, J.L. (2013) The Vestibulocochlear Nerve (VIII). Diagnostic and Interventional Imaging, 94, 1043-1050.
http://dx.doi.org/10.1016/j.diii.2013.08.015.
[2] Fujita, N., Yamanaka, T. and Hosoi, H. (2002) Usefulness of MR Angiography in Cases of Central Vertigo. Auris Nasus Larynx, 29, 247-252.
http://dx.doi.org/10.1016/S0385-8146(02)00016-0.
[3] Gacek, R.R. (2008) A Place Principle for Vertigo. Auris Nasus Larynx, 35, 1-10.
http://dx.doi.org/10.1016/j.anl.2007.04.002.
[4] Goycoolea, M., Mena, I. and Neubauer, S. (2009) Is There a Difference in Activation or in Inhibition of Cortical Auditory Centers Depending on the Ear That Is Stimulated? Acta Oto-Laryngologica, 129, 348-353.
http://dx.doi.org/10.1080/00016480802495420.
[5] Kandel, E.R., Schwartz, J.H. and Jessell, T.M. (2000) Principles of Neuroscience. 4th Edition, McGraw-Hill, New York, 591-624.
[6] Koyuncu, M., Elhami, A.R., Alkan, H., Sahin, M., Basoglu, T. and Simsek, M. (2001) Investigation of the Vertebrobasilar Arterial System in Vertigo by Vestibulocochlear Test, SPECT and Angiography. Auris Nasus Larynx, 28, 23-28.
http://dx.doi.org/10.1016/S0385-8146(00)00068-7.
[7] Lamontagne, A., Paquet, N. and Fung, J. (2003) Postural Adjustments to Voluntary Head Monitoring during Standing Are Modified Following Stroke. Clinical Biomechanics, 18, 832-842.
http://dx.doi.org/10.1016/S0268-0033(03)00141-4.
[8] Lee, H. and Baloh, R.W. (2005) Sudden Deafness in Vertebrobasilar Ischemia: Clinical Features, Vascular Topographical Patterns and Long-Term Outcome. Journal of the Neurological Sciences, 228, 99-104.
http://dx.doi.org/10.1016/j.jns.2004.10.016.
[9] Lonsbury-Martin, B.L., Martin, G.K. and Coats, A.C. (1985) The Physiology of the Auditory and Vestibular Systems. In: Ballenger, J.J., Ed., Diseases of the Nose, Throat, Ear, Head and Neck, 13th Edition, Lea and Febiger, Philadelphia, 952-954.
[10] Mills, J.H., Khariwala, S.S. and Weber, P.C. (2006) Anatomy and Physiology of Hearing. In: Bailey, B.J., Johnson, J.T. and Newlands, S.D., Eds., Head & Neck Surgery: Otolaryngology, 4th Edition, Vol. 2, Lippincott Williams & Wilkins, Philadelphia, 1883-1903.
[11] Nakamichi, R., Yamazaki, M., Ikeda, M., Isoda, H., Kawai, H., Sone, M., et al. (2013) Establishing Normal Diameter Range of the Cochlear and Facial Nerves with 3D-CISS at 3T. Magnetic Resonance in Medical Sciences, 12, 241-247.
http://dx.doi.org/10.2463/mrms.2013-0004
[12] Pagarkar, W. and Davies, R. (2004) Dizziness. Medicine, 32, 18-23.
http://dx.doi.org/10.1383/medc.32.9.18.49908
[13] Pollak, L., Kushnir, M. and Stryjer, R. (2006) Diagnostic Value of Vestibular Evoked Myogenic Potentials in Cerebellar and Lower-Brainstem Strokes. Neurophysiologie Clinique, 36, 227-233.
http://dx.doi.org/10.1016/j.neucli.2006.08.014
[14] Sooy, C.D. and Boles, R. (1980) Neuroanatomy for the Otolaryngologist-Head Neck Surgeon. In: Paparella, M.M., Shunrick, D.A., Gluckman, J.L. and Meyerhoff, W.L., Eds., Otolaryngology, 2nd Edition, Vol. I, W.B. Saunders Company, Philadelphia, 151-154.
[15] Tóth, M. and Csillag, A. (2005) The Organ of Hearing and Equilibrium. In: Cillag, A., Ed., Atlas of the Sensory Organs: Functional and Clinical Anatomy, Humana Press, Totowa, 1-83.
http://dx.doi.org/10.1385/1-59259-849-8:001
[16] Yamasoba, T., Kikuchi, S. and Higo, R. (2001) Deafness Associated with Vertebrobasilar Insufficiency. Journal of the Neurological Sciences, 187, 69-75.
http://dx.doi.org/10.1016/S0022-510X(01)00525-1
[17] Albernaz, P.L.M. and Gananca, M.M. (1972) The Use of Air in Vestibular Caloric Stimulation. The Laryngoscope, 82, 2198-2203.
http://dx.doi.org/10.1288/00005537-197212000-00008
[18] Fasold, O., Von Brevern, M., Kuhberg, M., Ploner, C.J., Villringer, A., Lempert, T. et al. (2002) Human Vestibular Cortex as Identified with Caloric Stimulation in Functional Magnetic Resonance Imaging. Neuroimage, 17, 1384-1393.
http://dx.doi.org/10.1006/nimg.2002.1241
[19] Fire, T.D., Tusa, R.J., Furman, J.M., Zee, D.S., Frohman, E., Baloh, R.W., et al. (2000) Assessment: Vestibular Testing Techniques in Adults and Children: Report of the Therapeutics and Technology Assessment. Subcommittee of the American Academy of Neurology. Neurology, 55, 1431-1441.
http://dx.doi.org/10.1212/WNL.55.10.1431
[20] Miller, S.M. and Ngo, T.T. (2007) Studies of Caloric Vestibular Stimulation: Implications for the Cognitive Neurosciences, the Clinical Neurosciences and Neurophilosophy. Acta Neuropsychiatrica, 19, 183-203.
http://dx.doi.org/10.1111/j.1601-5215.2007.00208.x
[21] (1995) Practice Parameters for Determining Brain Death in Adults (Summary Statement). The Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 45, 1012-1014.
[22] Webb, C. (1985) COWS Caloric Test. Annals of Emergency Medicine, 14, 938.
http://dx.doi.org/10.1016/S0196-0644(85)80671-5
[23] André, J.M., Martinet, N., Paysant, J., Beis, J.M. and Le Chapelain, L. (2001) Temporary Phantom Limbs Evoked by Vestibular Caloric Stimulation in Amputees. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 42, 190-196.
[24] Bisiach, E., Rusconi, M.L. and Vallar, G. (1991) Remission of Somatoparaphrenic Delusion through Vestibular Stimulation. Neuropsychologia, 29, 1029-1031.
http://dx.doi.org/10.1016/0028-3932(91)90066-H
[25] Bottini, G., Paulesu, E., Gandola, M., Loffredo, S., Scarpa, P., Sterzi, R., et al. (2005) Left Caloric Vestibular Stimulation Ameliorates Right Hemianesthesia. Neurology, 65, 1278-1283.
http://dx.doi.org/10.1212/01.wnl.0000182398.14088.e8
[26] Cappa, S., Sterzi, R., Vallar, G. and Bisiach, E. (1987) Remission of Hemineglect and Anosognosia during Vestibular Stimulation. Neuropsychologia, 25, 775-782.
http://dx.doi.org/10.1016/0028-3932(87)90115-1
[27] Le Chapelain, L., Beis, J.M., Paysant, J. and André, J.M. (2001) Vestibular Caloric Stimulation Evokes Phantom Limb Illusions in Patients with Paraplegia. Spinal Cord, 39, 85-87.
http://dx.doi.org/10.1038/sj.sc.3101093
[28] Mueller-Jensen, A., Neunzig, H.P. and Emskotter, T. (1987) Outcome Prediction in Comatose Patients: Significance of Reflex Eye Movement Analysis. Journal of Neurology, Neurosurgery & Psychiatry, 50, 389-392.
http://dx.doi.org/10.1136/jnnp.50.4.389
[29] Ramachandran, V.S. and McGeoch, P.D. (2007) Can Vestibular Caloric Stimulation Be Used to Treat Apotemnophylia? Medical Hypotheses, 69, 250-252.
http://dx.doi.org/10.1016/j.mehy.2006.12.013
[30] Ramachandran, V.S., McGeoch, P.D. and Williams, L. (2007) Can Vestibular Caloric Stimulation Be Used to Treat Dejerine-Roussy Syndrome? Medical Hypotheses, 69, 486-488.
http://dx.doi.org/10.1016/j.mehy.2006.12.036
[31] Rode, G., Charles, N., Perenin, M.T., Vighetto, A., Trillet, M. and Aimard, G. (1992) Partial Remission of Hemiplegia and Somatoparaphrenia through Vestibular Stimulation in a Case of Unilateral Neglect. Cortex, 28, 203-208.
http://dx.doi.org/10.1016/S0010-9452(13)80048-2
[32] Vallar, G., Sterzi, R., Bottini, G., Cappa, S. and Rusconi, M.L. (1990) Temporary Remission of Left Hemianesthesia after Vestibular Stimulation. A Sensory Neglect Phenomenon. Cortex, 26, 123-131.
http://dx.doi.org/10.1016/S0010-9452(13)80078-0
[33] Rossetti, Y. and Rode, G. (2002) Reducing Spatial Neglect by Visual and Other Sensory Manipulations: Noncognitive (Physiological) Routes to the Rehabilitation of a Cognitive Disorder. In: Karnath, H.O., Milner, D. and Vallar, G., Eds., The Cognitive and Neural Bases of Spatial Neglect, Oxford University Press, New York, 375-396.
http://dx.doi.org/10.1093/acprof:oso/9780198508335.003.0027
[34] Rubens, A.B. (1985) Caloric Stimulation and Unilateral Visual Neglect. Neurology, 35, 1019-1024.
http://dx.doi.org/10.1212/WNL.35.7.1019
[35] Utz, K.S., Korluss, K., Schmidt, L., Rosenthal, A., Oppenlander, K., Keller, I., et al. (2011) Minor Adverse Effects of Galvanic Vestibular Stimulation in Persons with Stroke and Healthy Individuals. Brain Injury, 25, 1058-1069.
http://dx.doi.org/10.3109/02699052.2011.607789
[36] Neuman, A.C. (2005) Central Auditory System Plasticity and Aural Rehabilitation of Adults. Journal of Rehabilitation Research & Development, 42, 169-186.
http://dx.doi.org/10.1682/JRRD.2005.01.0020
[37] Bottini, G., Gandola, M., Sedda, A. and Ferrè, E.R. (2013) Caloric Vestibular Stimulation: Interaction between Somatosensory System and Vestibular Apparatus. Frontiers in Integrative Neuroscience, 7, 66.
http://dx.doi.org/10.3389/fnint.2013.00066
[38] Ferrè, E.R., Bottini, G. and Haggard, P. (2012) Vestibular Inputs Modulate Somatosensory Cortical Processing. Brain Structure and Function, 217, 859-864.
http://dx.doi.org/10.1007/s00429-012-0404-7
[39] Ferrè, E.R., Bottini, G. and Haggard, P. (2011) Vestibular Modulation of Somatosensory Perception. European Journal of Neuroscience, 34, 1337-1344.
http://dx.doi.org/10.1111/j.1460-9568.2011.07859.x
[40] Bottini, G., Paulesu, E., Sterzi, R., Warburton, E., Wise, R.J., Vallar, G., et al. (1995) Modulation of Conscious Experience by Peripheral Sensory Stimuli. Nature, 376, 778-781.
http://dx.doi.org/10.1038/376778a0
[41] Vallar, G., Bottini, G., Rusconi, M.L. and Sterzi, R. (1993) Exploring Somatosensory Hemineglect by Vestibular Stimulation. Brain, 116, 71-86.
http://dx.doi.org/10.1093/brain/116.1.71

  
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