January 1, 2011 Selmin Karatayli-Ozgursoy, MD, Greta C. Stamper, AuD, Larry B. Lundy, MD, and David A. Zapala, PhD
article
Abstract
We describe a rarely encountered case of coexisting bilateral multicanal benign paroxysmal positional vertigo (BPPV) and vestibular schwannoma in a 56-year-old woman. The patient had presented with a 10-year history of dizziness and imbalance, and her vestibular findings were perplexing. We decided on a working diagnosis of BPPV and began treatment. After several months of canalith repositioning maneuvers had failed to resolve her symptoms, we obtained magnetic resonance imaging, which revealed the presence of the vestibular schwannoma. This case serves as a reminder of the importance of differentiating between central and peripheral vestibular disorders, as well as central and anterior canal BPPV-induced down-beating nystagmus in order to establish the correct diagnosis and initiate appropriate treatment.
March 31, 2010 Matthew L. Bush, MD, Raleigh O. Jones, MD, and Jennifer B. Shinn, PhD
article
Abstract
Vestibular evoked myogenic potential (VEMP) testing has gained popularity as a diagnostic modality in otolaryngology and audiology. To maximize the utility of this test, examiners need the availability of ideal test settings and reliable norms. We conducted a prospective study of 8 subjects with no history of neurotologic symptoms to examine the test-retest consistency of VEMP testing and to analyze the impact of stimulus type and muscle tension monitoring. All subjects underwent VEMP testing with two stimuli: a 500-Hz tone and a click. With each stimulus, testing was completed with and without monitoring of sternocleidomastoid muscle tension. All subjects participated in an initial testing session and then returned for a repeat testing session 2 to 4 weeks later. We measured the amplitude of primary waveforms P13 (first positive peak) and N23 (first negative peak) and analyzed the reliability and reproducibility of the mean amplitude asymmetry of these VEMP peaks. The P13 component of the VEMP (specificity: 86.25%) demonstrated a more stable amplitude than did the N23 component (specificity: 70.50%). Therefore, our statistical analysis of the effect of stimulus type and muscle tension monitoring on test-retest reliability was limited to the P13 waveform. We found that neither the type of stimulus nor the presence or absence of muscle tension monitoring had any statistically significant effect on amplitude asymmetry. We concluded that in VEMP testing, the P13 component was more specific than the N23 component in identifying normal subjects and that the P13 component provided consistent results across test sessions, regardless of the type of stimulus or the presence or absence of muscle tension monitoring.
July 31, 2009 Kenneth H. Brookler, MD, MS, FRCSC
April 30, 2009 Kenneth H. Brookler, MD, MS, FRCSC
April 30, 2008 Kenneth H. Brookler, MD, FRCSC
February 1, 2008 Kenneth H. Brookler, MD, FRCSC
October 31, 2007 Mohamed Hamid, MD, PhD and Kenneth H. Brookler, MD, FRCSC
July 31, 2007 Kenneth H. Brookler, MD, FRCSC; Mohamed A. Hamid, MD, PhD
article
A 69-year-old man presented with a 12-year history of balance difficulties. He had been admitted to a hospital 12 years earlier for treatment of nausea, vomiting, and left-upper-quadrant pain, and he was given intravenous fluids and antibiotics. Treatment alleviated his symptoms, but he noticed that once he was out of bed, he was unable to maintain his balance and had to hold on to the IV pole. Ever since then, his symptoms had persisted.
May 31, 2007 Kenneth H. Brookler, MD; Mohamed A. Hamid, MD, PhD
February 1, 2007 Kenneth H. Brookler, MD; Mohamed A. Hamid, MD, PhD
September 30, 2006 Mohamed A. Hamid, MD, PhD; Kenneth H. Brookler, MD
July 31, 2006 Kenneth H. Brookler, MD; Mohamed A. Hamid, MD, PhD
