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| Author | : Rhonda R. Ward |
| Publisher | : |
| Total Pages | : 74 |
| Release | : 2006 |
| Genre | : Audiology |
| ISBN | : |
| Author | : Toshihisa Murofushi |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 112 |
| Release | : 2009-03-28 |
| Genre | : Medical |
| ISBN | : 443185908X |
The vestibular labyrinth consists of ? ve compartments: the lateral, anterior, and posterior semicircular canals, the utricule, and the saccule. At the beginning of the twentieth century, Robert Bárány proposed the caloric test as a clinical test of the lateral semicircular canal. This test enabled clinicians to assess the individual lateral semicircular canal function easily by using the simple method of irrigating the external ear canal with cold or warm water and observing the induced nyst- mus. We believe that the caloric test was a breakthrough in the ? eld of vestibular research. However, as far as the other compartments were concerned, there was no simple clinical test equal to the caloric test for the lateral semicircular canal function. At the end of the twentieth century, the vestibular evoked myogenic potential (VEMP) test was proposed as a new method for assessing the individual saccule function. This test has some unique attributes. First, it uses sound stimulation, even though it is a test of the vestibular system. This appears to be a contradiction n- rophysiologically. As a result, in its early stages there were controversies conce- ing the origin of the responses. However, such controversies have been overcome by basic neurophysiological studies and clinical studies. Above all, sound sensit- ity of the saccular afferents shown in cats and guinea pigs with single-unit recording methods became the main supporting evidence. Nowadays, VEMP is one of the routine clinical tests for balance disorder.
| Author | : Alexsandra Ostrovska |
| Publisher | : |
| Total Pages | : 156 |
| Release | : 2004 |
| Genre | : |
| ISBN | : |
"It is uncertain whether clinically useful information of otolith function can be well characterized by vestibular-evoked-myogenic-potentials (VEMPs), i.e., electromyogenic activity recorded from sternomastoid muscles in response to brief loud auditory clicks. We aimed to assess the utility of VEMP testing in the differential diagnosis of dizziness (81 dizzy patients, 12 normals). We found that: (1) VEMP was reliably elicited from all controls and from 96% of patients without loss of vestibular function; (2) in patients with documented unilateral peripheral vestibular disorders, VEMP could reveal loss of otolith function that usefully facilitated diagnoses; and (3) such otolith function loss was independent of canal function loss revealed by caloric testing. We conclude that the VEMP-test is clinically useful to assess vestibular (otolith and/or inferior vestibular nerve) function, providing information complementary to that obtained from caloric testing (horizontal semicircular canal and/or superior vestibular nerve function)." --
| Author | : Srinivasamurthy Ravi Prakash |
| Publisher | : |
| Total Pages | : 144 |
| Release | : 2009 |
| Genre | : |
| ISBN | : |
(cont.) In the second part of the thesis, we develop a computational model of VEMP physiology, and use the model to separate external sources of variability from internal noise. The model outputs are also used to define a statistical measure, the inverse coefficient of variation (iCOV), which correlates with altered vestibular sensitivity, but is relatively robust to other changes. When applied to the experimental data, the iCOV is found to yield estimates of vestibular sensitivity that are more stable than the conventional VEMP amplitude. This measure also reveals a diversity of response threshold and growth characteristics within the clinically normal population. These findings suggest that the proposed approach could lead to the development of an improved clinical tool, but could also yield new insights into the physiological mechanisms of vestibular pathology.
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 337 |
| Release | : 2020-09-22 |
| Genre | : Medical |
| ISBN | : 0309677157 |
The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or other endocrine-based disorders. In recent decades, an increasing number of health care providers and patients have turned to custom-formulated, or compounded, drug preparations as an alternative to FDA-approved drug products for hormone-related health concerns. These compounded hormone preparations are often marketed as "bioidentical" or "natural" and are commonly referred to as compounded bioidentical hormone therapy (cBHT). In light of the fast-growing popularity of cBHT preparations, the clinical utility of these compounded preparations is a substantial public health concern for various stakeholders, including medical practitioners, patients, health advocacy organizations, and federal and state public health agencies. This report examines the clinical utility and uses of cBHT drug preparations and reviews the available evidence that would support marketing claims of the safety and effectiveness of cBHT preparations. It also assesses whether the available evidence suggests that these preparations have clinical utility and safety profiles warranting their clinical use and identifies patient populations that might benefit from cBHT preparations in lieu of FDA-approved BHT.
| Author | : Kathleen Szalda McNerney |
| Publisher | : |
| Total Pages | : 199 |
| Release | : 2007 |
| Genre | : |
| ISBN | : |
The vestibular evoked myogenic potential (VEMP) is a response that can be recorded from the sternocleidomastoid (SCM) muscle in response to either clicks or low-frequency tonebursts that are presented at a high stimulus level. The VEMP is most likely generated by the saccule. The saccule is part of our vestibular system, and normally contributes to our sense of balance. However, recent studies have shown that it is also responsive to sound. The exact neural pathway of the VEMP is not yet fully understood, limiting its clinical application. The present study has identified the areas of the brain that are activated by stimuli used clinically to evoke the VEMP, by utilizing both EEG (brain electrical activity) recordings, as well as functional imaging, which were collected separately. Stimuli consisted of 500 Hz tonebursts. Analysis of event related potentials (ERPs) derived from EEG recordings revealed that the responses to the 90 dB pSPL stimuli were absent or smaller than the responses that were recorded in response to the 120 dB pSPL stimuli. We recorded an initial negative-going peak which occurred at 13.5 ms, with the frontal electrodes producing the largest response amplitude, as well as a later positive-going peak which occurred at 20.5 ms, with the occipital electrodes and the electrodes which were placed over the right temporal lobe producing the largest amplitude. Source localization techniques (CURRY) were used to analyze the EEG data, while both PET and EEG data were analyzed using SPM5. When we compared the areas activated by the high vs. low-level stimuli, we found that the VEMP stimuli activated vestibular regions of the brain, specifically the premotor cortex, the inferior and medial temporal gyri, and Brodmann area 40, in addition to the auditory areas typically activated by sound, such as the primary auditory cortex. In addition, the brain activity for the initial negative-going peak was localized in the primary visual cortex, as well as the precuneus. In conclusion, several brain regions were activated in response to stimuli that are used clinically to evoke the VEMP. We believe that these areas are representative of the neural correlates of the VEMP.
| Author | : Seilesh Babu |
| Publisher | : Springer |
| Total Pages | : 391 |
| Release | : 2019-01-24 |
| Genre | : Medical |
| ISBN | : 3319978586 |
This text reviews the current understanding of vestibular anatomy allowing for a framework of reference, and how it's applied to vestibular testing, diagnosis and management of dizziness. Vestibular testing is an important tool in the evaluation and management of the patient with dizziness. It aids in establishing a diagnosis and determining the side or site of the lesion. In addition, it guides practitioners in selection of treatment and allows the ability of the patient’s condition to be evaluated over its time course. Common vestibular pathologies such as benign positional vertigo, Meniere’s disease, multisensory imbalance, vestibular neuritis, superior canal dehiscence, and vestibular migraine will be addressed in a concise and understandable manner. The text follows a clear format in which the etiology, pathophysiology, diagnostic features and medical or surgical management of such pathologies are discussed. The book gains increased importance as superior canal dehiscence and vestibular migraine are relatively new hot topics. Lastly, relatively rare entities such as bilateral vestibular hypofunction, pediatric vestibular disorders and central vestibular disorders are discussed. This text serves as a complete reference for clinicians, students and researchers interested in this common and severe disorder allowing for improved patient care and advancement of knowledge in the field. Chapters are written by acknowledged experts, allowing summary review of the newest and most up-to-date understanding of scientific information. Diagnosis and Treatment of Vestibular Disorders will be an invaluable resource for otolaryngologists, neurologists, otologists and neurotologists, basic science and translational researchers with interests in the vestibular system, fellows and residents in aforementioned fields, and general practitioners with an interest in patients with symptoms of dizziness.
| Author | : |
| Publisher | : Elsevier |
| Total Pages | : 428 |
| Release | : 2016-09-13 |
| Genre | : Medical |
| ISBN | : 0444634479 |
Neuro-Otology: a volume in the Handbook of Clinical Neurology series, provides a comprehensive translational reference on the disorders of the peripheral and central vestibular system. The volume is aimed at serving clinical neurologists who wish to know the most current established information related to dizziness and disequilibrium from a clinical, yet scholarly, perspective. This handbook sets the new standard for comprehensive multi-authored textbooks in the field of neuro-otology. The volume is divided into three sections, including basic aspects, diagnostic and therapeutic management, and neuro-otologic disorders. Internationally acclaimed chapter authors represent a broad spectrum of areas of expertise, chosen for their ability to write clearly and concisely with an eye toward a clinical audience. The Basic Aspects section is brief and covers the material in sufficient depth necessary for understanding later translational and clinical material. The Diagnostic and Therapeutic Management section covers all of the essential topics in the evaluation and treatment of patients with dizziness and disequilibrium. The section on Neuro-otologic Disorders is the largest portion of the volume and addresses every major diagnostic category in the field. Synthesizes widely dispersed information on the anatomy and physiology of neuro-otologic conditions into one comprehensive resource Features input from renowned international authors in basic science, otology, and neuroscience Presents the latest assessment of the techniques needed to diagnose and treat patients with dizziness, vertigo, and imbalance Provides the reader with an updated, in-depth review of the clinically relevant science and the clinical approach to those disorders of the peripheral and central vestibular system
| Author | : Robert F. Burkard |
| Publisher | : Lippincott Williams & Wilkins |
| Total Pages | : 156 |
| Release | : 2007 |
| Genre | : Medical |
| ISBN | : 9780781757560 |
Written by experts with extensive clinical and scientific experience, this comprehensive textbook presents the state of the art in auditory evoked potentials. Opening chapters explain the nature of electrical fields that generate surface recorded potentials, summarize the imaging modalities that complement evoked potential studies, and review acoustics and instrumentation. Major sections examine the anatomy and physiology of the auditory periphery, brainstem, and cortex and the principles and clinical applications of auditory, myogenic, visual, somatosensory, and vestibular evoked potentials. Chapters present hands-on laboratory exercises and clinical case studies. A full-color insert includes 3D images from multi-channel evoked potentials and functional imaging.
| Author | : Béla Büki |
| Publisher | : OUP Oxford |
| Total Pages | : 193 |
| Release | : 2013-12-19 |
| Genre | : Medical |
| ISBN | : 0191501921 |
Vertigo and dizziness rate among the most frequently occurring presenting complaints in neurology and in general medical practice. Since most patients do not have acute complaints at the time of examination, the clinician requires keen judgment in making a diagnosis, as patients often report confusing, real, or hypothetical causes of their problems. An improvement in the scientific understanding of vestibular physiology in recent years has led to the development of new diagnostic tests and more effective therapies. However, many of these advances have been slow to be adopted into routine clinical practice. Part of the Oxford Neurology Library (ONL) series, Vertigo and Dizziness helps clinicians improve their management of patients with these conditions. The text provides an overview of clinical vestibular physiology as well as of the latest developments in bedside examination, diagnosis/differential diagnosis, and state-of-the-art therapy. Vertigo and Dizziness serves as an essential clinical guide for neurologists, otorhinolaryngologists, and trainees in those disciplines, and for general practitioners and medical students.
