Pub Date : 2023-09-15DOI: 10.21790/rvs.2023.22.3.59
Jong Sei Kim, Minbum Kim
During the treatment process for benign paroxysmal positional vertigo (BPPV) using the canalith repositioning procedure, the otolith can inadvertently enter the semicircular canal instead of the utricle. Canal conversion refers to the situation where the otolith enters a different semicircular canal, while reentry occurs when the otolith returns to the same semicircular canal. The occurrence of a canal conversion can complicate the accurate diagnosis and treatment of BPPV, potentially leading to misdiagnosis and unsuccessful results in the canalith repositioning procedure. In this review, we aim to summarize the incidence, clinical features, and associated risk factors of canal conversion and reentries.
{"title":"Canal Conversion and Reentry of Otolith in Benign Paroxysmal Positional Vertigo","authors":"Jong Sei Kim, Minbum Kim","doi":"10.21790/rvs.2023.22.3.59","DOIUrl":"https://doi.org/10.21790/rvs.2023.22.3.59","url":null,"abstract":"During the treatment process for benign paroxysmal positional vertigo (BPPV) using the canalith repositioning procedure, the otolith can inadvertently enter the semicircular canal instead of the utricle. Canal conversion refers to the situation where the otolith enters a different semicircular canal, while reentry occurs when the otolith returns to the same semicircular canal. The occurrence of a canal conversion can complicate the accurate diagnosis and treatment of BPPV, potentially leading to misdiagnosis and unsuccessful results in the canalith repositioning procedure. In this review, we aim to summarize the incidence, clinical features, and associated risk factors of canal conversion and reentries.","PeriodicalId":499625,"journal":{"name":"Research in vestibular science","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.21790/rvs.2023.22.3.89
Dong Hwan Kwon, Eun kyung Jeon, Young Joon Seo
Isolated infarcts of the pons (IIP) are a rare subtype of ischemic stroke, accounting for less than 1% of all strokes. It refers to a specific type of ischemic stroke that occurs within the pons region of the brain. IIP can be associated with vertebrobasilar insufficiency in certain cases. This case report describes a 64-year-old female patient who presented with acute vertigo and spontaneous nystagmus to the lesion side, ultimately diagnosed with IIP in the posterior right side of pons. Tegmental pontine infarcts typically manifest as oblique small (lacunar) infarctions that are localized in the mediolateral tegmental area of the middle to upper pons. The patient’s symptoms resolved spontaneously, but a 2-mm infarct was confirmed by brain diffusion magnetic resonance imaging. This case highlights the distinctive symptoms associated with IIP and emphasizes the importance of careful neurological examination and advanced neuroimaging techniques for accurate diagnosis.
{"title":"A Rare Case of Isolated Infarcts of the Pons with Sudden Vertigo: Clinical Features and Imaging Findings","authors":"Dong Hwan Kwon, Eun kyung Jeon, Young Joon Seo","doi":"10.21790/rvs.2023.22.3.89","DOIUrl":"https://doi.org/10.21790/rvs.2023.22.3.89","url":null,"abstract":"Isolated infarcts of the pons (IIP) are a rare subtype of ischemic stroke, accounting for less than 1% of all strokes. It refers to a specific type of ischemic stroke that occurs within the pons region of the brain. IIP can be associated with vertebrobasilar insufficiency in certain cases. This case report describes a 64-year-old female patient who presented with acute vertigo and spontaneous nystagmus to the lesion side, ultimately diagnosed with IIP in the posterior right side of pons. Tegmental pontine infarcts typically manifest as oblique small (lacunar) infarctions that are localized in the mediolateral tegmental area of the middle to upper pons. The patient’s symptoms resolved spontaneously, but a 2-mm infarct was confirmed by brain diffusion magnetic resonance imaging. This case highlights the distinctive symptoms associated with IIP and emphasizes the importance of careful neurological examination and advanced neuroimaging techniques for accurate diagnosis.","PeriodicalId":499625,"journal":{"name":"Research in vestibular science","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.21790/rvs.2023.22.3.95
Han Cheol Lee, Seungjoon Yang, Sung Huhn Kim, Seong Hoon Bae
⋅Copyright c 2023 by The Korean Balance Society. ⋅This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A 26-year-old man presented with abnormal eye movement detected during childhood. On examinations, left-beating spontaneous nystagmus and horizontal gaze-evoked nystagmus during visual fixation (Supplementary Video 1). Video-oculography revealed normal saccades and impaired smooth pursuit in the left direction. Notably, the optokinetic nystagmus was reversed (Fig. 1). Moreover, there were no significant findings in the caloric test, video head impulse test, vestibular evoked myogenic potentials and posturography assessments. Ophthalmologic examinations and brain magnetic imaging revealed unremarkable findings. Previous studies have shown that in patients with congenital ocular disease, reversed optokinetic nystagmus may appear to be either bilaterally or unilaterally [1]. The reversed optokinetic nystagmus can be explained in terms of shifts in the position of the null point which is orbital eye position at which eye velocity is zero of the nystagmus induced by the pursuit or optokinetic stimuli [2]. Reversed optokinetic nystagmus is primarily observed in individuals with congenital nystagmus but can also occur in cases of acquired neurological abnormalities in the central nervous system, cerebellum, or brainstem. The precise cause of congenital nystagmus has not been definitively identified, but it is understood to result from abnormal decussation during the neural pathway’s formation [3].
{"title":"A Case of Congenital Nystagmus Showing Reversed Optokinetic Nystagmus","authors":"Han Cheol Lee, Seungjoon Yang, Sung Huhn Kim, Seong Hoon Bae","doi":"10.21790/rvs.2023.22.3.95","DOIUrl":"https://doi.org/10.21790/rvs.2023.22.3.95","url":null,"abstract":"⋅Copyright c 2023 by The Korean Balance Society. ⋅This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A 26-year-old man presented with abnormal eye movement detected during childhood. On examinations, left-beating spontaneous nystagmus and horizontal gaze-evoked nystagmus during visual fixation (Supplementary Video 1). Video-oculography revealed normal saccades and impaired smooth pursuit in the left direction. Notably, the optokinetic nystagmus was reversed (Fig. 1). Moreover, there were no significant findings in the caloric test, video head impulse test, vestibular evoked myogenic potentials and posturography assessments. Ophthalmologic examinations and brain magnetic imaging revealed unremarkable findings. Previous studies have shown that in patients with congenital ocular disease, reversed optokinetic nystagmus may appear to be either bilaterally or unilaterally [1]. The reversed optokinetic nystagmus can be explained in terms of shifts in the position of the null point which is orbital eye position at which eye velocity is zero of the nystagmus induced by the pursuit or optokinetic stimuli [2]. Reversed optokinetic nystagmus is primarily observed in individuals with congenital nystagmus but can also occur in cases of acquired neurological abnormalities in the central nervous system, cerebellum, or brainstem. The precise cause of congenital nystagmus has not been definitively identified, but it is understood to result from abnormal decussation during the neural pathway’s formation [3].","PeriodicalId":499625,"journal":{"name":"Research in vestibular science","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135354555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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