Electronystagmography: Dizziness and vestibulocollic symptoms.A 50-year-old woman complained of an intermittent tingling in the back of her head that had occurred four or five times during the previous 6 months. Each episode lasted approximately 15 minutes. During this 6-month period, she had also experienced intermittent dizziness, which she described as "feeling like I'm moving back and forth." The dizzy spells had occurred three or four times. The patient was not certain that there was any connection between the tingling and the dizziness. She had experienced severe dizziness in the past, but it had cleared up with the use of an estrogen patch. She also said that she had sensed hyperacusis in her right ear for the previous 2 years and that she occasionally heard a high-pitched tone in the right ear. She also had an exquisite nuchal nuchal (nyōōˑ·k  l),adj pertaining to the posterior or nape of the neck. tenderness over the right occipital occipital /oc·cip·i·tal/ (ok-sip´i-t'l) pertaining to the occiput; located near the occipital bone. oc·cip·i·tal adj. Of or relating to the occipital bone. n. area. Neurotologic examination revealed that the woman experienced a marked difficulty in performing the sharpened tandem Romberg test with the right foot forward. She had no difficulty with the left foot forward. Electronystagmography revealed no spontaneous, positional, or neck torsion nystagmus Nystagmus Definition Rhythmic, oscillating motions of the eyes are called nystagmus. The to-and-fro motion is generally involuntary. Vertical nystagmus occurs much less frequently than horizontal nystagmus and is often, but not necessarily, a sign of . The overall nystagmus on caloric testing had a dysrhythmic pattern, mostly of an alerting nature. She exhibited no response to the warm-water stimulus on the right, which is abnormal. Yet according to Jongkees' formula, there was only a 16% reduced vestibular response on the right and a 16% directional preponderance to the left. These findings suggested that the information provided by the formula might have been misleading because the formula has an averaging effect that can diminish the importance of an absent response from one of the caloric caloric /ca·lo·ric/ (kah-lor´ik) pertaining to heat or to calories. ca·lor·ic adj. 1. Of or relating to calories. 2. Of or relating to heat. stimuli. The simultaneous binaural binaural /bi·nau·ral/ (bi-naw´r'l) pertaining to both ears. bin·au·ral adj. Having or relating to both ears. binaural pertaining to both ears. bithermal (SEB Noun 1. SEB - a form of staphylococcal enterotoxin that has been used as an incapacitating agent in biological warfare staphylococcal enterotoxin B ) revealed a type 4 response with a left-beating response to the cool stimulus. This finding also clearly pointed to an abnormally functioning vestibular system, but it had no localizing value. These results illustrate the unpredictable effect of central nervous system processing with a binaural stimulus. In addition, the patient's neck symptoms were explained by the clinical findings. From Neurotologic Associates, P.C., New York City New York City: see New York, city. New York City City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. . |
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