• Title/Summary/Keyword: vestibular disorder

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Review on Physical Therapy for Patients with Vestibular Disorder

  • Kwon, Yong Hyun;Ko, Yu Min
    • The Journal of Korean Physical Therapy
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    • v.29 no.6
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    • pp.316-323
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    • 2017
  • Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.

Current diagnosis and treatment of vestibular neuritis: a narrative review

  • Ba, Chang Hoon;Na, Hyung Gyun;Choi, Yoon Seok
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.81-88
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    • 2022
  • Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

Pitfalls in the Diagnosis of Vertigo (현훈 진단에 있어 함정)

  • Kim, Hyun Ah;Lee, Hyung
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.280-288
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    • 2018
  • Vertigo/dizziness is a common complaint in patients who are seeking a primary health clinic. Vertigo is traditionally attributed to damage of the vestibular system. Many peripheral and central vestibular disorders are usually presented with vertigo. However, patients with benign paroxysmal positional vertigo (BPPV), a leading cause of vertigo, may present with postural lightheadedness, near faint, imbalance rather than true vertigo. On the contrary, patients with orthostatic hypotension may present with true spinning vertigo, not dizziness. Persistent postural perceptual dizziness, a second most common cause of dizziness (after BPPV), is mainly occurred after organic vestibular disorders such as BPPV or vestibular neuritis, and classified as a chronic functional vestibular disorder. This article describes non-vestibular disorders presenting dizziness and/or vertigos, which conditions may be misdiagnosed as structural vestibular disorders.

A Clinical Review of Peripheral Dizziness Patient-one case (末梢性 眩暈을 主症狀으로 入院한 患者 1例에 對한 症例報告)

  • Jeong Hyun-a;Yeon Kyung-jin;Roh Seok-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.2
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    • pp.146-152
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    • 2004
  • Introduction: Vertigo is one of the common symptoms that we can see often clinically. It is hallucination to motion of oneself or surroundings. Vertigo include not only simple whirling sensation but also leaning or falling down sensation. Particularly in vestibular neuritis, the principal symptoms is dizziness and accompanied by nystagmus, gait imbalance, nausea, vomiting. Cause of vestibular neuritis is inflammatory disease such as common cold. Objective: The aim of this study was to estimate the efficacy of oriental-treatment on vestibular neuritis patient Subjects: We diagnosed one patient who had severe vertigo and gait imbalance as "dizziness retention of phlegm"(담훈) and treat orientally. Conclusion: After oriental-treatment for 15 days, walk balance was improved and no more vertigo was appeared. We could assume that in the vertigo and gait inbalance due to vestibular neuritis, the acupuncture and herbal medicine can be used.

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Posttraumatic Peripheral Vertigo (외상 후 말초성현훈)

  • Yoon, Soyeon;Kim, Mi Joo;Kim, Minbum
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.125-129
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    • 2018
  • Posttraumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral, and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of posttraumatic vertigo; benign paroxysmal positional vertigo, temporal bone fracture, perilymphatic fistula, labyrinthine concussion, posttraumatic hydrops, and cervical vertigo. Since the differential diagnosis of the posttraumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of posttraumatic vertigo were described according to the current literature.

The Change of Postural Sway of Diabetic Neuropathy by Galvanic Vestibular Stimulation (평류전정자극에 의한 당뇨성 신경증 환자의 자세동요 변화)

  • Hwang, Tae-Yeun;Kim, Young-Nam;Kim, Tae-Youl;Park, Jang-Sung;Yoon, Se-Won
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.3 no.1
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    • pp.71-84
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    • 2005
  • This study had performed with purposes to analyze the influence of the change of vestibular sens, visual and proprioceptive sense to the postural sway, so as to supply the necessary clinical materials through developing the physical therapeutic interventions and assessment format for the diabetic neuropathy patients. The sample consisted of fifteen diabetic neuropathy patients with sensory disorder in their lower limbs and fifteen age-matched normal control group. Then the effect of the GVS and the visual cue open and closed to the postural sway were measured by CoP. The summary of the comparison results were obtained below. In the comparison of diabetes neuropathy patients group and age matched normal control group, however diabetes neuropathy patients group had a decrease in superficial tactile sense(p<.001) and nerve conduction velocity(p<.001), they were able to control the posture and walk. So it is, diabetes neuropaty patients had more disturbance compared with AMC group on at a hard surface, particularly in the visual cue open(p<.001) and visual cue closed(p<.01). Moreover, since diabetes neuropathy patients group had more differences in visual cue open and closed(p<. 01), GVS(p<.01), it meant that they're affected largely by vestibular sense, visual sense. In addition, since there're the largest change in doubled sense disturbance such as visual cue open and closed under GVS, it meant that compensation of other senses were quite important for the diabetes neuropathy patients' postural control. In the conclusion, diabetes neuropathy patients who decrease or lose the somatosensory system, sensory training of visual and vestibular system are likely to be quite essential to control the posture and balance.

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A Case Report of Treatment of Dizziness and Gait Disturbance, Arising from Removal of a Vestibular Schwannoma, with Jaeumkunbi-tang-gagambang and Yookmijihwang-Insamyangyoung-tang-gagambang (청신경초종 절제술 후 어지럼증 및 보행장애 호소하는 환자 자음건비탕가감방 및 육미지황합인삼양영탕가감방 투약하여 치료한 한방치험 1례)

  • Ha, You-kyoung;Kim, Su-min;Noh, Hyeon-seok;Yi, Chan-sol;Choi, Dong-jun
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.893-902
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    • 2016
  • Objective: To describe the effects of traditional Korean medicine on dizziness and gait disturbance arising after removal of a vestibular schwannoma. Methods: The patient was treated using Korean medical treatments, such as herbal medicines (Jaeumkunbi-tang-gagambang and Yookmijihwang-Insamyangyoung-tang-gagambang), acupuncture, and moxibustion. We measured the state and progress of this case with the Korean Vestibular Disorder Activities of Daily Living Scale (K-VADL), Berg Balance Scale (BBS), and a visual analogue scale (VAS). Results: After treatment, the K-VADL score decreased from 167 to 74 and the VAS score decreased from 10 to 5.7, while the BBS score increased from 3 to 42. Conclusion: Jaeumkunbi-tang-gagambang (滋陰健脾湯) and Yookmijihwang-Insamyangyoung-tang-gagambang(六味地黃湯 合 人蔘養榮湯 加減方) appear to be effective for controlling dizziness and gait disturbances occurring after removal of vestibular schwannomas.

A clinical review of Zexie-tang in vertigo and gait inbalance patients -2 case (택사탕(澤瀉湯)으로 회전성 현훈과 보행장애 치험 2례)

  • Lee, Eun;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.511-514
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    • 2000
  • We diagnosis two patients who have severe vertigo and gait inbalance as ‘dizziness due to retention of phlegm’ (痰暈) and gave Zexie-tang(澤瀉湯). They improved enable to walk balance and no more vetigo. Therefore we could assume that Ku-ren-xuan-mao(苦人眩冒) which is the main symptom of Zexie-tang means the vertigo and gait imbalance due to vestibular disorder.

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The Difference of Duration of Post-rotatory Nystagmus Test Between Normal Children and Children With Pervasive Developmental Disorder (비장애 아동과 전반적 발달장애 아동에서 회전 후 안구진탕 기간의 비교)

  • Kim, Jin-Mi;Song, Ji-Won;Hong, Eung-Kyoung;Kim, Sung-Hee;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.3 no.1
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    • pp.1-11
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    • 2005
  • Objective : The purpose of this study was to get the mean of duration of post-rotatory nystagmus test in normal children and to differentiate the duration of post-rotatory nystagmus test between normal children and children with pervasive developmental disorder. Method : 84 subjects were between 3 and 5 years of age and consisted of 64 normal children and 20 children with the pervasive developmental disorder. Analysis of the data was done by using t-test and ANOVA. Results : The results were as follows: 1. Range of duration of post-rotatory nyatagmus test in normal children was $5{\sim}22$second on left and $7{\sim}21$ second on right and the mean was 12.63 second on left and 12.59 second on right. 2. Range of duration of post-rotatory nystagmus test in children with the pervasive developmental disorder was $3{\sim}11$ second on both and the mean was 5.65 second on left and 5.60 second on right. 3. There was no significant difference between males and females with normal children in duration of post-rotatory nystagmus test. However, there was a significant difference of the mean duration between 3 and 5 years old normal group. 4. Children with pervasive developmental disorder significantly have relatively lower duration than the duration of post-rotatory nystagmus test of normal children. Conclusions : The results of the study showed significant difference between normal children and children with pervasive developmental disorder in duration of post-rotatory nystagmus test and suggest that they could be applied to the baseline of clinical therapy.

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Four Cases of Benign Paroxysmal Positional Vertigo Diagnosed as Damhun (담훈(痰暈)으로 변증된 양성 돌발성 체위성 현훈의 치험 4례)

  • Lee, Seoung-Geun;Lee, Jae-Hwa;Kim, Young-Eun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.734-739
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    • 2009
  • Benign paroxysmal positional vertigo(BPPV) is the most common peripheral vestibular disorder clinically. It causes dizziness or vertigo, lightheadedness, imbalance, and nausea. by a change of position of the head with respect to gravity. BPPV is very well explained by mechanical consequences of loose debris within the inner ear and oriental medical theory of vertigo resulting from Phlegm(痰). Therefore, for treatment of BPPV, we can consider not only oriental medical therapy but also Canalith Repositioning Procedure. We report four improved cases of dizziness patient diagnosed BPPV and Dam Hun(痰暈) treated by canalith repositioning procedure and herbal medication and acupuncture.