• Journal of Audiology & Otology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• The Korean Journal of Physiology and Pharmacology
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• v.7 no.2
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• pp.73-77
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• 2003

The effects of nitric oxide on the vestibular function recovery following unilateral labyrinthectomy (UL) were studied. Sprague-Dawley male rats, treated with nitric oxide liberating agent sodium nitroprusside (SNP) and NOS inhibitor $N^G$-nitro-L-arginine methyl ester (L-NAME), were subjected to destruction of the unilateral vestibular apparatus, and then spontaneous nystagmus was observed in the rat. To explore the effects of nitric oxide on the neuronal excitability, whole cell patch clamp technique was applied on isolated medial vestibular nuclear neurons. The frequency of spontaneous nystagmus in SNP treated rats was lesser than that of spontaneous nystagmus in control animals. In contrast, pre-UL treatment with L-NAME resulted in a significant increase in spontaneous nystagmus frequency. In addition, SNP increased the frequency of spontaneous action potential in isolated medial vestibular nuclear neurons. Potassium currents of the vestibular nuclear neurons were inhibited by SNP. After blockade of calcium dependent potassium currents by high EGTA (11 mM) in a pipette solution, SNP did not inhibit outward potassium currents. 1H-[1,2,4] oxadiazolo [4,3-a] quinozalin-1-one (ODQ), a specific inhibitor of soluble guanylyl cyclase, inhibited the effects of SNP on the spontaneous firing and the potassium current. These results suggest that nitric oxide after unilateral labyrinthectomy would help to facilitate vestibular compensation by inhibiting calcium-dependent potassium currents through increasing intracellular cGMP, and consequently would increase excitability in ipsilateral vestibular nuclear neurons.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.3
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• pp.263-273
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• 1997

The purpose of this study was to evaluate the effects of electrical stimulation on vestibular compensation following ULX in rats. Electrical stimulation (ES) with square pulse ($100{\sim}300uA$, 1.0 ms, 100 Hz) was applied to ampullary portion bilaterally for 6 and 24 hours in rats receiving ULX. After ES, animals that showed the recovery of vestibular symptoms by counting and comparing the number of spontaneous nystagmus were selected for recording resting activity of type I, II neurons in the medial vestibular nuclei (MVN) of the lesioned side. And then the dynamic neuronal activities were recorded during sinusoidal rotation at a frequency of 0.1 Hz and 0.2 Hz. The number of spontaneous nystagmus was significantly different 24 hours (p<0.01, n=10), but not 6 hours after ULX+ES. As reported by others, the great reduction of resting activity only in the type I neurons ipsilateral to lesioned side was observed 6, 24 hours after ULX compared to that of intact labyrinthine animal. However, the significant elevation (p<0.01) of type I and reduction (p<0.01) of type II neuronal activity were seen 24 hours after ULX+ES. Interestingly, gain, expressed as maximum neuronal activity(spikes/sec)/maximum rotational velocity(deg/sec), was increased in type I cells and decreased in type II cells 24 hours after ULX+ES in response to sinusoidal rotation at frequencies of both 0.1 Hz and 0.2 Hz. This result suggests that accompanying the behavioral recovery, the electrical stimulation after ULX has beneficial effects on vestibular compensation, especially static symptoms (spontaneous nystagmus), by enhancing resting activity of type I neurons and reducing that of type II neurons.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.3
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• pp.275-284
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• 1997

Unilateral labyrinthectorny (ULX) causes autonomic symptoms, ocular and postural asymmetries, which disappear over tune in the process of equilibrium recovery known as vestibular compensation. In the present study in order to elucidate mechanisms responsible for the effects of electrical stimulation on vestibular compensation and investigate the relationship between vestibular compensation and c-Fos expression in the medial vestibular nuclei following ULX, we measured spontaneous nystagmus, eye movement induced by sinusoidal rotation and c-Fos expression or to 72 hs after ULX in Sprague-Dawley rats. Experimental animals were divided into two groups: ULX group with ULX only, and electrical stimulation (ES) group with electrical stimulation of $-2{\sim}-5V$, 1.0ms, 100 Hz to the lesioned vestibular system for 4 hs/day. Spontaneous nystagmus following ULX disappeared by 72 hs in ULX group and 36 hs in ES group. In eye movement induced by sinusoidal rotation, normal pattern of eye movement by rotation toward the lesioned side was recovered 24 hs after ULX at rotation of 0.1 Hz and 6 hs after at 0.2 Hz, 0.5 Hz in ULX group. In ES group, the eye movement recovered after 12 hs at 0.1 Hz, 6 hs at 0.2 Hz, and 4 hs at 0.5 Hz. Directional Preponderance which represents the symmetry of bilateral vestibular functions showed significantly early recovery in ES group compared with that of ULX group. Expression or c-Fos immunoreactive cells in the bilateral medial vestibular nuclei was severely asymmetrical till 36 hs in ULX group, and then it became a symmetry and disappeared after 72 hs. However, ES group showed the symmetry of c-Fos expression after 6 hs, which was significantly early recovery in 25 group. All these findings suggest that electrical stimulation ameliorates recovery of vestibuloocular reflex following ULX by the restoration of the balance of the resting activity between bilateral medial vestibular nuclei. In addition, c-Fos expression in the medial vestibular nuclei could be used as a marker of vestibular compensation since c-Fos expression is closely related to the course of recovery following ULX.

• Annals of Clinical Neurophysiology
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• v.9 no.1
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• pp.1-4
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• 2007

Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. This review focuses on two common presentations of spontaneous vertigo: acute prolonged spontaneous vertigo and recurrent spontaneous vertigo. Common causes of acute prolonged spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. The history and detailed neurological/neurotological examinations usually provide the key information for distinguishing between peripheral and central causes of vertigo. Brain MRI is indicated in any patient with acute vertigo accompanied by abnormal neurological signs, profound imbalance, severe headache, and central patterns of nystagmus. Recurrent spontaneous vertigo occurs when there is a sudden, temporary, and largely reversible impairment of resting neural activity of one labyrinth or its central connections, with subsequent recovery to normal or near-normal function. Meniere's disease, migrainous vertigo, and vertebrobasilar insufficiency (VBI) are common causes. The duration of the vertigo attack is a key piece of information in recurrent spontaneous vertigo. Vertigo of vascular origin, such as VBI, typically lasts for several minutes, whereas recurrent vertigo due to peripheral inner-ear abnormalities lasts for hours. Screening neurotological evaluations, and blood tests for autoimmune and otosyphilis are useful in assessment of recurrent spontaneous vertigo that are likely to be peripheral in origin.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.5
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• pp.505-513
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• 1997

To search the correlations between electrical activity and c-Fos expression in the process of vestibular compensation, we examined the changes of those two parameters in the medial vestibular nuclei (MVN) of unilaterally labyrinthectomized (ULX) rats. Spontaneous nystagmus with fast component toward the intact side disappeared gradually within 48 hours. Fourty eight hours after ULX, directional preponderance of the eye movement induced by sinusoidal rotation of the whole body which represents the symmetry of bilateral vestibular functions showed less than 20% by rotation of 0.1, 0.2, and 0.5 Hz, indicating the recovery of symmetry in bilateral vestibular functions. Six hours after ULX, spontaneous electrical activity of type I neurons resulted in asymmetry between bilateral MVN, however, the asymmetry of the electrical activity was decreased 48 hours after ULX. Immunocytochemical staining revealed that ULX produced dramatic induction of c-Fos positive cells in the MVN bilaterally. The number of c-Fos immunoreactive cells in the contralateral MVN was significantly higher than those in the ipsilateral MVN (p＜0.0001) 2 hours after ULX. Thereafter, the number of c-Fos positive cells decreased bilaterally and was slightly, but not significantly higher in the ipsilateral MVN at 48 hours after ULX. The present results suggest that both electrical activity of type I neurons and c-Fos expression in MVN following ULX will reflect underlying mechanisms of recovery process of vestibular compensation.

• The Korean Journal of Physiology and Pharmacology
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• v.5 no.2
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• pp.123-131
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• 2001

To investigate the effects of electrical stimulation on vestibular compensation, which is the recovery of vestibular symptoms following unilateral labyrinthectomy (UL), intermittent electrical stimulation was applied to the injured vestibular portion in Sprague-Dawley rats. Vestibuloocular and vestibulospinal reflexes, electrical activity and expression of c-Fos protein in medial vestibular nuclei (MVN) were measured with time following UL. Spontaneous nystagmus occurred with frequency of $2.9{\pm}0.2$ beats/sec at 2 hours after UL and disappeared after 72 hours. Electrical stimulation decreased the frequency of nystagmus significantly till 24 hours after UL. Roll head deviation was $107{\pm}9.7^{\circ}$ at 2 hours after UL and the deviation was maintained till 72 hours, but electrical stimulation decreased the deviation significantly 6 hours after UL. Resting activity of type I neurons in ipsilateral MVN to the injured vestibular side decreased significantly compared with control at 6 and 24 hours after UL, but the activity of type I neurons was recovered to control level by electrical stimulation at 24 hours after UL. Gain of type I neurons induced by sinusoidal rotation of 0.1 Hz decreased significantly till 24 hours after UL, but electrical stimulation restored the activity at 24 hours. The gain of type II neurons decreased significantly at 6 hours after UL, but electrical stimulation restored the activity. Expression of c-Fos protein was asymmetric between bilateral MVN till 24 hours after UL, but the asymmetry disappeared by electrical stimulation 6 hours after UL. These results suggest that electrical stimulation to the injured vestibular portion facilitates vestibular compensation following UL by restoration of symmetry of neuronal activity between bilateral vestibular nuclei resulting from increased activity in ipsilateral vestibular nuclei to the injured side.

• The Journal of Korean Medicine
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• v.20 no.3 s.39
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• pp.66-76
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• 1999

The purpose of this study was to asses the etlect of Uncaria rhynchophylla (UR). one of the oriental herbs having a capability to block calcium channels, on affecting vestibular compensation (VC) in Sprague - Dawley rats. Animals were divided into a drug treatment group receiving, UR per oral for 10 days preceding unilateral labyrinthectomy (ULX) and a control group with saline ingestion, To evaluate behavioral changes. horizontal spontaneous nystagmus (SN) and roll head tilt (RHT) were recorded by a video camem with zoom lens in the course of vestibular compensation (VC). Immunohistochemical staining was performed by conventional ABC method to visualize cFos-like immunoreactive (cFLI) neurons in the medial vestibular nuclei (MVN) and cFLI cells were counted by image analyzer. Bodyweight was increased significantly, about 35g, by UR treatment for 10 clays before ULX. Compared with the control group, the drug group showed significant reduction of RHT 6 hrs after ULX as well as fast disappearance of SN at early stages of vestibular compensation. Also, recovery of the spatial and temporal cFLI expressions in the bilateral MVN was accelerated 24 hrs after ULX. These results suggest that Uncaria rhynchophyila has a beneficial effect to ameliorate vestibular compensation in unilateral labryinthectomized rats.