Document Detail


Hyperventilation-induced nystagmus in peripheral vestibulopathy and cerebellopontine angle tumor.
MedLine Citation:
PMID:  17785675     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the incidence and characteristics of hyperventilation-induced nystagmus (HIN) in cerebellopontine angle (CPA) tumors and unilateral peripheral vestibulopathy (UPV), and to elucidate differential contribution of hyperventilation to bring out vestibular asymmetry between acute and chronic phases of UPV.
METHODS: We recorded horizontal HIN in 33 patients with CPA tumors and 145 with UPV. The UPV included patients of either acute (7 days or less from symptom onset, n = 47) or chronic (more than 7 days from symptom onset, n = 98) phases.
RESULTS: The incidence of HIN was higher in the CPA tumor than in the UPV group (82 vs 34%, p < 0.01) and was also higher in the acute than in the chronic UPV group (60 vs 21%, p < 0.01). Furthermore, HIN was more commonly ipsilesional (i-HIN) in the CPA tumor than in the UPV group (52 vs 8%, p < 0.01) and more commonly ipsilesional in the acute than in the chronic UPV group (21 vs 1%, p < 0.01). The patients with i-HIN and acoustic neuroma had a tendency to harbor smaller tumors and to have less severe caloric asymmetry.
CONCLUSIONS: The contribution of hyperventilation on vestibular nystagmus differs depending on the disease phase or underlying pathologies. Our study demonstrates that hyperventilation-induced nystagmus (HIN) beating to the side of reduced caloric response, hearing impairment, or abnormal auditory brainstem response responses may be a valuable sign for bedside detection of cerebellopontine angle (CPA) tumors. CPA tumor should be a prime suspicion in patients with acute vertigo and ipsilesional HIN, especially when the vertigo accompanies hearing impairments.
Authors:
K-D Choi; J S Kim; H-J Kim; J-W Koo; J H Kim; C-Y Kim; C W Oh; H J Kee
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  69     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-05     Completed Date:  2007-09-28     Revised Date:  2010-12-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1050-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cerebellar Neoplasms / diagnosis,  physiopathology*
Cerebellopontine Angle / pathology,  physiopathology*
Evoked Potentials, Auditory, Brain Stem / physiology
Female
Humans
Hyperventilation / complications,  physiopathology*
Male
Middle Aged
Nystagmus, Pathologic / etiology,  physiopathology*
Vestibular Neuronitis / diagnosis,  physiopathology*
Comments/Corrections
Erratum In:
Neurology. 2010 Nov 30;75(22):2046

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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