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Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery 4/2019

18.02.2019 | Original Article

Brain Stem and Audio-Vestibular Regulation

verfasst von: Anupam Mishra, Subhash Chandra Mishra

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Ausgabe 4/2019

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Abstract

The central pathologies present with perverted auditory perception and compromised postural control. Considering the existing controversy this study involves assessments of 100 cases of post fossa tumefactions in which a detailed clinical and neuro-otological (pure tone audiometry, electronystagmography, brainstem evoked response audiometry) profile is compared with their imaging patterns. The CP angle schwannomas (N = 26) presented with abnormal speech tests (N = 18), abnormal auditory adaptation (N = 7) and ABR with pathologically increased latency of wave V (N = 32), poor formation of wave I (N = 31) along with abnormal inter-wave interval (N = 32). In lesions (N = 32) compressing deeper nuclei, vermis and axial parts of brain stem, a gross truncal ataxia, incoordination, nystagmus, speech defects, subtotal deafness and bilateral ABR abnormalities were observed. The abnormal optomotor activities were seen as saccadic (N = 44) and deformed slow pursuit eye movements (N = 20). Inability to sustain holding function resulted in gaze nystagmus (N = 71), and poor timing manifested as fixation overshoots (N = 42). The midline cerebellar and upper brain stem lesions revealed bilateral OKN abnormalities whereas paramedian pathology showed only ipsilateral distortion. Caloric tests revealed culmination frequency as the most sensitive parameter for assessment of the hypo-reflexia in diffuse cerebellopathies while slow phase velocity in cases of posterior fossa lesion. The caloric hypo-activity appears to be of a better localizing value than the directional preponderance. The slow pursuit tracking revealed Type III curve perhaps due to defective regulation of slow movements in partially intact cerebellum (N = 15), while gross cerebellar dysfunctioning resulted into Type IV curve (N = 5).
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Metadaten
Titel
Brain Stem and Audio-Vestibular Regulation
verfasst von
Anupam Mishra
Subhash Chandra Mishra
Publikationsdatum
18.02.2019
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe 4/2019
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-019-01612-2

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