[Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology]

Vision concerns after mild traumatic brain injury

OPINION STATEMENT

Mild traumatic brain injury (mTBI) can manifest with visual dysfunction including deficits in accommodation, vergence movements, versions, and field of vision as well increased photosensitivity and a decline in ocular and overall health. Patients with incomitant strabismus should be referred to an ophthalmologist for intervention. Patients with mTBI who experience photosensitivity, or deficits in accommodation, versions, vergences, or field of vision may benefit from vision rehabilitation. These therapies may include spectacles with tinting and a variety of prism combinations. Patients with chronic visual dysfunction following mTBI may benefit from occupational, vestibular, cognitive, and other forms of physical therapy.

[The evaluation of the efficiency of kinesitherapy in the patients with mixed-type vertigo]

INTRODUCTION

The aim of this work was to evaluate the efficiency of kinesitherapy in the patients with mixed-type vertigo.

MATERIAL AND METHODS

The study was conducted on a randomized group of 35 patients, 21 women and 14 men aged 24-75 years (mean age 42.5 years), who were treated at the Department of Otolaryngology and Laryngological Oncology Medical University Teaching Hospital in Lodz for mixed-type vertigo. The inclusion criteria were an interview, physical and otorhinolaryngological examinations, laboratory investigations, complete audiological and otoneurological examinations, including BERA and VNG, USG examination of the blood vessels to the cranium, and CT of the cervical spine. Each patient underwent an individually selected set of habituation exercises, corrective exercises for posture and its orientation in space through 2 months. The efficiency of the implemented therapy was evaluated after two weeks, one month and two months with the use of the complete videonystagmographic test and Silvoniemi's criteria.

RESULTS

The mean excitability of the labyrinths was 25.38 degrees/s before rehabilitation and 22.26 degrees/s after rehabilitation, absolute directional preponderance was 7.62 degrees/s and 1.92 degrees/s respectively, relative directional preponderance was 31.36 degrees/s and 12.57 degrees/s, and unilateral deficit 32.12 degrees/s and 14.34 degrees/s. The subjective evaluation of the vertigo intensification based on the 5 stages of Silvoniemi's scale indicates that the mean point-based evaluation reported by the patients at the beginning of the therapy was 3.85 points, whereas after the therapy was 2.91 points after two weeks, 2.35 points after one month, and 1.2 points after two months.

CONCLUSIONS

Kinesitherapy is an alternative and very effective method for treating mixed-type vertigo.

Analysis of visually guided eye movements in subjects after whiplash injury

OBJECTIVE

The aims of present research were to analyze the visually guided eye movements of subjects suffering from the consequences of whiplash injury and the possibility to differentiate patients from feigning subject. We analyzed the role of video-nystagmography for clinical and forensic aspects.

METHODS

It was a prospective case-control study. Detailed history was taken and patients were thoroughly investigated. Smooth pursuit and saccadic eye movements were assessed in 33 patients affected by imbalance following a whiplash injury. A control group of 20 subjects was also evaluated. All tests were executed in neutral neck position and after left and right trunk rotation.

RESULTS

The t-test, applied to all parameters showed that difference of the parameter between the groups was not statistically significant.

CONCLUSION

The visually guided eye movement evaluation does not seem to offer a clinically relevant method to differentiate patients suffering from the effects of whiplash injury from normal subjects.