Periferik Vestibüler Fonksiyon Bozukluğu Olan Hastalarda Okülomotor Test Değişiklikleri

Öz

Amaç: Periferik vestibüler hipofonksiyon tek taraflı veya bilateral olarak görülebilir. Çalışmanın amacı tek taraflı ve bilateral periferik vestibüler zayıflığı olan hastalarda okülomotor test sonuçlarını araştırmaktır. Gereç ve Yöntemler: Çalışmaya, kalorik test sonucuna göre normal periferik vestibüler sistemi olan 35 hasta, idiopatik tek taraflı periferik vestibüler zayıflığı olan 35 hasta ve idiopatik bilateral periferik vestibüler zayıflığı olan 30 hasta dahil edildi. Tüm hastalara sakkad test, smooth pursuit test ve optokinetik testlerden oluşan okülomotor testler yapıldı ve değerlendirildi.Bulgular: Smooth pursuit testi açısından tek taraflı periferik vestibüler zayıflığı olan 35 hastanın %14,2 5’inde, bilateral periferik vestibüler zayıflığı olan 30 hastanın %30,0 9ʼunda patoloji gözlenirken, kontrol grubunda patoloji gözlenmedi.Sonuç: Smooth pursuit patolojisi hem tek taraflı periferik vestibüler zayıflığı olan hem de bilateral periferik vestibüler zayıflığı olan hastalarda görülebilir. Optokinetik test ve sakkad test tek taraflı veya bilateral periferik vestibüler zayıflıktan etkilenmez

Anahtar Kelimeler

• Kalorik test, Okülomotor test, Periferik vestibüler disfonksiyon

Oculomotor Test Changes in Patients with Peripheral Vestibular Dysfunction

Öz

Objective: Peripheral vestibular hypofunction can be seen unilaterally or bilaterally. The aim of this study is to investigate the oculomotor test results in patients with unilateral and bilateral peripheral vestibular weakness.Material and Methods: The study consisted of 35 patients with a normal peripheral vestibular system, 35 patients with idiopathic unilateral peripheral vestibular weakness and 30 patients with idiopathic bilateral peripheral vestibular weakness according to the caloric test. Oculomotor tests including saccade, smooth pursuit and optokinetic tests were performed and evaluated in all patients.Results: A pathology was observed in 5 of 35 14.2% patients with unilateral vestibular weakness and 9 of 30 30.0% patients with bilateral vestibular weakness while no pathology was observed in the control group in terms of smooth pursuit. Conclusion: Smooth pursuit pathology can be seen both in patients with unilateral vestibular weakness and bilateral vestibular weakness. The optokinetic test and saccade test are not affected by unilateral vestibular weakness or bilateral vestibular weakness

Anahtar Kelimeler

• Caloric tests, Oculomotor test, Peripheral vestibular dysfunction

Kaynakça

1. 1. Li CM, Hoffman HJ, Ward BK, Cohen HS, Rine RM. Epidemiology of dizziness and balance problems in children in the United States: A population-based study. J Pediatr 2016; 171:240-7.e1-3.
2. 2. Shahrami A, Norouzi M, Kariman H, Hatamabadi HR, Arhami Dolatabadi A. True vertigo patients in emergency department; an epidemiologic study. Emerg (Tehran) 2016; 4(1):25-8.
3. 3. Valovich McLeod TC, Hale TD. Vestibular and balance issues following sport-related concussion. Brain Inj 2015; 29(2):175-84.
4. 4. Corwin DJ, Wiebe DJ, Zonfrillo MR, Grady MF, Robinson RL, Goodman AM, Master CL. Vestibular deficits following youth concussion. J Pediatr 2015; 166(5):1221-5.
5. 5. Arnold SA, Stewart AM, Moor HM, Karl RC, Reneker JC. The effectiveness of vestibular rehabilitation interventions in treating unilateral peripheral vestibular disorders: A systematic review. Physiother Res Int 2017; 22(3). DOI: 10.1002/pri.1635.
6. 6. Brodovsky JR, Vnenchak MJ. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction.Phys Ther 2013; 93(3):293-8.
7. 7. Karapolat H, Celebisoy N, Kirazli Y, Ozgen G, Gode S, Gokcay F, Bilgen C, Kirazli T. Is vestibular rehabilitation as effective in bilateral vestibular dysfunction as in unilateral vestibular dysfunction? Eur J Phys Rehabil Med 2014; 50(6):657-63.
8. 8. Mostafa BE, Kahky AO, Kader HM, Rizk M. Central vestibular dysfunction in an otorhinolaryngological vestibular unit: Incidence and diagnostic strategy. Int Arch Otorhinolaryngol 2014; 18(3):235-8.

9. 9. Doettl SM, Plyler PN, McCaslin DL, Schay NL. Pediatric oculomotor findings during monocular videonystagmography: A developmental study. J Am Acad Audiol 2015; 26(8):703-15.
10. 10. Tuma VC, Ganança CF, Ganança MM, Caovilla HH. Oculomotor evaluation in patients with peripheral vestibular dysfunction. Braz J Otorhinolaryngol 2006; 72(3):407-13.
11. 11. Ghazizadeh Hashemi SA, Jafarzadeh S, Haddadi Aval M, Hosseinabadi R. Ocular motor function in patients with bilateral vestibular weakness. Iran J Otorhinolaryngol 2016; 28(86):177-81.
12. 12. Kayabası S, Iriz A, Cayönü M, Cengiz B, Acar A, Boynueğri S, Mujdeci B, Eryılmaz A. Vestibular functions were found to be impaired in patients with moderate to severe obstructive sleep apnea. Laryngoscope 2015; 125:1224-8.
13. 13. Katz J, Chasin M, English K, Hood L, Tillery K. Handbook of clinical audiology, 7th ed, Philadelphia: Wolters Kluwer, 2015: 414.
14. 14. Wuyts F, Boniver R. Normative data in ENG and VNG. B-ENT 2008; 4: 45-7.
15. 15. Yorke AM, Smith L, Babcock M, Alsalaheen B. Validity and reliability of the vestibular/ocular motor screening and associations with common concussion screening tools. Sports Health 2017; 9(2):174-80.
16. 16. Mucha A, Collins MW, Elbin RJ, Furman JM, TroutmanEnseki C, DeWolf RM, Marchetti G, Kontos AP. A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: Preliminary findings. Am J Sports Med 2014; 42(10):2479-86.
17. 17. Brandt T, Strupp M. General vestibular testing. Clin Neurophysiol 2005; 116(2):406-26.
18. 18. Koo JW, Kim JS, Hong SK. Vibration-induced nystagmus after acute peripheral vestibular loss: Comparative study with other vestibule-ocular reflex tests in the yaw plane. Otol Neurotol 2011; 32(3):466-71.
19. 19. Gonçalves DU, Felipe L, Lima TM. Interpretation and use of caloric testing. Braz J Otorhinolaryngol 2008; 74(3):440-6.
20. 20. Guinand N, Pijnenburg M, Janssen M, Kingma H. Visual acuity while walking and oscillopsia severity in healthy subjects and patients with unilateral and bilateral vestibular function loss. Arch Otolaryngol Head Neck Surg 2012; 138(3):301-6.
21. 21. Oh SY, Kim DH, Yang TH, Shin BS, Jeong SK. Clinical classification and neuro-vestibular evaluation in chronic dizziness. Clin Neurophysiol 2015; 126(1):180-6.