Vibration-induced nystagmus in patients with vestibular schwannoma: Characteristics and clinical implications Jeon Mi Lee, Mi Joo Kim, Jin Won Kim, Dae.

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Presentation transcript:

Vibration-induced nystagmus in patients with vestibular schwannoma: Characteristics and clinical implications Jeon Mi Lee, Mi Joo Kim, Jin Won Kim, Dae Bo Shim, Jinna Kim, Sung Huhn Kim Clinical Neurophysiology Volume 128, Issue 7, Pages 1372-1379 (July 2017) DOI: 10.1016/j.clinph.2017.02.023 Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions

Fig. 1 (A) Measurement of slow-phase velocity (SPV). Vibration-induced nystagmus (VIN) during stimulation was recorded by videonystagmography in the dark, and SPV was calculated by dividing the degree of eye movement by the time consumed. For example, the SPV of pointed nystagmus was 23.3°/s, which was arrived at by dividing 35° by 1.5s. (B) The bithermal caloric test was performed and the canal paresis value was calculated using Jonkee’s formula. (C) Cervical vestibular evoked myogenic potential (cVEMP) responses were considered present when the peaks of p13 and n23 were reproducible. Clinical Neurophysiology 2017 128, 1372-1379DOI: (10.1016/j.clinph.2017.02.023) Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions

Fig. 2 Correlation between tumor volume and canal paresis value. The two variables exhibited a statistically significant positive correlation with each other (p=0.04, R2=0.3120). Clinical Neurophysiology 2017 128, 1372-1379DOI: (10.1016/j.clinph.2017.02.023) Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions

Fig. 3 Correlation of preoperative maximum slow-phase velocity (MSPV) of vibration-induced nystagmus (VIN) with canal paresis (CP) value (A) and tumor volume (B). Preoperative MSPV was significantly and positively correlated with both CP value and tumor volume. Although there were no significant differences in correlation between stimulation at different sites, the MSPV of VIN exhibited stronger correlation with CP value and tumor volume upon stimulation of the sternocleidomastoid (SCM) muscle than upon stimulation of other sites. Clinical Neurophysiology 2017 128, 1372-1379DOI: (10.1016/j.clinph.2017.02.023) Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions

Fig. 4 Serial postoperative maximum slow-phase velocities (MSPVs) of vibration-induced nystagmus (VIN) upon stimulation of the contralateral (A) and ipsilateral (B) mastoid processes and the contralateral (C) and ipsilateral (D) sternocleidomastoid (SCM) muscles. The MSPVs of VIN upon stimulation of the contralateral mastoid process and SCM muscle were significantly increased at 1month post-surgery (p=0.03 and 0.04, respectively). After acoustic tumor surgery, all 13 subjects exhibited VIN, which persisted without significant changes in the MSPV during the 6-month postoperative follow-up. Clinical Neurophysiology 2017 128, 1372-1379DOI: (10.1016/j.clinph.2017.02.023) Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions

Fig. 5 Correlation of change in vibration-induced nystagmus (VIN) with changes in canal paresis (CP) value (A) and tumor volumes (B). Changes in VIN and CP value were positively correlated, although no statistically significant correlation between the two parameters was observed upon stimulation of the contralateral mastoid process. The correlation between changes in VIN and CP value upon stimulation of the ipsilateral SCM muscle was stronger compared to that upon stimulation of the ipsilateral mastoid process. Changes in VIN and tumor volume were significantly correlated regardless of the site of stimulation; however, a stronger correlation between the two parameters was observed upon stimulation of the SCM muscle than upon stimulation of the mastoid process. Clinical Neurophysiology 2017 128, 1372-1379DOI: (10.1016/j.clinph.2017.02.023) Copyright © 2017 International Federation of Clinical Neurophysiology Terms and Conditions