Vertigo Research Today is a free monthly online journal that collates and summarizes the latest research about Vertigo, including details on causes, symptoms, treatment, dizziness. | ||||||||
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Gentamicin ototoxicity: clinical features and the effect on the human vestibulo-ocular reflex.Ishiyama G, Ishiyama A, Kerber K, Baloh RW Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095, USA. gishiyama@mednet.ucla.edu CONCLUSIONS: Gentamicin ototoxicity presents with gait imbalance and oscillopsia, but only rarely with hearing loss and vertigo. Sinusoidal rotational stimuli with high accelerations such as the bedside head-thrust test or rotational step changes in velocity are useful to diagnose bilateral vestibulopathy. OBJECTIVE: To describe the salient clinical features and vestibular testing results in gentamicin ototoxicity. PATIENTS AND METHODS: A retrospective review of the quantitative vestibular function testing results for patients presenting to the UCLA Neurotology Clinic with gentamicin ototoxicity over the past 10 years (n=35). RESULTS: All patients presented with imbalance and 33 out of 35 had oscillopsia. Three patients reported a noticeable change in hearing and five reported vertigo. Of the 35 patients, 15 were in renal failure at the time of gentamicin administration. Patients with pre-existing peripheral neuropathy compensated poorly. Sinusoidal rotational testing demonstrated profoundly decreased gain and increased phase lead over the entire frequency range, with a subset of patients having relatively preserved gain at the intermediate frequencies (0.8-1.6 Hz) and low acceleration (<30 degrees/s). There was little or no response to high acceleration step changes in velocity. The time constant measured both by sinusoidal and step responses was ultra-low. All patients tested had a positive head-thrust test bilaterally. Published 22 August 2006 in Acta Otolaryngol, 126(10): 1057-61.
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