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The aim of this study was to compare the frequency of pathological types of smooth-pursuit and saccadic movements in different localizations of vestibular lesions. We tested 112 patients using videonystagmography. The smooth pursuit was appreciated qualitatively on the basis of Malecki's patterns. We analyzed the saccadic movements taking three parameters into consideration: latency, velocity, and accuracy. The patients suffered from posterior cranial fossa lesions, supratentorial damage, and peripheral vestibular disorders. We discovered that testing of smooth pursuit and saccades was very helpful in pointing to the localization of the damage in the posterior fossa. The frequency of the pathological saccadic and eye-tracking movements was similar for the different sites of deficit inside the posterior fossa, so recognizing the precise localization of lesion in this anatomical region was difficult.

The aim of this study was to search for the reason for vertigo in children who complain of it. We tested 30 children who had been treated by a pediatrician for various diseases. We performed the detailed protocol of anamnesis, videonystagmography, posturography, and additional tests ordered by the pediatrician and then compared the results of these procedures with those of a group of 30 healthy children. Respiratory system infections, gastritis, and spondylosis were diagnosed most often by pediatricians in young people with vertigo. From videonystagmography results, we observed only four types of pathological reactions: positional nystagmus, cervical nystagmus, abnormal eye-tracking test results, and square wave abnormalities. Only 40% of children demonstrated objective signs of vertigo. Posturography results did not provide specific findings as compared with those from the healthy children. We discussed the probable reasons for vertigo, among which psychogenic origin, side effect of medications, hormonal disturbances, spondylosis, and diet errors had to be taken into consideration.

The origin of the generation of saccadic and smooth-pursuit eye movements has not been proved. The goal of the study reported here was to search for the connection of visuooculomotor reactions--saccades and eye-tracking test--with cerebellar damage. Using electronystagmography, we tested 11 patients treated with aminoglycosides because of pneumonia. After a mean of 21 days of pharmacological therapy, a neurological examination revealed cerebellar disability in all cases. On the basis of our previous studies, we suspected cortical Purkinje cell damage. In all tested patients, saccadic movements were disturbed: We observed overshoot, undershoot, and prolonged latencies. In seven patients, eye-tracking test results were not correct: We noted the degradation of the sinusoidal pattern most often. The results pointed to a connection between the generation of these two tested visuooculomotor reactions with cerebellar diseases possibly located in the cortex.

The aim of this study was to observe the usefulness of betahistine dihydrochloride--Betaserc--in therapy for vestibular disorders in patients with vertebrobasilar insufficiency. Two groups of patients, in each of which were 150 patients (mean age, 52.2 years), were tested on the basis of videonystagmography and stabilometry. Betaserc was administrated in two separate doses: 8 mg three times daily and 16 mg three times daily for 120-180 days (mean, 132 days). In every case before and after therapy, visuo-oculomotor and vestibulo-oculomotor reflexes were tested, and amplitude and velocity of the sway were measured during dynamic posturographic testing. After Betaserc treatment, pathological visuo-oculomotor reactions and pathological cervical test results disappeared in most cases: Smooth pursuit improved in 59.9% of cases and saccadic movements in 55.9% of patients, and cervical nystagmus disappeared in 62.2% of tested people. During stabilometry, mean and maximal platform amplitude and mean head velocity decreased as compared with results from tests performed before treatment. These observations were significant after the greater dose of Betaserc; nonetheless, improvement was noted after both doses. The usefulness of Betaserc in vertebrobasilar insufficiency was proved, 4-6 months' therapy was sufficient, and the effect on central compensation seemed to be most probable.

The aim of this study was to evaluate the usefulness of ozone and pressure-pulse therapies in treating Ménière's disease. Using objective otoacoustic emissions and short-increment sensitivity index (SISI) tests together with subjective anamnesis, we tested 15 patients (8 men, 7 women) who had suffered from Ménière's disease for 1-3 years and had permanent sensorineural hypoacusis; we compared results before and after treatment. We performed ozone therapy and pressure-pulse treatments simultaneously for one 10-minute session each day for 10 consecutive days. After treatment, both otoacoustic-spontaneous and transiently evoked emissions and SISI test results exhibited no statistically significant changes. However, the subjective state of the patients was clearly improved. The frequency, severity of attacks, and tinnitus decreased. The mechanism of such an improvement is discussed.

Vertigo, tinnitus, and hearing loss are common complaints among populations of industrial countries, especially in persons older than 40 years. Numerous agents are known to incite vertigo, tinnitus, and hearing loss, among them hyperinsulinemia, diabetes mellitus, and hyperlipidemia. In this study, we proposed to assess the occurrence of hyperinsulinemia, diabetes mellitus, and hyperlipidemia in patients suffering from vertigo, tinnitus, or hearing loss of unknown origin. Results of various tests in 48 patients were compared to those in 31 control subjects. Assessments of body mass index, blood pressure, and laryngological, audiometric, and electronystagmographic parameters were performed in all study participants. An oral glucose tolerance test was used to evaluate insulin levels, and lipoprotein phenotyping served to determine cholesterol, triglyceride, and lipoprotein levels. Patients were found to be significantly more overweight (on the basis of body mass index) than were the control subjects. Hypertension was more common among patients than controls, but the difference was significant only between the men in the two groups. Disturbances of glucose metabolism were found in 27.1% of patients but in only 9.7% of controls. Diabetes mellitus was not present in any controls but was identified in four patients. Hyperinsulinemia was almost twice as common in patients as in controls. Only the occurrence of hyperlipoproteinemia seemed not to differ between patients and control subjects. We conclude that such disturbances of glucose metabolism as diabetes mellitus and hyperinsulinemia may be responsible for inner ear diseases, whereas the role of disturbances of lipid metabolism remains vague.

Using electronystagmography, we tested 100 patients (ages 65-80 years) manifesting the clinical signs of presbyvertigo, for the purpose of demonstrating their visuoocular reflexes. We administered not only simple optokinetic and eye-tracking stimuli but caloric modification of each one as well (with contrary directed optokinetic trace movement). The results were compared with those obtained in a group of 40 healthy subjects between the ages of 20 and 25 years. In the older group, we observed a statistically significant increased frequency of asymmetry of optokinetic nystagmus and pathological patterns revealed by the eye-tracking test and caloric modification of both the optokinetic and eye-tracking tests. We discuss the hypothetical predominant localization of age-dependent changes, with emphasis on the disturbances of visual-vestibular integration, on the basis of data obtained from anamnesis and other electronystagmographic findings.

The authors reached the neurological and psychiatric diagnosis of chronic schizophrenia in 20 patients after examination of both vestibulooculomotor and visuooculomotor reflexes on electronystagmography. The type and intensity of the disease were established on adequate scales, and the entire group was tested in the remission stage, during the absence of psychotic signs. Electronystagmographic study, particularly the eye-tracking test with caloric modification, revealed the significant pathology of optokinetic nystagmus. The disturbances of the suppression effect of fixation on caloric nystagmus were observed in one-half the cases. Caloric stimulation demonstrated no case of canal paresis and a very small amount of directional preponderance.