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Published in: European Archives of Oto-Rhino-Laryngology 11/2023

Open Access 28-04-2023 | Hypotension | Otology

A study of otolith function in patients with orthostatic dizziness

Authors: Nada Medhat El Medany, Enaas Ahmad Kolkaila, Trandil Hassan El Mehallawi, Reham Mamdouh Lasheen

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2023

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Abstract

Background

Orthostatic dizziness (OD) is the dizziness that occurs when moving from a sitting or a supine to a standing position. It is typically thought to be connected to orthostatic hypotension (OH). The otolithic control of respiratory and cardiovascular system through vestibulosympathetic reflex has been the focus of considerable recent interest. This study aimed to evaluate the relationship between the orthostatic dizziness and otolith organ function.

Methods

This study was carried on 50 adults aged from 18 to 50 years with normal peripheral hearing. Subjects were divided into two groups: controls (GI): 20 healthy adults and study group (GII): 30 patients who were complaining of OD. Patients were submitted to; blood pressure measurement in sitting and standing positions, combined vestibular-evoked myogenic potentials (VEMPs) and subjective visual vertical and horizontal tests (SVV) and (SVH).

Results

The study group showed abnormal absent cVEMP, oVEMP. There were also statistically significant differences of P13 and N23 latencies and (P13N23) amplitudes between the two groups in the left ears. Both groups differed significantly in SVH values deviated to the left side. Study group were further subdivided into ten patients with OH and 20 patients with OD without OH. The both study subgroups showed abnormal absent cVEMP, oVEMP and abnormal SVH. OH patients showed statistically significant differences of cVEMP waves P13, N23 latencies in the left ears when compared with the control.

Conclusions

Otolith malfunction may be the cause of orthostatic dizziness (OD) in patients with and without orthostatic hypotension.
Literature
1.
go back to reference Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. Vestib Res 19:1–13CrossRef Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. Vestib Res 19:1–13CrossRef
2.
go back to reference Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I et al (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72CrossRefPubMed Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I et al (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72CrossRefPubMed
3.
go back to reference Jeon EJ, Park YS, Park SN, Park KH, Kim DH, Nam IC et al (2013) Clinical significance of orthostatic dizziness in the diagnosis of benign paroxysmal positional vertigo and orthostatic intolerance. Am J Otolaryngol 34:471–476CrossRefPubMed Jeon EJ, Park YS, Park SN, Park KH, Kim DH, Nam IC et al (2013) Clinical significance of orthostatic dizziness in the diagnosis of benign paroxysmal positional vertigo and orthostatic intolerance. Am J Otolaryngol 34:471–476CrossRefPubMed
4.
go back to reference Soliman S, Shehata W, Fatthallah A (1985) Development of Arabic Staggered Spondee Words (SSW). In: Paper presented at the 8th Ain Shams Annual Congress. 2:1220–1246 Soliman S, Shehata W, Fatthallah A (1985) Development of Arabic Staggered Spondee Words (SSW). In: Paper presented at the 8th Ain Shams Annual Congress. 2:1220–1246
5.
go back to reference Soliman SM (1976) Speech discrimination audiometry using arabic phonetically balanced words. Ain Shams Med J 27:30 Soliman SM (1976) Speech discrimination audiometry using arabic phonetically balanced words. Ain Shams Med J 27:30
6.
go back to reference Radtke A, Lempert T, von Brevern M, Feldmann M, Lezius F, Neuhauser H (2011) Prevalence and complications of orthostatic dizziness in the general population. Clin Auton Res 21:161–168CrossRefPubMed Radtke A, Lempert T, von Brevern M, Feldmann M, Lezius F, Neuhauser H (2011) Prevalence and complications of orthostatic dizziness in the general population. Clin Auton Res 21:161–168CrossRefPubMed
8.
go back to reference Bogle JM, Benarroch E, Sandroni P (2022) Vestibular-autonomic interactions: beyond orthostatic dizziness. Curr Opin Neurol 35(1):126–134CrossRefPubMed Bogle JM, Benarroch E, Sandroni P (2022) Vestibular-autonomic interactions: beyond orthostatic dizziness. Curr Opin Neurol 35(1):126–134CrossRefPubMed
9.
go back to reference Pliego A, Vega R, Gómez R et al (2021) A transient decrease in heart rate with unilateral and bilateral galvanic vestibular stimulation in healthy humans. Eur J Neurosci 54:4670–4681CrossRefPubMed Pliego A, Vega R, Gómez R et al (2021) A transient decrease in heart rate with unilateral and bilateral galvanic vestibular stimulation in healthy humans. Eur J Neurosci 54:4670–4681CrossRefPubMed
10.
go back to reference Sammon MP, Darnall RA (1994) Entrainment of respiration to rocking in premature infants: coherence analysis. J Apply Physiol 77:1548–1554CrossRef Sammon MP, Darnall RA (1994) Entrainment of respiration to rocking in premature infants: coherence analysis. J Apply Physiol 77:1548–1554CrossRef
11.
go back to reference Bisdorff A, Von Brevern M, Lempert T et al (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res 19(1–2):1–13CrossRefPubMed Bisdorff A, Von Brevern M, Lempert T et al (2009) Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res 19(1–2):1–13CrossRefPubMed
12.
go back to reference Aoki M, Sakaida Y, Tanaka K, Mizuta K, Ito Y (2012) Evidence for vestibular dysfunction in orthostatic hypotension. Exp Brain Res 217:251–259CrossRefPubMed Aoki M, Sakaida Y, Tanaka K, Mizuta K, Ito Y (2012) Evidence for vestibular dysfunction in orthostatic hypotension. Exp Brain Res 217:251–259CrossRefPubMed
13.
go back to reference Morita H, Kaji H, Ueta Y et al (2020) Understanding vestibular-related physiological functions could provide clues on adapting to a new gravitational environment. J Physiol Sci 70:17CrossRefPubMedPubMedCentral Morita H, Kaji H, Ueta Y et al (2020) Understanding vestibular-related physiological functions could provide clues on adapting to a new gravitational environment. J Physiol Sci 70:17CrossRefPubMedPubMedCentral
14.
go back to reference Kwon E, Lee JY, Kim HJ, Choi JY, Kim JS (2022) Can dyssynergia of vestibulosympathetic and baroreflexes cause vestibular syncope? The hypothesis based on the velocity-storage function. Cerebellum 21(2):244–252CrossRefPubMed Kwon E, Lee JY, Kim HJ, Choi JY, Kim JS (2022) Can dyssynergia of vestibulosympathetic and baroreflexes cause vestibular syncope? The hypothesis based on the velocity-storage function. Cerebellum 21(2):244–252CrossRefPubMed
15.
go back to reference Lin KY, Wang SJ, Young YH (2012) Vestibular-evoked myogenic potential tests in orthostatic dizziness. Clin Auton Res 22:281–287CrossRefPubMed Lin KY, Wang SJ, Young YH (2012) Vestibular-evoked myogenic potential tests in orthostatic dizziness. Clin Auton Res 22:281–287CrossRefPubMed
16.
go back to reference Ahn SH, Jeon EJ, Park YS, Kim DH, Nam IC (2015) Otolith function tests in patients with orthostatic dizziness. Res Vestib Sci 14:15–20 Ahn SH, Jeon EJ, Park YS, Kim DH, Nam IC (2015) Otolith function tests in patients with orthostatic dizziness. Res Vestib Sci 14:15–20
17.
go back to reference Alpini D, Pugnetti L, Caputo D, Cornelio F, Capobianco S, Cesarani A (2004) Vestibular evoked myogenic potentials in multiple sclerosis: clinical and imaging correlations. Mult Scler J 10:316–321CrossRef Alpini D, Pugnetti L, Caputo D, Cornelio F, Capobianco S, Cesarani A (2004) Vestibular evoked myogenic potentials in multiple sclerosis: clinical and imaging correlations. Mult Scler J 10:316–321CrossRef
18.
go back to reference Murofushi T, Halmagyi GM, Yavor RA, Colebatch JG (1996) Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis: an indicator of inferior vestibular nerve involvement? Arch Otolaryngol-Head & Neck Surg 122:845848CrossRef Murofushi T, Halmagyi GM, Yavor RA, Colebatch JG (1996) Absent vestibular evoked myogenic potentials in vestibular neurolabyrinthitis: an indicator of inferior vestibular nerve involvement? Arch Otolaryngol-Head & Neck Surg 122:845848CrossRef
19.
go back to reference Mitchell J (2005) The vertebral artery: a review of anatomical, histopathological and functional factors influencing blood flow to the hindbrain. Physiother Theory Pract 21:23–36CrossRefPubMed Mitchell J (2005) The vertebral artery: a review of anatomical, histopathological and functional factors influencing blood flow to the hindbrain. Physiother Theory Pract 21:23–36CrossRefPubMed
20.
21.
go back to reference Vingerhoets G, Stroobant N (1999I) Lateralization of cerebral blood flow velocity changes during cognitive tasks: a simultaneous bilateral transcranial Doppler study. Stroke 30:2152–2158CrossRefPubMed Vingerhoets G, Stroobant N (1999I) Lateralization of cerebral blood flow velocity changes during cognitive tasks: a simultaneous bilateral transcranial Doppler study. Stroke 30:2152–2158CrossRefPubMed
22.
go back to reference Bogle JM (2022) The role of otolith reflexes in orthostatic intolerance. Clin Auton Res 32(6):395–398CrossRefPubMed Bogle JM (2022) The role of otolith reflexes in orthostatic intolerance. Clin Auton Res 32(6):395–398CrossRefPubMed
23.
go back to reference Kim JG, Lee JH, Lee SU, Choi JY, Kim BJ, Kim JS (2022) Utricular dysfunction in patients with orthostatic hypotension. Clin Auton Res 32(6):431–444CrossRefPubMed Kim JG, Lee JH, Lee SU, Choi JY, Kim BJ, Kim JS (2022) Utricular dysfunction in patients with orthostatic hypotension. Clin Auton Res 32(6):431–444CrossRefPubMed
24.
Metadata
Title
A study of otolith function in patients with orthostatic dizziness
Authors
Nada Medhat El Medany
Enaas Ahmad Kolkaila
Trandil Hassan El Mehallawi
Reham Mamdouh Lasheen
Publication date
28-04-2023
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 11/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-07985-z

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