TY - JOUR
T1 - Evidence of central and peripheral vestibular pathology in blast-related traumatic brain injury
AU - Scherer, Matthew R.
AU - Burrows, Holly
AU - Pinto, Robin
AU - Littlefield, Philip
AU - French, Louis M.
AU - Tarbett, Aaron K.
AU - Schubert, Michael C.
PY - 2011/6/1
Y1 - 2011/6/1
N2 - Objective: To prospectively assay the vestibular and oculomotor systems of blast-exposed service members with traumatic brain injury (TBI). Study Design: Prospective, nonblinded, nonrandomized descriptive study. Setting: Tertiary care facility (Department of Defense Medical Center). Patients: Twenty-four service members recovering from blast-related TBI sustained in Iraq or Afghanistan. InterventionS: Focused history and physical, videonystagmography (VNG), rotational chair, cervical vestibular-evoked myogenic potentials, computerized dynamic posturography, and self-report measures. Results: Vestibular testing confirms a greater incidence of vestibular and oculomotor dysfunction in symptomatic (vestibular-like dizziness) personnel with blast-related TBI relative to asymptomatic group members. VNG in the symptomatic group revealed abnormal nystagmus or oculomotor findings in 6 of 12 subjects tested. Similarly, rotational chair testing in this group revealed evidence of both peripheral (4/12) and central (2/12) vestibular pathology. By contrast, the asymptomatic group revealed less vestibular impairment with 1 of 10 rotational chair abnormalities. The asymptomatic group was further characterized by fewer aberrant nystagmus findings (4/12 abnormal VNGs). Computerized dynamic posturography testing revealed no significant differences between groups. Self-report measures demonstrated differences between groups. Conclusion: Vestibular function testing confirms a greater incidence of peripheral vestibular hypofunction in dizzy service members with blast-related TBI relative to those who are asymptomatic. Additionally, oculomotor abnormalities and/or nystagmus consistent with central involvement were present in 10 of the 24 study participants tested. The precise cause of these findings remains unknown.
AB - Objective: To prospectively assay the vestibular and oculomotor systems of blast-exposed service members with traumatic brain injury (TBI). Study Design: Prospective, nonblinded, nonrandomized descriptive study. Setting: Tertiary care facility (Department of Defense Medical Center). Patients: Twenty-four service members recovering from blast-related TBI sustained in Iraq or Afghanistan. InterventionS: Focused history and physical, videonystagmography (VNG), rotational chair, cervical vestibular-evoked myogenic potentials, computerized dynamic posturography, and self-report measures. Results: Vestibular testing confirms a greater incidence of vestibular and oculomotor dysfunction in symptomatic (vestibular-like dizziness) personnel with blast-related TBI relative to asymptomatic group members. VNG in the symptomatic group revealed abnormal nystagmus or oculomotor findings in 6 of 12 subjects tested. Similarly, rotational chair testing in this group revealed evidence of both peripheral (4/12) and central (2/12) vestibular pathology. By contrast, the asymptomatic group revealed less vestibular impairment with 1 of 10 rotational chair abnormalities. The asymptomatic group was further characterized by fewer aberrant nystagmus findings (4/12 abnormal VNGs). Computerized dynamic posturography testing revealed no significant differences between groups. Self-report measures demonstrated differences between groups. Conclusion: Vestibular function testing confirms a greater incidence of peripheral vestibular hypofunction in dizzy service members with blast-related TBI relative to those who are asymptomatic. Additionally, oculomotor abnormalities and/or nystagmus consistent with central involvement were present in 10 of the 24 study participants tested. The precise cause of these findings remains unknown.
KW - Blast
KW - Traumatic brain injury
KW - Vestibular function testing
KW - Videonystagmography
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U2 - 10.1097/MAO.0b013e318210b8fa
DO - 10.1097/MAO.0b013e318210b8fa
M3 - Article
C2 - 21358450
AN - SCOPUS:79958005788
VL - 32
SP - 571
EP - 580
JO - American Journal of Otology
JF - American Journal of Otology
SN - 1531-7129
IS - 4
ER -