Case Report of Vestibular Rehabilitation in a Resistant to Treatment Patient with Saccular Abnormality

Document Type : Case Report

Author

Department of Audiology, School of Paramedical, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Purpose:
Case report of a head trauma patient with saccular abnormality who was resistant to treatment.
Clinical Findings: 
Normal results in electronystagmography and oVEMP. Results of cVEMP showed abnormal saccular function in the right side.
Diagnosis:
Vestibular abnormality because of the head trauma
Management: 
Vestibular rehabilitation
Results:
In the beginning, patient had frequent episodes of vertigo and poor balance. Results of Romberg and tandem gate were abnormal. Regular vestibular rehabilitation sessions were planned and adaptation and gaze stability exercises were used. After five months, vertigo were significantly decreased. Balance function also showed great improvements.

Keywords

References

  1. Kisilevski V, Podoshin L, Ben-David J, Soustiel JF, et al. Results of otovestibular tests in mild head injuries. Int Tinnitus J 2001; 7(2): 118-21.
  2. Thomke F, Dieterich M. Medicolegal assessment of post-traumatic vertigo. Der Nervenarzt 2011; 82(12): 1548-56.
  3. Naguib MB, Madian Y, Refaat M, Mohsen O, El et al. Characterisation and objective monitoring of balance disorders following head trauma, using videonystagmography. J Laryngol Otol 2012; 126(1): 26-33.
  4. Gurley JM, Hujsak BD, Kelly JL. Vestibular rehabilitation following mild traumatic brain injury. NeuroRehabilitation 2013; 32(3): 519-28.
  5. Scherer MR, Burrows H, Pinto R, Littlefield P, et al. Evidence of central and peripheral vestibular pathology in blast-related traumatic brain injury. Otology & neurotology 2011; 32(4): 571-80.
  6. Mallinson AI, Longridge NS. Specific vocalized complaints in whiplash and minor head injury patients. The American journal of otology 1998; 19(6): 809-13.
  7. Ernst A, Basta D, Seidl RO, Todt I, et al. Management of posttraumatic vertigo. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2005; 132(4): 554-8.
  8. Golrokhian Sani M, Ghazizadeh Hashemi A, Mokhtari Amirmajdi N, Jafarzadeh S, Firouzi M. Benign Paroxysmal Positional Vertigo and Concomitant Otolithic Dysfunction. Journal of Otolaryngology-ENT Research 2016; 5(3): 00141.
  9. Jafarzadeh S, Golrokhian-Sani MR. The challenge of vestibular rehabilitation in a patient with bilateral vestibular dysfunction following surgery: A case report. Iranian journal of otorhinolaryngology 2018; 30(3): 167-70.
  10. Jafarzadeh S, Golrokhian Sani MR. Long term medical treatment and vestibular rehabilitation in a patient with complicated active bilateral Meniere’s disease. Journal of Rehabilitation Sciences and Research 2019; 6(1): 47-50.
  11. Jafarzadeh S, Pourbakht A, Bahrami E, Jalaie S, Bayat A. Effect of Early Vestibular Rehabilitation on Vertigo and Unsteadiness in Patients with Acute and Sub-Acute Head Trauma. Iranian journal of otorhinolaryngology 2018; 30(97): 85-90.
  12. Ghazizadeh Hashemi SA, Jafarzadeh S, Haddadi Aval M, Hosseinabadi R. Ocular Motor Function in Patients with Bilateral Vestibular Weakness. Iranian journal of otorhinolaryngology 2016; 28(86): 177-81.
  13. Brantberg K. Vestibular evoked myogenic potentials (VEMPs): usefulness in clinical neurotology. Seminars in neurology 2009; 29(5): 541-7.
  14. Cal R, Bahmad Jr F. Vestibular evoked myogenic potentials: an overview. Braz J Otorhinolaryngol 2009; 75(3): 456-62.
  15. Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S. Clinical Applications and Psychometric Properties of Dizziness Handicap Inventory in English, Persian and other Languages. JPSR 2017; 6(2): 99-109. [Persian] 
  16. Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S, Daneshi A. Validity and reliability of the Persian version of the dizziness handicap inventory. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2014; 19(8): 769-75.
  17. McCaslin DL, Jacobson GP, Grantham SL, Piker EG, Verghese S. The influence of unilateral saccular impairment on functional balance performance and self-report dizziness. Journal of the American Academy of Audiology 2011; 22(8): 542-9; quiz 60-1.
  18. Lee JD, Park MK, Lee BD, Park JY, et al. Otolith function in patients with head trauma. Eur Arch Otorhinolaryngol 2011; 268(10): 1427-30.
  19. Slattery EL, Sinks BC, Goebel JA. Vestibular tests for rehabilitation: applications and interpretation. NeuroRehabilitation 2011; 29(2): 143-51.
  20. Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S. Effect of early vestibular rehabilitation on vertigo and unsteadiness of patients with acute and sub-acute head trauma. Iranian journal of otorhinolaryngology 2018; in press.
  21. Naguib MB, Madian YT. Betahistine dihydrochloride with and without early vestibular rehabilitation for the management of patients with balance disorders following head trauma: a preliminary randomized clinical trial. J Chiropr Med 2014; 13(1): 14-20.
  22. Lei-Rivera L, Sutera J, Galatioto JA, Hujsak BD, Gurley JM. Special tools for the assessment of balance and dizziness in individuals with mild traumatic brain injury. NeuroRehabilitation 2013; 32(3): 463-72.

Journal of Paramedical Sciences & Rehabilitation
Volume 8, Issue 2
July 2019
Pages 98-102

Files

Share

How to cite

Statistics