急性中枢性头晕/眩晕通常为危急重症,早期明确诊断并有效治疗在急诊诊疗中至关重要。头脉冲-眼震-眼偏斜检查法(Head Impulse-Nystagmus-Test of Skew, H.I.N.T.S)是一项可有效鉴别中枢性与外周性头晕/眩晕的床旁检查法。为更好地了解H....急性中枢性头晕/眩晕通常为危急重症,早期明确诊断并有效治疗在急诊诊疗中至关重要。头脉冲-眼震-眼偏斜检查法(Head Impulse-Nystagmus-Test of Skew, H.I.N.T.S)是一项可有效鉴别中枢性与外周性头晕/眩晕的床旁检查法。为更好地了解H.I.N.T.S检查法,我们回顾了近年来国内外大量相关文献,并予以综述,同时对视眼动检查技术未来在我国急诊的临床应用进行展望。展开更多
Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the p...Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.Methods: Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity(maxSPV) > 15 deg/sec and a caloric asymmetry of≤10%. Following the caloric, patients were asked, "Did you have any sensation of motion?"Results: Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of.9 for maxSPV and 1.06 for age.Conclusions: The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo.展开更多
Vertigo is a common symptom with impact on daily life. Vertigoheel®(VH-04) has demonstrated to be effective for Vertigo in former studies. This paper aims to investigate the mode of action of the medicinal pr...Vertigo is a common symptom with impact on daily life. Vertigoheel®(VH-04) has demonstrated to be effective for Vertigo in former studies. This paper aims to investigate the mode of action of the medicinal product VH-04 in the rat brain. In an in vitro study neurophysiological recording from hippocampal slices from adult male Sprague Dawley®rats was performed in order to substantiate a possible direct effect on the brain of VH-04 in different concentrations. In an in vivo cross-over study with 11 Fischer 344®?rats, a neurophysiological method was applied to systemically analyse VH-04’s activity in the rat brain. This method combines quantitative assessments of telemetrically transmitted field potentials after drug treatment with subsequent discriminant analysis to classify the compound. The database used for the analysis of classification contained numerous chemicals and medicinal products of different dosages, all tested in the same paradigm, which is continuous wireless monitoring of the EEG of freely moving rats before and after drug intake. Following single stimuli on the Schaffer collaterals in the presence of VH-04 in different concentrations, in vitro responses of pyramidal cells increased depending on the VH-04 concentration (0.25 - 4 ml/L). Results were statistically significant for concentrations above 2.5 ml/L. Long-term potentiation was only marginally affected. Out of several specific glutamate receptor antagonists the effect of VH-04 was only antagonized by AMPA and kainic acid receptor-mediated signalling. Their enhancement indicates better information processing in the hippocampus, a brain structure primarily involved in memory processes. The in vivo characterisation of VH-04-induced changes in EEG-signatures of four brain areas (the frontal cortex (FC), the hippocampus (HC), the striatum (ST) and the reticular formation (RF)) revealed a dose-dependent attenuation of delta, theta, alpha 2 and beta 1 waves. The subsequent discriminant function analysis classified the VH-04 EEG-signature into a subset of cognition-enhancing medicinal products.展开更多
文摘急性中枢性头晕/眩晕通常为危急重症,早期明确诊断并有效治疗在急诊诊疗中至关重要。头脉冲-眼震-眼偏斜检查法(Head Impulse-Nystagmus-Test of Skew, H.I.N.T.S)是一项可有效鉴别中枢性与外周性头晕/眩晕的床旁检查法。为更好地了解H.I.N.T.S检查法,我们回顾了近年来国内外大量相关文献,并予以综述,同时对视眼动检查技术未来在我国急诊的临床应用进行展望。
文摘Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.Methods: Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity(maxSPV) > 15 deg/sec and a caloric asymmetry of≤10%. Following the caloric, patients were asked, "Did you have any sensation of motion?"Results: Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of.9 for maxSPV and 1.06 for age.Conclusions: The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo.
文摘Vertigo is a common symptom with impact on daily life. Vertigoheel®(VH-04) has demonstrated to be effective for Vertigo in former studies. This paper aims to investigate the mode of action of the medicinal product VH-04 in the rat brain. In an in vitro study neurophysiological recording from hippocampal slices from adult male Sprague Dawley®rats was performed in order to substantiate a possible direct effect on the brain of VH-04 in different concentrations. In an in vivo cross-over study with 11 Fischer 344®?rats, a neurophysiological method was applied to systemically analyse VH-04’s activity in the rat brain. This method combines quantitative assessments of telemetrically transmitted field potentials after drug treatment with subsequent discriminant analysis to classify the compound. The database used for the analysis of classification contained numerous chemicals and medicinal products of different dosages, all tested in the same paradigm, which is continuous wireless monitoring of the EEG of freely moving rats before and after drug intake. Following single stimuli on the Schaffer collaterals in the presence of VH-04 in different concentrations, in vitro responses of pyramidal cells increased depending on the VH-04 concentration (0.25 - 4 ml/L). Results were statistically significant for concentrations above 2.5 ml/L. Long-term potentiation was only marginally affected. Out of several specific glutamate receptor antagonists the effect of VH-04 was only antagonized by AMPA and kainic acid receptor-mediated signalling. Their enhancement indicates better information processing in the hippocampus, a brain structure primarily involved in memory processes. The in vivo characterisation of VH-04-induced changes in EEG-signatures of four brain areas (the frontal cortex (FC), the hippocampus (HC), the striatum (ST) and the reticular formation (RF)) revealed a dose-dependent attenuation of delta, theta, alpha 2 and beta 1 waves. The subsequent discriminant function analysis classified the VH-04 EEG-signature into a subset of cognition-enhancing medicinal products.
