Spin-Doctor in Murwillumbah, New South Wales | Doctor

Spin-Doctor

Locality: Murwillumbah, New South Wales

Phone: +61 2 6672 7796

Address: 16 Prince Street 2484 Murwillumbah, NSW, Australia

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19.01.2022 Subliminal Passive Motion Stimulation Improves Vestibular Perception Subliminal passive motion conditioning might offer an additional treatment approach to boost previously suggested autoregulatory changes within the vestibular system (Jahn et al., 2003; Peters et al., 2016) to compensate for the loss of vestibular function. Prolonged subliminal passive motion exposure might enforce vestibular plasticity to shift vestibular sensitivity into the required working range for eff...ective balance and gaze stabilizing reflexes in the case of uncompensated vestibular hyposensitivity. Complementary, attenuation of vestibular sensitivity by prolonged exposure to excessive passive motion stimuli could serve to treat patients with vestibular hypersensitivity as suggested previously (Fitzpatrick and Watson, 2015). For example, patients with vestibular migraine, in whom vestibular perception has already been shown to be modulated by prolonged visual motion stimuli could benefit from such an intervention (Bednarczuk et al., 2019). In both cases, the present findings suggest that a generally effective conditioning stimulus would require simultaneous translational and rotatory motion exposure along multiple axes to stimulate the entire peripheral vestibular apparatus. Since the observed changes in vestibular sensitivity recede with a relatively short time constant, further research is required to examine whether longer-lasting or repetitive conditioning sessions might yield more sustained adaptions in vestibular information processing. Keywan A et al (2020) Subliminal Passive Motion Stimulation Improves Vestibular Perception. Neuroscience, 2020-08-10, Volume 441, Pages 1-7

05.01.2022 Early Signs of Thiamine Deficiency Case: a 29-year-old woman reported unsteadiness when walking, vertigo, and oscillopsia. In addition, she had prominent horizontal nystagmus. On closer examination, the patient had intermittent nystagmus that was horizontal and left beating when she was looking straight ahead, and she could not keep her eyes in an eccentric, lateral position (bilateral gaze-holding failure). Recognition of early thiamine deficiency is necessary to avoid the r...isk of permanent neurologic deficits and early death. The Wernicke triad of encephalopathy, ataxia and ophthalmoplegia may be a late manifestation of thiamine deficiency. The Caine criteria require a history of malnutrition and component of the Wernicke triad to consider the diagnosis of thiamine deficiency. The earliest sign of thiamine deficiency: Horizontal gaze-evoked nystagmus is the most common neurologic finding in a large series of patients with thiamine deficiency. Kattah J C (2020) Early Signs of Thiamine Deficiency: A Case Report. Annals of Internal Medicine, Vol. 173 No. 1, July 2020

04.01.2022 Characteristics of assessment and treatment in Benign Paroxysmal Positional Vertigo (BPPV) Laura Power et al. Journal of Vestibular Research 30 (2020) 5562 Abstract... QUESTION: Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of dizziness presenting to specialist vestibular centres and accounts for approximately 2030% of referrals to these clinics. In spite of the amount of clinical knowledge surrounding its diagnosis and management, the treatment of BPPV remains challenging for even the most experienced clinicians. This study outlines the incidence of BPPV in specialised vestibular physiotherapy clinics and discusses the various nuances encountered during the assessment and treatment of BPPV. DESIGN: Observational Study PARTICIPANTS: 314 patients with various forms of Benign Paroxysmal Positional Vertigo (BPPV) INTERVENTION: Canalith repositioning manoeuvres (CRP) for posterior canal (PC) or horizontal canal (HC) BPPV depending on the canal and variant of BPPV. OUTCOME MEASURES: Negative Dix-Hallpike (DHP) or Supine roll test (SRT) examination. RESULTS: In 91% of cases, PC BPPV was effectively treated in 2 manoeuvres or less. Similarly, 88% of HC BPPV presentations were effectively managed with 2 treatments. Bilateral PC, multiple canals or canal conversions required a greater number of treatments. There was no noticeable difference in treatment outcomes for patients who had nystagmus and symptoms during the Epley manoeuvre (EM) versus those who did not have nystagmus and symptoms throughout the EM. Nineteen percent of patients experienced post-treatment down-beating nystagmus (DBN) and vertigo or otolithic crisis after the first or even the second consecutive EM. CONCLUSION: Based on the data collected, we make several clinical recommendations for assessment and treatment of BPPV. Firstly, repeated testing and treatment of BPPV within the same session is promoted as a safe and effective approach to the management of BPPV with a low risk of canal conversion. Secondly, vertigo and nystagmus throughout the EM are not indicative of treatment success. Thirdly, clinicians must remain vigilant and mindful of the possibility of post-treatment otolithic crisis following the treatment of BPPV. This is to ensure patient safety and to prevent possible injurious falls. Our results challenge several clinical assumptions about the assessment and treatment of BPPV including the utility of certain markers of treatment success; hence influencing the current clinical guidelines and clinical practice and paving the way for future studies of the assessment and management of patients with BPPV.