Reversal of paradoxical stimulation (false inversion) in perforated tympanic membranes by increasing the time of warm stimulation, evidenced by a physical model
| Autor: | Fernando de Andrade Quintanilha Ribeiro, Lucia Kazuko Nishino, Lissa Maira Matsuo |
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| Rok vydání: | 2020 |
| Předmět: |
genetic structures
Perforation (oil well) Stimulation Nystagmus Caloric test Nystagmus Pathologic 03 medical and health sciences 0302 clinical medicine Nystagmus Physiologic Caloric Tests medicine Humans Tympanic Membrane Perforation Vestibular system medicine.diagnostic_test business.industry General Neuroscience Electronystagmography Sensory Systems Peripheral Cross-Sectional Studies Otorhinolaryngology Anesthesia Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Vestibular Research. 29:309-314 |
| ISSN: | 1878-6464 0957-4271 |
| Popis: | Objective To measure the time required in patients with tympanic perforation to reverse paradoxical stimulation (reverse pseudo-nystagmus) and to create a physical model of the process. Method An analytical, observational, cross-sectional study with vestibular evaluation (electronystagmography) of 52 individuals with tympanic membrane perforation without otorrhea or concomitant disease. Increased duration of caloric stimulation in the presence of paradoxical stimulation (reverse pseudo-nystagmus) reverses nystagmic responses. Results Reversal of nystagmus was observed in 90.9% of patients. The average reversal time was 105.5 seconds. The physical model we prepared provided supporting evidenced for the effects seen in these individuals: warm stimulation in a moist environment initially caused a decrease in temperature (nystagmus to the unexpected side, which characterizes paradoxical stimulation in the warm caloric test); but, as time passed by, the moisture evaporated, and the temperature gradually increased (reversal of nystagmus). Conclusions Increasing the stimulation time can be used as a strategy to differentiate reverse nystagmus from paradoxical stimulation. Confusion is thus avoided in diagnostic findings, allowing peripheral alterations to be distinguished from central ones. |
| Databáze: | OpenAIRE |
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