Vestibular hypersensitivity to sound - (Tullio phenomenon) - Structural and functional assessment

被引:140
作者
Watson, SRD
Halmagyi, GM
Colebatch, JG [1 ]
机构
[1] Prince Wales Hosp, Inst Neurol Sci, Randwick, NSW 2031, Australia
[2] Prince Wales Hosp, Sch Med, Randwick, NSW 2031, Australia
[3] Royal Prince Alfred Hosp, Dept Neurootol, Sydney, NSW, Australia
关键词
Tullio phenomenon; dehiscence; CT scan; vestibulocollic reflex; clicks; galvanic;
D O I
10.1212/WNL.54.3.722
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: To establish the role of high-resolution CT imaging and tests of vestibulocollic reflexes in diagnosing and understanding the pathogenesis of the Tullio phenomenon. Background: The Tullio phenomenon is a syndrome in which acoustic stimulation produces symptoms and signs of vestibular activation. It has previously been associated with an abnormally low threshold for click-evoked vestibulocollic responses and also with dehiscence of the roof of the anterior (superior) semicircular canal on high-resolution CT scans of the temporal bones. Methods: High-resolution CT scans of the temporal bones and vestibulocollic responses in sternocleidomastoid to both clicks and transmastoid galvanic stimulation (3 mA/2 msec) were studied in four patients with the Tullio phenomenon (one bilateral). Results: Click-evoked thresholds were low for all affected ears (four at 65 dB nHL, one at 55 dB nHL) and normal (>70 dB nHL) for the three unaffected ears. In contrast, galvanic-evoked vestibulocollic responses were symmetric and of normal size in all patients. The bony roof of the anterior (superior) semicircular canal was thin, possibly absent, on CT of all affected ears and also in two out of three unaffected ears. Conclusions: The normal galvanic vestibulocollic responses indicate that sound sensitivity in patients with the Tullio phenomenon is likely to occur distal to the vestibular nerve, probably at the level of the receptors. Both click hypersensitivity and dehiscence of the anterior (superior) semicircular canal are associated with the Tullio phenomenon but as the CT scan abnormality can occur in clinically unaffected ears, click testing is important for specific diagnosis. Abnormal sound sensitivity, as demonstrated by click responses, confirms that the radiologic abnormality is function significant.
引用
收藏
页码:722 / 728
页数:7
相关论文
共 31 条
[1]
BENJAMINS CE, 1938, ACTA OTO-LARYNGOL, V26, P249
[2]
Brantberg K, 1999, ACTA OTO-LARYNGOL, V119, P633
[3]
CAWTHORNE T, 1955, J Laryngol Otol, V69, P437, DOI 10.1017/S0022215100050933
[4]
MYOGENIC POTENTIALS GENERATED BY A CLICK-EVOKED VESTIBULOCOLLIC REFLEX [J].
COLEBATCH, JG ;
HALMAGYI, GM ;
SKUSE, NF .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1994, 57 (02) :190-197
[5]
Vestibular hypersensitivity to clicks is characteristic of the Tullio phenomenon [J].
Colebatch, JG ;
Day, BL ;
Bronstein, AM ;
Davies, RA ;
Gresty, MA ;
Luxon, LM ;
Rothwell, JC .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1998, 65 (05) :670-678
[6]
CURTHOYS IS, 1987, AVIAT SPACE ENVIR MD, V58, pA192
[7]
TULLIO PHENOMENON WITH TORSION OF THE EYES AND SUBJECTIVE TILT OF THE VISUAL SURROUND [J].
DEECKE, L ;
MERGNER, T ;
PLESTER, D .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1981, 374 (NOV) :650-655
[8]
ACOUSTIC RESPONSES RECORDED FROM THE SACCULAR BUNDLE ON THE 8TH NERVE OF THE GUINEA-PIG [J].
DIDIER, A ;
CAZALS, Y .
HEARING RESEARCH, 1989, 37 (02) :123-127
[9]
OTOLITH FUNCTION IN MAN - RESULTS FROM A CASE OF OTOLITH TULLIO PHENOMENON [J].
DIETERICH, M ;
BRANDT, T ;
FRIES, W .
BRAIN, 1989, 112 :1377-1392
[10]
THE TULLIO PHENOMENON AND PERILYMPH FISTULA [J].
FOX, EJ ;
BALKANY, TJ ;
ARENBERG, IK .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 1988, 98 (01) :88-89