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Inicio Acta Otorrinolaringológica Española Resultados del análisis videonistagmográfico (Vng) en la patología vestibular...
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Vol. 52. Issue 7.
Pages 567-574 (October 2001)
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Vol. 52. Issue 7.
Pages 567-574 (October 2001)
Resultados del análisis videonistagmográfico (Vng) en la patología vestibular post-traumática
Results Of Videonystagmographic (Vng) Analysis In Vestibular Post-Traumatic Diseases
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E. Armato1
Corresponding author
ulss13.otorino@tin.it

Enrico Armato. U.O. ORL – Ospedale di Dolo. Riviera XXIX Aprile, 2. 30031 – DOLO (Venezia) – ITALIA.
, E. Ferri
Servicio De Otorrinolaringología. Hospital Civil De Dolo. Venecia (Italia).
F. García Purrinos*
* Servicio De Otorrinolaringología, Hospital De Hellín (España).
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Resumen

Estudiamos 569 pacientes que sufrieron síndrome vertiginoso secundario a traumatismo craneal o cervical en el período comprendido entre febrero de 1998 a julio de 1999. El examen audiovestibular comprendió una audiometría tonal, potenciales evocados auditivos del tronco cerebral, examen otorrinolaringológico clínico e instrumental (pruebas calóricas, rotatorias, videonistagmograma y test de posturografía estática). El estudio oculomotor se realizó con un sistema de videonistagmografía Ulmer. El objetivo del trabajo es analizar, tanto de forma cualitativa como cuantitativa, los datos vestibulométricos y semiológicos recogidos. Queremos remarcar la incidencia estadísticamente significativa del nistagmo "up-beating" en las diversas categorías de pacientes. Proponemos una hipótesis etiopatogénica del citado nistagmus basada en una alteración de la información propioceptiva cervical y un patrón anómalo de estimulación de los otolitos. Subrayamos además la importancia del sistema videonistagmográfico que permite un análisis estandarizado y objetivo tanto con fines clínicos como médico-legales.

Palabras Clave:
Latigazo cervical
Videonistagmografía
Nistagmo vertical superior
Diagnóstico vestibular
Abstract

From February 1998 to July 1999, 569 patients affected by vestibular disorders -following a whiplash injury and/or a cranial trauma- were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

Key Words:
Whiplash injury
Videonystagmography
Up-beating Nystagmus
Vestibular diagnosis

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