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Handbook of Clinical Neurology 2016The leading symptoms of bilateral vestibulopathy (BVP) are postural imbalance and unsteadiness of gait that worsens in darkness and on uneven ground. There are typically... (Review)
Review
The leading symptoms of bilateral vestibulopathy (BVP) are postural imbalance and unsteadiness of gait that worsens in darkness and on uneven ground. There are typically no symptoms while sitting or lying under static conditions. A minority of patients also have movement-induced oscillopsia, in particular while walking. The diagnosis of BVP is based on a bilaterally reduced or absent function of the vestibulo-ocular reflex (VOR). This deficit is diagnosed for the high-frequency range of the angular VOR by a bilaterally pathologic bedside head impulse test (HIT) and for the low-frequency range by a bilaterally reduced or absent caloric response. If the results of the bedside HIT are unclear, angular VOR function should be quantified by a video-oculography system (vHIT). An additional test supporting the diagnosis is dynamic visual acuity. Cervical and ocular vestibular-evoked myogenic potentials (c/oVEMP) may also be reduced or absent, indicating impaired otolith function. There are different subtypes of BVP depending on the affected anatomic structure and frequency range of the VOR deficit: impaired canal function in the low- and/or high-frequency VOR range only and/or otolith function only; the latter is very rare. The etiology of BVP remains unclear in more than 50% of patients: in these cases neurodegeneration is assumed. Frequent known causes are ototoxicity mainly due to gentamicin, bilateral Menière's disease, autoimmune diseases, meningitis and bilateral vestibular schwannoma, as well as an association with cerebellar degeneration (cerebellar ataxia, neuropathy, vestibular areflexia syndrome=CANVAS). In general, in the long term there is no improvement of vestibular function. There are four treatment options: first, detailed patient counseling to explain the cause, etiology, and consequences, as well as the course of the disease; second, daily vestibular exercises and balance training; third, if possible, treatment of the underlying cause, as in bilateral Menière's disease, meningitis, or autoimmune diseases; fourth, if possible, prevention, i.e., being very restrictive with the use of ototoxic substances, such as aminoglycosides. In the future vestibular implants may also be an option.
Topics: Bilateral Vestibulopathy; Eye Movements; Humans; Otolithic Membrane; Reflex, Vestibulo-Ocular
PubMed: 27638075
DOI: 10.1016/B978-0-444-63437-5.00017-0 -
Journal of Medical Imaging and... Dec 2012Bilateral adrenal lesions include a spectrum of disorders: neoplastic disorders (metastases, lymphoma, bilateral phaeochromocytoma, adrenocortical carcinoma and... (Review)
Review
Bilateral adrenal lesions include a spectrum of disorders: neoplastic disorders (metastases, lymphoma, bilateral phaeochromocytoma, adrenocortical carcinoma and myelolipoma); longstanding congenital adrenal hyperplasia and macronodular adrenal hyperplasia; infections such as tuberculosis, histoplasmosis and blastomycosis; adrenal haemorrhage; adrenals in hypoperfusion complex and paediatric masses. Bilateral distribution in addition to other imaging characteristics can help narrow differential diagnoses in case of adrenal masses. We present a pictorial review highlighting the adrenal lesions that can present bilaterally.
Topics: Adrenal Gland Diseases; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 23210583
DOI: 10.1111/j.1754-9485.2012.02435.x -
HNO Jul 2017Cochlear implants (CI) are standard for the hearing rehabilitation of severe to profound deafness. Nowadays, if bilaterally indicated, bilateral implantation is usually... (Review)
Review
Cochlear implants (CI) are standard for the hearing rehabilitation of severe to profound deafness. Nowadays, if bilaterally indicated, bilateral implantation is usually recommended (in accordance with German guidelines). Bilateral implantation enables better speech discrimination in quiet and in noise, and restores directional and spatial hearing. Children with bilateral CI are able to undergo hearing-based hearing and speech development. Within the scope of their individual possibilities, bilaterally implanted children develop faster than children with unilateral CI and attain, e.g., a larger vocabulary within a certain time interval. Only bilateral implantation allows "binaural hearing," with all the benefits that people with normal hearing profit from, namely: better speech discrimination in quiet and in noise, as well as directional and spatial hearing. Naturally, the developments take time. Binaural CI users benefit from the same effects as normal hearing persons: head shadow effect, squelch effect, and summation and redundancy effects. Sequential CI fitting is not necessarily disadvantageous-both simultaneously and sequentially fitted patients benefit in a similar way. For children, earliest possible fitting and shortest possible interval between the two surgeries seems to positively influence the outcome if bilateral CI are indicated.
Topics: Child; Cochlear Implantation; Cochlear Implants; Deafness; Humans; Speech Perception; Treatment Outcome
PubMed: 28702821
DOI: 10.1007/s00106-017-0370-8 -
Journal of Surgical Orthopaedic Advances 2021Lipomatosis of nerve (LN) is an intriguing pathological entity defined by the abundance of fibro-adipose tissue within the epineurium, a pathognomonic magnetic resonance... (Review)
Review
Lipomatosis of nerve (LN) is an intriguing pathological entity defined by the abundance of fibro-adipose tissue within the epineurium, a pathognomonic magnetic resonance imaging (MRI), and frequently associated nerve-territory overgrowth. A recent systematic review showed that the majority of cases are unilateral and predominately involve the median nerve. We reviewed bilateral cases of LN to further understand this pathology. We conducted a review of the literature and our institutional databases. The cases from the literature were sorted into three groups - bilaterally confirmed LN (n = 9), unilaterally confirmed, opposite side probable LN (n = 4), and probable bilateral LN (n = 10). Review of our institutional databases identified one case: a 47-year-old man. MRI revealed LN of the brachial plexus bilaterally. To our knowledge, this is the first reported case of brachial plexus LN occurring bilaterally. More research is necessary on this topic to further understand the genetic background of this entity, particularly in relationship to the overgrowth. (Journal of Surgical Orthopaedic Advances 30(1):044-049, 2021).
Topics: Humans; Lipomatosis; Magnetic Resonance Imaging; Male; Median Nerve; Middle Aged; Peripheral Nerves
PubMed: 33851914
DOI: No ID Found -
The Journal of Craniofacial Surgery Nov 2012This report describes an unusual case of bilateral buccal bifurcation cyst in a 9-year-old patient, presenting as a slight expansion in the mandibular body region in... (Review)
Review
This report describes an unusual case of bilateral buccal bifurcation cyst in a 9-year-old patient, presenting as a slight expansion in the mandibular body region in correspondence with the first permanent mandibular molar bilaterally.
Topics: Child; Cone-Beam Computed Tomography; Humans; Jaw Cysts; Mandibular Diseases; Radiography, Panoramic; Surgical Flaps
PubMed: 23172511
DOI: 10.1097/SCS.0b013e31827103b8 -
Cancer Imaging : the Official... May 2012Masses can involve the kidney unilaterally or bilaterally. The purpose of this article is to review common and uncommon adult renal masses that present bilaterally.... (Review)
Review
Masses can involve the kidney unilaterally or bilaterally. The purpose of this article is to review common and uncommon adult renal masses that present bilaterally. Clinical and imaging findings are described. Renal masses that present in a bilateral fashion can have particular clinical and imaging characteristics and knowledge of their presentation enables appropriate diagnosis and management, especially in a multidisciplinary care setting. More commonly found bilateral renal masses that are discussed include metastasis, lymphoproliferative disorders, adult polycystic kidney disease, angiomyolipomas, renal infracts and renal abscesses. Less common bilateral renal masses include transitional cell carcinoma, oncocytoma, and hematomas.
Topics: Adult; Aged; Diagnosis, Differential; Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Middle Aged; Tomography, X-Ray Computed
PubMed: 22750134
DOI: 10.1102/1470-7330.2012.0022 -
Urology Case Reports Sep 2023Both guaifenesin and dextromethorphan are routinely available nonprescription medications that are also common drugs of abuse amongst young adults. We describe a...
Both guaifenesin and dextromethorphan are routinely available nonprescription medications that are also common drugs of abuse amongst young adults. We describe a presentation of guaifenesin and dextromethorphan misuse resulting in acute renal failure due to bilateral nephrolithiasis. The patient underwent placement of bilateral ureteral stents but again formed small renal stones bilaterally. While most renal calculi are not drug-induced, this case highlights the potential for nephrolithiasis after guaifenesin and dextromethorphan ingestion. It suggests that in this combination ingestion multiple mechanisms lead to a prolonged period of nephrolith formation.
PubMed: 37455782
DOI: 10.1016/j.eucr.2023.102481 -
Cureus Sep 2023Posterior shoulder dislocations are a recognised complication of generalised seizure episodes. Although less frequent, anterior shoulder dislocations are now being...
Posterior shoulder dislocations are a recognised complication of generalised seizure episodes. Although less frequent, anterior shoulder dislocations are now being acknowledged as an emerging consequence. Particularly when they occur bilaterally, they can contribute to diagnosing a seizure disorder in a patient who shows no other signs during the post-ictal period. This article presents a case of bilateral anterior shoulder dislocations in an otherwise physically healthy young Sudanese gentleman following a generalised seizure episode on clozapine for a schizoaffective disorder. The case aims to raise awareness of the occurrence of this phenomenon and emphasises the importance of timely diagnostic testing, seizure prophylaxis, and follow-up to minimise the risk of further seizure episodes and potential consequences. Additionally, there is a discussion regarding the utility of monitoring clozapine concentrations.
PubMed: 37872936
DOI: 10.7759/cureus.45778 -
National Journal of Maxillofacial... 2020Bilateral condylar fractures are common but are frequently undertreated. In most of the cases, only one side is surgically addressed and the other side is managed...
Bilateral condylar fractures are common but are frequently undertreated. In most of the cases, only one side is surgically addressed and the other side is managed conservatively. Bilateral condylar fractures lead to loss of ramal height bilaterally, accentuated anterior open bite, disruption of articular surfaces, and disc and muscle attachments. In a mandibular bilateral condylar fracture, even though open reduction and internal fixation (ORIF) is done on one side, a patient still needs Inter Maxillary Fixation (IMF) for 2-4 weeks postoperatively to correct occlusion and deviation. The possibility of doing ORIF on the other is never explored. Here, we present two cases of bilateral condylar fracture treated both sides by ORIF. The article discusses the advantages and new approach to consider treating both sides.
PubMed: 33897196
DOI: 10.4103/njms.NJMS_10_19 -
World Neurosurgery Apr 2019Vertebral artery injury is known to potentially occur in conjunction with blunt cervical spine trauma. Rarely, these injuries present bilaterally as complete occlusions....
BACKGROUND
Vertebral artery injury is known to potentially occur in conjunction with blunt cervical spine trauma. Rarely, these injuries present bilaterally as complete occlusions. Twelve cases of bilateral vertebral artery occlusions after closed cervical spine trauma have been described in the reported data, nearly all of which demonstrated signs and symptoms of vertebrobasilar insufficiency and ischemia.
CASE DESCRIPTION
Our patient presented after a traumatic C5-C6 flexion-distraction injury that had resulted in bilateral locked facets and spinal cord injury and bilateral vertebral artery occlusions at the V1 segment. However, our patient did not show any cranial symptoms despite his neurovascular injury.
CONCLUSIONS
We present our patient's case as a rare illustration of a bilateral vertebral artery occlusion after blunt cervical spine trauma without clinical vertebrobasilar ischemic sequelae.
PubMed: 30684719
DOI: 10.1016/j.wneu.2019.01.033