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Vestibular impairment in patients with Charcot-Marie-Tooth disease.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2013
Author Poretti Andrea, Palla Antonella, Tarnutzer Alexander A, Petersen Jens A, Weber Konrad P, Straumann Dominik, Jung Hans H,
Project Three-dimensional kinematical analysis of ocular motor disorders in humans
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Original article (peer-reviewed)

Journal Neurology
Page(s) 2099 - 105
Title of proceedings Neurology

Abstract

OBJECTIVE: This case-control study aimed to determine whether the imbalance in Charcot-Marie-Tooth (CMT) disease is caused only by reduced proprioceptive input or whether the involvement of the vestibular nerve is an additional factor. METHODS: Fifteen patients with CMT disease (aged 48 ± 17 years; 8 women) underwent cervical vestibular-evoked myogenic potentials, which reflect otolith-spinal reflex function, and quantitative horizontal search-coil head-impulse testing, which assesses the high-acceleration vestibulo-ocular reflex of the semicircular canals. RESULTS: Relative to healthy age-matched control subjects, cervical vestibular-evoked myogenic potentials were found to be impaired in 75% of patients (average p13 latency: 23.0 ± 2.7 milliseconds, p = 0.01; average n23 latency: 29.0 ± 1.8 milliseconds, p = 0.01) and the quantitative head-impulse test in 60% of patients (average gain ± 1 SD: 0.67 ± 0.24, p < 0.001). All patients with head-impulse test impairment also showed cervical vestibular-evoked myogenic potential abnormalities, while the reverse was not true. CONCLUSIONS: We conclude that the neuropathic process in patients with CMT disease frequently involves the vestibular nerve and that cervical vestibular-evoked myogenic potentials may be more sensitive than quantitative head-impulse testing for detecting vestibular involvement, in particular at an early disease stage
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