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Vestibular Assessment in Patients with Persistent Symptoms of Mild Traumatic Brain Injury

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Aim

The estimated worldwide incidence of TBI is 10 million cases per year. Dizziness and imbalance are two common symptoms in mild TBI (mTBI). In about 10–15% of TBI patients, these symptoms remain for a long time and may show no recovery. These persistent symptoms may relate to different factors including vestibular abnormalities. The aim of this study is a vestibular assessment of patients with persistent symptoms of mTBI by different tests including computerized dynamic posturography.

Materials and Methods

21 patients with mTBI evaluated in this study. Patients were civilians with persistent symptoms. TBI did cause by blunt force trauma (mainly from falling) in the past 6 months. They had normal neurologic and musculoskeletal assessments and no temporal bone fracture. Several auditory and vestibular evaluations were performed for each patient. They included: case history, otoscopy, pure tone and speech audiometry, tympanometry, vestibular bedside examination (spontaneous nystagmus, gaze, saccade, pursuit, Dix–Hallpike maneuver, side-lying maneuver, roll, and Romberg test), cervical Vestibular Myogenic Evoked Potential (c-VEMP), Computerized Dynamic Posturography (CDP) and Dizziness Handicap Inventory (DHI).

Results

Patients showed hearing loss in 10 (47.6%) and tinnitus in 4 (19.0%) cases. In ocular motor tests, patients had the most abnormal results in the pursuit test. 6 patients also had Benign Paroxysmal Positional Vertigo (BPPV) in the posterior canal. c-VEMP showed abnormal saccular function in 14 patients. In CDP, the composite scores were decreased relative to normal populations.

Conclusion

vestibular tests showed abnormal results in most patients. Vestibular abnormality could relate to persisting symptoms of mTBI patients.

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Acknowledgements

Authors thank patients. This article is derived from the Ph.D thesis of the first author.

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Authors and Affiliations

  1. Department of Audiology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

    Sadegh Jafarzadeh

  2. Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

    Akram Pourbakht

  3. Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran

    Eshagh Bahrami

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  1. Sadegh Jafarzadeh
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Correspondence to Sadegh Jafarzadeh.

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All procedures performed in study involving human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. This study accepted by the Ethics Committee of Tehran University of Medical Sciences (Project Number: 91/d/130/3430).

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Jafarzadeh, S., Pourbakht, A. & Bahrami, E. Vestibular Assessment in Patients with Persistent Symptoms of Mild Traumatic Brain Injury. Indian J Otolaryngol Head Neck Surg 74 (Suppl 1), 272–280 (2022). https://doi.org/10.1007/s12070-020-02043-0

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