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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer Berlin Heidelberg

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DOI

10.1016/0140-6701(95)97168-j

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1432-1459

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Masticationinduced vertigo and nystagmus

Authors: SeongHo Park HyoJung Kim JiSoo Kim JaWon Koo Seo Won Oh DongUk Kim JoonTae Kim Miriam Welgampola Franca Deriu
Publish Date: 2013/12/31
Volume: 261, Issue: 3, Pages: 480-489
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Abstract

Even though trigeminovestibular connections are well established in animals masticationinduced dizziness has been described only as a vascular steal phenomenon in humans We determined induction or modulation of nystagmus in two index patients with masticationinduced vertigo 12 normal controls and 52 additional patients with peripheral n = 38 26 with vestibular neuritis/labyrinthitis and 12 with Meniere’s disease or central n = 14 11 with Wallenberg syndrome two with cerebellar infarction and one with pontine infarction vestibulopathy during their acute or compensated phase Both index patients developed masticationinduced vertigo after near complete resolution of the spontaneous vertigo from presumed acute unilateral peripheral vestibulopathy The nystagmus and vertigo gradually built up during mastication and dissipated slowly after cessation of mastication Brain MRI and cerebral angiography were normal in these patients Mastication did not induce nystagmus in normal controls However mastication induced nystagmus in five 24  of the 21 patients without spontaneous nystagmus SN but with a previous history of a vestibular syndrome and either increased 21/31 68  or decreased 7/31 23  the SN in almost all the patients 28/31 90  with SN Mastication may induce significant vertigo and nystagmus in patients with a prior history of acute vestibulopathy The induction or modulation of nystagmus by mastication in both peripheral and central vestibulopathies supports trigeminal modulation of the vestibular system in human The gradual buildup and dissipation suggest a role of the velocity storage mechanism in the generation of masticationinduced vertigo and nystagmusThe authors are grateful to Professor Thomas Brandt for his helpful comments in preparing this manuscript This study was supported by a grant from the Korea Medical Devices Industrial Cooperative Association and the Small and Medium Business Administration 082011065Dr Kim serves as an Associate Editor of Frontiers in Neurootology and on the editorial boards of the Journal of Korean Society of Clinical Neurophysiology Research in Vestibular Science Journal of Clinical Neurology Frontiers in Neuroophthalmology Journal of Neuroophthalmology and Case Reports in Ophthalmological Medicine he has received research support from SK Chemicals Co Ltd SH Park JW Koo DU Kim JT Kim HJ Kim Oh Welgampola and Deriu report no conflicts of interest

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