Michael Baxter1, Yuri Agrawal. 1. Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, U.S.A.
Abstract
OBJECTIVE: Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. PATIENT: A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. INTERVENTION: After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. MAIN OUTCOME MEASURE: VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. RESULTS: VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. CONCLUSION: We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndrome patients may be warranted.
OBJECTIVE:Turner syndrome is a well-known cause of sensorineural hearing loss, and the lack of estrogen has been implicated in cochlear dysfunction. It has never been associated with vestibular dysfunction. We report a case of a patient with Turner syndrome who was found to have bilateral vestibular dysfunction based on video-oculography (VOG) testing. PATIENT: A single patient with a history of Turner syndrome who was found to have significant bilateral vestibular dysfunction. INTERVENTION: After noticing a deficit in the vestibulo-ocular reflexes on qualitative horizontal head impulse examination, the patient underwent VOG testing. MAIN OUTCOME MEASURE: VOG testing quantatively measures angular vestibulo-ocular reflex (AVOR) gain in the horizontal semicircular canal plane. AVOR gain represents the eye movement response to a head movement; in normal individuals the eye movement is fully compensatory and gain values are close to unity. RESULTS: VOG results showed AVOR gains of 0.29 and 0.36 on the right and left sides, respectively. CONCLUSION: We have presented a case of a woman with Turner syndrome with asymptomatic vestibular dysfunction demonstrated with VOG testing. Although there is a documented relationship between Turner syndrome and sensorineural hearing loss, there are no previous studies or case reports linking Turner syndrome and vestibular dysfunction. Additional research and added vigilance in monitoring Turner syndromepatients may be warranted.
Authors: Tomoko Makishima; Kelly King; Carmen C Brewer; Christopher K Zalewski; John Butman; Vladimir K Bakalov; Carolyn Bondy; Andrew J Griffith Journal: Int J Pediatr Otorhinolaryngol Date: 2009-09-03 Impact factor: 1.675
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