Jeffrey R Hebert1,2,3, Prem S Subramanian4,5,6,7. 1. Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, 80045, USA. 2. Department of Neurology, University of Colorado School of Medicine, Aurora, CO, 80045, USA. 3. Marcus Institute for Brain Health, University of Colorado School of Medicine, Aurora, CO, 80045, USA. 4. Department of Neurology, University of Colorado School of Medicine, Aurora, CO, 80045, USA. prem.subramanian@ucdenver.edu. 5. Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, 80045, USA. prem.subramanian@ucdenver.edu. 6. Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, 80045, USA. prem.subramanian@ucdenver.edu. 7. Sue Anschutz-Rodgers UCHealth Eye Center, 1675 Aurora Ct Mail Stop F731, Aurora, CO, 80045, USA. prem.subramanian@ucdenver.edu.
Abstract
PURPOSE OF REVIEW: Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders. RECENT FINDINGS: Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke). Patients with traumatic brain injury can exhibit visual vertigo despite otherwise normal visual functioning. The effect of visual neglect on posture and balance, even in the absence of a demonstrable visual field defect, has been characterized quantitatively through gait analysis and validates the potential therapeutic value of prism treatment in some patients. In addition, the underlying neural dysfunction in visual vertigo has been explored further using functional imaging, and these observations may allow discrimination of patients with structural causes from those whose co-morbid psychosocial disorders may be primarily contributory.
PURPOSE OF REVIEW: Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders. RECENT FINDINGS:Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke). Patients with traumatic brain injury can exhibit visual vertigo despite otherwise normal visual functioning. The effect of visual neglect on posture and balance, even in the absence of a demonstrable visual field defect, has been characterized quantitatively through gait analysis and validates the potential therapeutic value of prism treatment in some patients. In addition, the underlying neural dysfunction in visual vertigo has been explored further using functional imaging, and these observations may allow discrimination of patients with structural causes from those whose co-morbid psychosocial disorders may be primarily contributory.
Authors: William V Padula; Christine A Nelson; William V Padula; Raquel Benabib; Taygan Yilmaz; Steven Krevisky Journal: Brain Inj Date: 2009-06 Impact factor: 2.311