RESUMO
OBJECTIVE: To determine whether vestibular autorotation tests (VAT) would show significant differences in vestibular oculomotor reflex (VOR) parameters in vertiginous patients before and after treatment with flunarizine. STUDY DESIGN: Prospective study in a tertiary referral academic center. METHODS: Twenty-three patients (10 men, 13 women, mean age 45.57 years, mean length of disease 99.48 days, mean treatment 38.61 days), with vertigo due to vestibular neuritis, underwent VAT testing before and after treatment with 5 mg of flunarizine daily. RESULTS: The parameter improvement value (IV) resulted from subtracting posttreatment from pretreatment VAT numerical values. Regarding subjective improvement, 3 patients (13%) said they had none, 5 (21.7%) expressed moderate progress, 9 (39.1) considered the results satisfactory, and 6 (26%) became asymptomatic. The VAT results gave high positive IV for horizontal restriction, low positive for horizontal and vertical gains and horizontal asymmetry, and negative IV for horizontal phase and vertical restriction. Regarding the individual frequencies, horizontal and vertical gains improved in all the frequencies tested except one. The horizontal phase improved at low frequencies (2.0 and 2.3 Hz) and deteriorated from 2.7 to 3.9 Hz. Vertical and horizontal restriction showed both improvement and deterioration. Horizontal asymmetry displayed improvement from -0.01 at 2.0 Hz to 0.50 at 5.9 Hz, deteriorating from -0.41 at 9.0 Hz. CONCLUSIONS: Flunarizine is useful in the treatment of vertigo caused by vestibular neuritis. VAT is a valid instrument for the objective and quantitative evaluation of the vestibular-oculomotor reflexes.
Assuntos
Flunarizina/uso terapêutico , Reflexo Vestíbulo-Ocular/efeitos dos fármacos , Neuronite Vestibular/tratamento farmacológico , Administração Oral , Adulto , Idoso , Esquema de Medicação , Eletronistagmografia/efeitos dos fármacos , Feminino , Flunarizina/efeitos adversos , Humanos , Masculino , Doença de Meniere/diagnóstico , Doença de Meniere/tratamento farmacológico , Pessoa de Meia-Idade , Resultado do Tratamento , Testes de Função Vestibular , Neuronite Vestibular/diagnósticoRESUMO
The acute and chronic toxicities of streptomycin sulfate (SS) and of the streptomycin hydrochloride-calcium chloride complex (SCC) were compared. The LD50 determined in mice was significantly higher for SCC than for SS. Chronic toxicity was evaluated by recording the nystagmus induced by damped torsion pendulum in rabbits. SS and SCC treatments (200 mg/kg intramuscularly of absolute streptomycin base) decreased the duration, the maximal frequency, and the total number of beats of nystagmus. However, SCC-induced changes were significantly lower than SS-induced ones. The extent of the lesion in the crista ampullaris was evaluated by light and electron microscopy and was correlated with the electrophysiological findings. Because the authors also demonstrated that there are no differences in the antibacterial effects of these salts, SCC may have a place in long-term streptomycin treatment.