Quinine Derivatives

Numerous quinine derivatives, including quinidex, at-abrine, plaquenil, quinine sulfate, mefloquine (Lariam), and chloroquine, have reported ototoxicity (Jung et al., 1993). The toxicity is primarily cochleotoxic and is generally confined to tinnitus, but it can cause a syndrome that includes tinnitus, sensorineural hearing loss, and vertigo. Some quinine derivatives taken for malaria prevention can occasionally cause significant and long-lasting tinnitus. Recent studies suggest that quinine...

Psychogenic Voice Disorders Direct Therapy

Psychogenic voice disorder refers to a voice disorder that is a manifestation of some confirmed psychological disequilibrium (Aronson, 1990). In its purest form, the psychogenic voice disorder is not associated with structural laryngeal changes or frank central or peripheral nervous system pathology. It is asserted that the larynx, by virtue of its neural connections to emotional centers within the brain, is vulnerable to excess or poorly regulated musculoskeletal tension arising from stress,...

Vestibular Rehabilitation

The concept of prescribing exercise for persons with dizziness was first described by Cooksey and Cawthorne in the 1950s (Cawthorne, 1944 Cooksey, 1946). Today, exercise for persons with vestibular disorders is considered to be the standard of care (Cowand et al., 1998 Herdman, 1990 Herdman, 1992 Herdman et al., 1995 Herdman and Whitney, 2000). Exercises are specifically prescribed that help the person with a vestibular disorder either compensate for or adapt to the impairment (She- pard and...

Treatment of Ototoxicity

Because most cochleotoxicity is caused by damage to hair cells, and because once dead, hair cells do not regenerate in humans, treatment of completed ototox-icity, whether it be cochlear or vestibular, is limited to substitution of other inputs, procedures that recalibrate remaining function, and behavioral adaptations. For cochleotoxicity, the approach is largely amplification. Hearing aids and related devices assistive devices such as telephone amplifiers can be helpful in those whose hearing...

Electronystagmography

Nystagmography Smooth Pursuit

Electronystagmography ENG refers to a battery of tests used to evaluate the vestibular system. The tests include 1 the Dix-Hallpike test, 2 ocular motor tests, 3 a search for positional and or spontaneous nystagmus, 4 the caloric test, and 5 the failure of fixation suppression test. During ENG testing, eye movement is measured to determine the presence of peripheral vestibular nerve and or end-organ vestibular or central nervous system CNS dysfunction. Two methods for recording eye movement are...