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Ear Infections Infections can affect the outer part of the ear (Otitis externa), behind the ear drum (Otits media) or the inner ear. Ear Discharge and Perforated Ear Drum Recurrent or persistent discharge from the ear can be due to chronic infection, trapped skin (cholesteatoma) or a hole in the ear drum (perforation). Hearing Tests & Hearing Impairment Hearing is something we take for granted but people of any age can suffer from hearing loss.
Glue Ear & Grommets Grommets are tiny plastic ventilation tubes which sit in the ear drum. Vertigo & Dizziness Vertigo or the illusion of movement is the medical term for dizziness.
Cervicocranial syndrome - is a painful condition cervico-occipital junction, resulting from head or neck (cervical spine) trauma or their chronic overload.
The source of pain in the neck and head injury is chronic overload of supporting structures in this area (trauma or injury of the cervical spine).
The whiplash mechanism of injury of the ligaments and muscles of the neck and brain during a car accident or a collision when skating, rollerblading, skiing or snowboarding, the injury of the neck and head during the fall. Acute traumatic neck (cervical spine) and the cervico-occipital junction injury occurs at falling, collision with another moving or stationary object, person (skiing, snowboarding, etc.). Sometimes the range of motion in the neck may be greater than cervical spine physiological norm. Localization of the typical muscle pain points in trauma (injury) or chronic overload the muscles and ligaments of the neck. Because of the intensity of pain in the nape and neck in the cervical spine trauma or contusion, patient is unable to find a comfortable sleeping position.
Chronic neck (cervical spine) and the cervico-occipital junction trauma is formed by static load of repetitive motion over a long period of time (sedentary work). On the background of whiplash cervical spine injury and neck pain can occur irritation of the vertebral arteries, which extending in the transverse processes of the cervical vertebrae.
Localization of pain with whiplash neck, radiating from the neck to the area between the shoulder blades or below, in the shoulders.
It should be noted that in addition to neck and head pain (back of the head, temples, crown, forehead), patients may experience and vestibular disorders. At cervical-cranial syndrome are also possible complaints about tinnitus (ringing or buzzing in the ears) and head (cochlear manifestation), numbness of the face, nape, ear and tongue. Vertebral artery, extending in the transverse processes of the cervical vertebrae, can react with vascular spasm and dizziness. There is also Allen and Ferguson classification in cervical spine injuries and used in the specialized literature and in scientific research. For the diagnosis of neck (cervical spine) injuries and cervical-cranial syndrome patient should consult with a doctor for neurological examination, where also should be evaluated cervical spine biomechanics changes (range of motion, muscle tone and strength, myofascial trigger in neck muscles, etc). Diagram segmental innervation on the surface of the body helps to clarify the level of localization of radiculopathy and spinal cord compression.
Articular processes (facet joints) unilateral dislocation at the C6-C7 vertebrae level is usually manifested in the form of C7 nerve radiculopathy. Spinal cord compression neurological symptoms occur in cervical vertebrae bilateral dislocation case, which may be exacerbated with subluxation increase. Magnetic resonance imaging (MRI) of the cervical spine (side view) helps in diagnosing damage to the discs and the determination of the position of the cervical vertebrae during their displacement. In case of the cervical spine injury, when conventional treatment does not give a positive effect, in the neck muscles and intervertebral joints can be produced injection of drugs (therapeutic blockade).
With a combination of a properly chosen physiotherapy, these injections can give to patient a good and long-lasting effect at headaches and neck pains after the whiplash injury. Reduction of swelling, inflammation, pain and facet joints and neck muscles range of motion restoration in the cervical spine injury treatment is accelerating by physiotherapy. Using a neck brace (Philadelphia collar) in the treatment of sprains and traumatized facet joints after the cervical spine injury. Using a special neck brace (Philadelphia collar) or neck corset (Schantz bandage) limits the range of motion in the stretched ligaments and injured facet joints capsules at cervico-cranial syndrome (subaxial cervical spine injury). The use of a cervical corset (Philadelphia collar) in the treatment of sprains and the cervical facet joints injury after whiplash trauma.
Due to the limitation of movement, using a neck brace (Philadelphia collar) or neck corset (Schantz bandage) eliminate pain symptoms in the neck and nape (cervico-cranial syndrome) much faster. Electrical stimulation is one of a variety of non-invasive treatment protocols we frequently use here at the Headache Center of Chicago. At the Headache Center of Chicago our neuromuscular dentists rely on a specific type of electrical stimulation device called an AlphaStim.
How Does AlphaStim Technology Compare to Other Commonly Used Electrical Stimulation Devices?
Over the years, many devices have been used for applied electrical stimulation to treat a wide variety of conditions. The microcurrent applications of the alpha wave technology in an AlphaStim device are uniquely designed for neuromotor re-education of functional pathways and management of the abnormal neurochemistry present in chronic pain patients.
Since we are talking about treating areas of our bodies that contribute to the dysfunction and pain one experiences, let’s ask the obvious question: Exactly what IS dysfunctional when you have these types of pain conditions? The Headache Center of Chicago uses AlphaStim to reduce pain and heal patients with chronic headaches, persistent migraines, as well as a host of other debilitating conditions. If you are suffering, or someone you love is, know that AlphaStim technology is just one of many things that HCC can potentially offer you in your effort to find lasting pain relief.
Pathologies from childhood to adolescence carry physical, cognitive, motor, linguistic, perceptual, social, emotional, and neurosensory characteristics. Uneri and Turkdogan [3] examined 34 children (ages 4-18 years) having paroxysmal dizziness or vertigo attacks or both. Examining the prevalence of migraine and migraine equivalents in children of school age (N = 314), Russel and Abu-Arafeh [4] found that benign paroxysmal vertigo is common in children and that, although it is seldom diagnosed, it appears to cause few major problems for the affected children. Other less frequent causes include trauma [7], Meniere's disease [8,9], cerebellopontine angle tumor [10], seizure, postmeningitic vertigo [11], acute vestibular neuritis, and juvenile rheumatoid arthritis. By stabilography, examined parameters were worse in a diabetic group in comparison to controls, reaching statistical significance in younger children [13], and were better in diabetic patients with a longer history of the disease. Meniere's disease in children is rare, and its clinical appearance is not as typical as in adults. Acetylsalicylic acid (aspirin) and other nonsteroidal antiinflammatory drugs can also cause tinnitus, deafness, and vertigo [14]. In the majority of cases, vestibular dysfunction appears together with cochlear dysfunction. The vestibulospinal pathways are controlled by craniocorpography recordings of the standing test [16] and the stepping test [17,18]. All the tests are related to standardized test evaluations of the major databanks of NODEC I-IV.


More than one-half of our sample group complained of subjective hearing loss, which is very frequent for this young age range. The equilibriometric, objective, and quantitative investigation results of polygraphic electronystagmography of spontaneous and caloric vestibuloocular nystagmus are shown in Table 2. The rotatory acceleration test stimulates the right and left inner-ear vestibular canals in opposite directions.
During the rotatory intensity-damping test, we recorded the electrocardiographic reactions.
Pathology from childhood to adolescence carries physical, cognitive, motor, linguistic, perceptual, social, emotional, and neurosensory characteristics. Physiological and clinical vertigo syndromes commonly are found as a combination of four principal phenomena: perceptual (vertigo), oculomotor (nystagmus), postural (dystaxia), and vegetative (nausea, vomiting).
A large number of children suffering from vertigo have additional problems in daily life, such as learning disabilities, reduced attention, decreased endurance and concentration capacity, disturbances of precise motor functions, and hyperactive behavior [19]. This research was presented at the Thirty-First Congress of the Neurootological and Equilibriometric Society, Bad Kissingen, Germany, March 26-28, 2004. A small suction tube is used under microscope guidance for a more gentle and complete cleaning of the ear.
It causes irritation of pain receptors in ligaments, intervertebral (facet) joints capsules, cervical spine muscles and aponeurosis in an occipital part of the skull (at the nape). Cervical spine injury by occurrence time may be acute (because of motor vehicle accidents, falls, head impacts, falling neck and occipital injury), or chronic (a sedentary job, infant feeding, etc.). By a similar cervical spine injury (contusion) mechanism is occurs a jerk in cervico-occipital junction and intervertebral joints. Then the probability of rupture of ligaments and muscles with subluxation of intervertebral (facet) joints and the odontoid process of C2 cervical vertebrae. Vestibular disorders because of irritation of the vertebral arteries, which are expressed dizziness and unsteadiness when walking, nausea and vomiting.
Unilateral dislocation of the articular processes (facet joints) at the C5-C6 vertebrae level is usually manifested in the form of C6 nerve radiculopathy.
In this case, the patient complains of muscle weakness during arms extension at the elbow (triceps), in wrist flexion, as well as numbness and tingling of the index and middle fingers. For this it suffices low doses of anesthetic (Novocaine, Lidocaine) and Cortisone, Diprospan or Kenalog, injected into the affected facet joint lumen.
Neck brace (Philadelphia collar) and neck corset (Schantz bandage) creates additional support for a protective muscle tension and spasm, which is always formed in the patient because of the neck injury (cervical spine trauma). This facilitates rapid range of motion restoration in stretched ligaments and injured facet joints after the cervical spine injury.
And believe it or not, use of AlphaStim also simultaneously encourages the restoration of normal sleep patterns which are necessary for the correction of chronic pain. The ages between 8 and 14 or 15 especially carry very special traits of a rollover in data processing with respect to balance regulation.
Otitis media and middle-ear effusion could be the most common causes of vertigo in children, but problems exist in detecting the other causes of vertigo.
Regarding the medical history of the group, chronic headache attacks consistent with migraine were reported in 12 children, and motion sickness was reported in 30 (some patients experiencing both conditions). In common with previous studies, these authors found that benign paroxysmal vertigo appears to be related to migraine. The triad of vertigo, tinnitus, and deafness are not usually elicited; diagnosis is often made after years of follow-up and batteries of investigations [8,9]. One hypothesis attributes these outcomes to a reactive immunological mechanism, but this hypothesis has been confirmed only in exceptional cases. Examining a group of 72 children (ages 4-14 years) with unilateral sensorineural hearing loss of probable viral origin and concomitant vestibular affects, Melagrana et al. All patients complaining of vertigo either with or without hearing loss and tinnitus presented for our neurootological investigation. We also performed an acoustic analysis: pure-tone audiometry, tympanometry, speech audiometry, and brainstem evoked response audiometry. They comprise data from approximately 30,000 neurootological patients and normal controls, spanning ten decades of life and both genders.
Regarding the history of our patients, we found the parameter frequencies outlined in Table 1. A spontaneous ECG was defined as an electrocardiographic response during the culmination phase of the nystagmus reaction in the supine position without any stimulation. We saw few site differences between perrotatory right- and left-beating nystagmus, whereas postrotatory rightand left-beating nystagmus show a major laterality, with higher activities in postrotatory left-beating nystagmus. Baseline is an electrocardiogram obtained with the subject in a seated position with a spontaneous nystagmus beating to the right or to the left. To compile the best results, we recorded speech audiometry, which gave us an impression of the patients' social understanding. Associated with ages 8 to 14 or 15 years especially are very special traits of a rollover in data processing with respect to balance regulation. These four cardinal manifestations of vertigo are related to different levels of the vestibular analyzer and require different methods of investigation. Because of the variability in symptoms, no specific therapy exists for children with learning disabilities. Because of the cervical spine trauma occurs neck's muscles and ligaments sprain (anterior, posterior, lateral group, or its combinations).
Acute pain in the cervical spine may cause hypothermia, rapid head movement (head turning aside or backward), uncomfortable neck position during sleep. Sometimes the clinical manifestations of cervical-cranial syndrome lead to brain concussion misdiagnosis by some physicians. In this case, the patient complains of muscle weakness during wrist extension, fingers numbness and tingling. Data acquisition of neurootological function provides us with a network of information about the sensory status of our young patients. The authors found spontaneous vestibular nystagmus (41%) and benign paroxysmal positional nystagmus (59%). Possible mechanisms that can explain the aura in migraine or the paroxysmal vertigo disorder are an ischemia by vasodilatation due to abnormal accumulation of vasoactive substances (prostaglandin, serotonin, tyramine) or a neural dysfunction located in a specific area mediated by neurons containing serotonin [5,6]. The evaluation of vertigo in children requires a questionnaire for extensive and complete history recording, audiograms, and vestibular function tests. According to some authors, the therapy for Meniere's disease in children is mainly based on drug treatment, but when the disease has progressed, intratympanic gentamicin injections and endolymphatic sac decompression (or, in some cases, nerve section) might be performed subsequently. The theory of the cyclooxygenase pathway, currently the most widely accepted, is based on the ability of nonsteroidal antiinflammatory drugs to inhibit the cyclooxygenase pathway of arachidonic acid metabolism, leading to prostaglandin depletion and an increase in leukotrienes. Sometimes, when children could not cooperate with us or because of their behavior, we had to forgo some investigations.


For our study, we transferred all the test results into a special Excel spreadsheet (Microsoft), some of which we used for demonstration here. Most of the complaints are related to low blood pressure; however, in a few cases we also found complaints of hypertension. Quite a few young patients had head and neck trauma, mostly due to traffic accidents and home accidents and, less frequently, to sports accidents.
When we synoptically fit together the four results of the caloric tests (right warm, right cold, left warm, left cold), we use trinary coding. In combining the monolateral caloric warm response as a nystagmus response on a weak stimulus with the perrotatory binaural stimulus as a supraliminal stronger stimulus, we can establish the vestibular response intensity comparison (VSRIC [20]), for which we used trinary coding.
We saw thereafter that the four caloric responses-ECGs at 44°C right and left and ECGs at 30°C right and left-systematically depicted lowering heart rates, which is systemic and may be due to an action of the vagal system. In the postrotatory reactions, we observed sympathicotonia in postrotatory left-beating nystagmus, which showed a higher release of the ECG rhythm (Figs. The more sensitive test is stepping craniocorpography (CCG), using the stepping test of Unterberger and Fukuda [17,18]. We used a trinary coding scheme for the four parameters-displacement, lateral sway, angular deviation, and body spin-depicted in Figure 4. It is astonishing that the parameters of understanding double-digit numbers and monosyllabic words and loss of discrimination are much more pathological in the left ear than in the right ear (Table 3). Early and Later Lesions in the Auditory and Vestibular System in Children and Juveniles After Meningitis.
Are there any disturbances in vestibular organ of children and young adults with type I diabetes? The influence of metabolic disturbances present in diabetes mellitus type I on vestibulo-spinal reflexes in children and young adults. Electronystagmography findings in child unilateral sensorineural hearing loss of probable viral origin.
Neue registrierbare Vestibularis-Korperdreh- Reaktionen, erhalten durch Treten auf der Stelle.
Major neurootological complaints leading to functional neurootological investigations are vertigo (including giddiness), dizziness, and nausea. In selected cases, electroencephalography, hematological evaluation, and imaging of the brain or temporal bone should be performed. They examined 95 children and young adults 6-28 years of age and found that type 1 diabetes causes disturbances in different parts of the vestibular organ but mostly in its central part.
At the authors' department, the incidence of Meniere's disease in pediatric patients with vertigo was 2.9%. The patients completed an extensive questionnaire of the NODEC III type, and then we performed a series of neurootometric investigations according to our neurootological network system.
Also, cases with cardiac insufficiency were related to vertigo and to a low rate of diabetes and kidney disorders.
The results for the standing-test CCGs exhibited the parameters of longitudinal sway and lateral sway. We evaluated the four principle parameters-displacement, lateral sway, angular deviation, and body spin-with mean and standard deviation.
These complaints may occur acutely but also are present in some patients at a young age as longer-lasting complaints.
The range of vestibular organ impairment seems to depend mainly on the presence and character of hypoglycemic incidents and the duration of the disease (and, to some extent, on the compensation of diabetes).
Most frequently (42.86%), the pattern s0000 occurs, which means all four caloric test characteristics were positioned in the normal range.
The three types of VSRIC can again be grouped into three subdivisions each: parallel behavior, recruitment behavior, and decruitment behavior.
All these parameters derive from the arrangement pointing to the right direction; however, the body spin overshot the normal range (n = 35). They are confronted as characteristics with the normal ranges for each of the parameters in our special chart. Although the total number of young patients investigated in our study was small (N = 35), we attempted to present a picture of this special group of patients. Physiological and clinical vertigo syndromes are commonly found as a combination of four principal phenomena: perceptual (vertigo), oculomotor (nystagmus), postural (dystaxia), and vegetative (nausea, vomiting). Simultaneously with electronystagmography, we recorded the cardiac reactions by a three-channel electrocardiogram (ECG) scheme.
We found higher frequencies of vertigo with rocking movements (as if on board ship) and of rotating sensations (as if riding a carousel) than of blackouts or instability. This is followed in frequency by a typical peripheral pattern with a monolateral inhibition of warm left and cold left in 7.14% of subjects. Of equal percentage is the third position in the graph, representing a central disorder with disinhibition of left cold. This, however, is followed by a monolateral recruiting phenomenon in 10% of our sample (trinary code v0010), demonstrating that peripheral vestibular inhibition can be straightened out and compensated when increasing the power of a stimulus. The second most frequent pattern was s0022, which shows a pathological deviation toward the right, including a pathological body axis spin toward the right. The focus of our study is the phase of restructuring of equilibrium regulation in children between the ages of 8 and 15 years.
Among the main vertigo-triggering factors were the orthostatic mechanisms of getting up and head turning. The fourth bar represents a typical monolateral peripheral receptor lesion s1000 with an inhibition of the right warm and a spontaneous nystagmus to the opposite side. Other findings were a mixture of disinhibitive recruitments (v0202), parallel inhibition on both sides (v1111), monolateral decruitment phenomenon (v0001), bilateral recruitment (v1010), monolateral overshooting decruitment (v2000), monolateral parallel inhibition (v1100), monolateral parallel disinhibition (v2200), monolateral right decruitment (v0100), and monolateral parallel inhibition with an opposite site recruitment (v1110). Patterns three and four exhibit minor deficits in the lateral sway or in the lateralization toward the right side, as far as body spin is concerned. We also demonstrate that juvenile vertigo depends not only on peripheral vestibular lesions, which partly are compensated and partly are decompensated, but also on central regulatory deficits. In the next stage of s1001, we see a midbrain inhibition of the right-beating nystagmus and, in the pattern s2002 we have a disinhibited nystagmus preponderance pointing at the right temporal lobe, which demonstrates that the dysfunction likely shares peripheral and central sites of origin (n = 27). However, overshooting central responses are seen in pattern s2000 and (especially with a centrally enlarged lateral sway) in pattern s0200. Finally, pattern s0222 exhibits a combination of broadened sway with a pathological deviation toward the right side.



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