Gentamicin ototoxicity: clinical features and the effect on the human vestibulo-ocular reflex.

Abstract:

CONCLUSIONS:Gentamicin ototoxicity presents with gait imbalance and oscillopsia, but only rarely with hearing loss and vertigo. Sinusoidal rotational stimuli with high accelerations such as the bedside head-thrust test or rotational step changes in velocity are useful to diagnose bilateral vestibulopathy. OBJECTIVE:To describe the salient clinical features and vestibular testing results in gentamicin ototoxicity. PATIENTS AND METHODS:A retrospective review of the quantitative vestibular function testing results for patients presenting to the UCLA Neurotology Clinic with gentamicin ototoxicity over the past 10 years (n=35). RESULTS:All patients presented with imbalance and 33 out of 35 had oscillopsia. Three patients reported a noticeable change in hearing and five reported vertigo. Of the 35 patients, 15 were in renal failure at the time of gentamicin administration. Patients with pre-existing peripheral neuropathy compensated poorly. Sinusoidal rotational testing demonstrated profoundly decreased gain and increased phase lead over the entire frequency range, with a subset of patients having relatively preserved gain at the intermediate frequencies (0.8-1.6 Hz) and low acceleration (<30 degrees/s). There was little or no response to high acceleration step changes in velocity. The time constant measured both by sinusoidal and step responses was ultra-low. All patients tested had a positive head-thrust test bilaterally.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Ishiyama G,Ishiyama A,Kerber K,Baloh RW

doi

10.1080/00016480600606673

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1057-61

issue

10

eissn

0001-6489

issn

1651-2251

pii

R722K5137R10G416

journal_volume

126

pub_type

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