Betahistine in treating Meniere’s disease patients

What is the long term efficacy of betahistine dihydrochloride on the incidence of vertigo attacks in patients with Meniere’s disease, compared with placebo? METHODS: The BEMED trial is a multicentre, double blind, randomised, placebo controlled, three arm, parallel group, phase III, dose defining superiority trial conducted in 14 German tertiary referral centres Results of this […]


INO – Internuclear ophtalmoplegia


Internuclear ophtalmoplegia (INO) results from the damage of the MLF (medial longitudinal fasciculus). The eye on the lesional side can’t adduct during horizontal eye movements. That results in dubble vision when looking contralesionaly. But contruary to III nerve paresis, the eye can adduct during convergence eye movement. The most frequent cause of INO are stroke […]


Big CPA tumor without symptoms

43yr woman noticed few month ago when she listened to the music with earphones that it didn’t sound the same at both sides, she haired worse at the left. In her family hearing problems has father, uncle and aunt. She hasn’t have any balance problems. Here’s her audiogram: reduced hearing at high frequencies at both […]


Hummingbird sign and Mickey Mouse sign in PSP

Hummingbird sign

Progressive Supranuclear Palsy (PSP) or Steele-Richardson-Olszewski Syndrome is neurodegenerative dissorder, characterized by akinetic rigid parkinsonism, dizziness, unsteadiness, slowness, falls, and pseudobulbar dysarthria, and also supranuclear eye movement abnormalities which presented as downward, or upward, or combination gaze palsy. The very characteristic radiologic signs are: Hummingbird sign (penguin sign) Mickey Mouse sign Here’s few very useful […]


Neuropathy vs Neuronopathy

A discussion of neuropathic disorders encompasses those diseases that affect the neuron’s cell body, or neuronopathies, and those affecting the peripheral process, or peripheral neuropathies. Neuronopathies can be further subdivided into those that affect only the anterior horn cells, or motor neuron disease, and those involving only the sensory neurons, also called sensory neuronopathies or […]


VVOR test positive in CANVAS

VVOR test

62yr woman with instability as main complain, lasting for 7 years, which deteriorated in last two years. She felt down for two times completely conscious. Six months ago she noticed double vision when looking to the right. She has slight headaches in occipital part and she is very forgetful. Paresthesias in extremities and clumsiness with […]


Inferior Vestibular Neuritis – How often do we diagnose it?

inf Vestibular Neuritis

Patient in late 50thies feels one week slight instability from time to time, and describes it as difficulty walking straight and also has a short vertigo spells (discomfort in the head) when moving head, especially quick turns. Also, he complains to have left-sided tinnitus (pulsating hissing) since this instability problems has started. He had no […]