Imperial College London
Portrait Picture

Professor Mark Wilson

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice
 
 
 
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Contact

 

+44 (0)20 7594 1532m.wilson

 
 
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Location

 

Cambridge WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Marcus:2019:10.1007/s00415-019-09403-z,
author = {Marcus, HJ and Paine, H and Sargeant, M and Wolstenholme, S and Collins, K and Marroney, N and Arshad, Q and Tsang, K and Jones, B and Smith, R and Wilson, MH and Rust, HM and Seemungal, BM},
doi = {10.1007/s00415-019-09403-z},
journal = {Journal of Neurology},
pages = {2430--2433},
title = {Vestibular dysfunction in acute traumatic brain injury},
url = {http://dx.doi.org/10.1007/s00415-019-09403-z},
volume = {266},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Traumatic brain injury (TBI) is the commonest cause of disability in under-40-year-olds. Vestibular features of dizziness (illusory self-motion) or imbalance which affects 50% of TBI patients at 5 years, increases unemployment threefold in TBI survivors. Unfortunately, vestibular diagnoses are cryptogenic in 25% of chronic TBI cases, impeding therapy. We hypothesized that chronic adaptive brain mechanisms uncouple vestibular symptoms from signs. This predicts a masking of vestibular diagnoses chronically but not acutely. Hence, defining the spectrum of vestibular diagnoses in acute TBI should clarify vestibular diagnoses in chronic TBI. There are, however, no relevant acute TBI data. Of 111 Major Trauma Ward adult admissions screened (median 38-years-old), 96 patients (87%) had subjective dizziness (illusory self-motion) and/or objective imbalance were referred to the senior author (BMS). Symptoms included: feeling unbalanced (58%), headache (50%) and dizziness (40%). In the 47 cases assessed by BMS, gait ataxia was the commonest sign (62%) with half of these cases denying imbalance when asked. Diagnoses included BPPV (38%), acute peripheral unilateral vestibular loss (19%), and migraine phenotype headache (34%), another potential source of vestibular symptoms. In acute TBI, vestibular signs are common, with gait ataxia being the most frequent one. However, patients underreport symptoms. The uncoupling of symptoms from signs likely arises from TBI affecting perceptual mechanisms. Hence, the cryptogenic nature of vestibular symptoms in TBI (acute or chronic) relates to a complex interaction between injury (to peripheral and central vestibular structures and perceptual mechanisms) and brain-adaptation, emphasizing the need for acute prospective, mechanistic studies.
AU  - Marcus,HJ
AU  - Paine,H
AU  - Sargeant,M
AU  - Wolstenholme,S
AU  - Collins,K
AU  - Marroney,N
AU  - Arshad,Q
AU  - Tsang,K
AU  - Jones,B
AU  - Smith,R
AU  - Wilson,MH
AU  - Rust,HM
AU  - Seemungal,BM
DO  - 10.1007/s00415-019-09403-z
EP  - 2433
PY  - 2019///
SN  - 0340-5354
SP  - 2430
TI  - Vestibular dysfunction in acute traumatic brain injury
T2  - Journal of Neurology
UR  - http://dx.doi.org/10.1007/s00415-019-09403-z
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31201499
UR  - https://link.springer.com/article/10.1007%2Fs00415-019-09403-z
UR  - http://hdl.handle.net/10044/1/71496
VL  - 266
ER  -
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