Papers by Alexandre Bisdorff
Neurophysiologie Clinique-clinical Neurophysiology, Sep 1, 1999
This book provides an up-to-date comprehensive review of vestibular system disorders. It is struc... more This book provides an up-to-date comprehensive review of vestibular system disorders. It is structured in four parts: basic mechanisms, clinical approach and laboratory evaluation, diseases of the vestibular system and treatment of vertigo. There are 46 chapters written by many leaders in the field and the book is well referenced and indexed. The first part covers the basic mechanisms of vestibular physiology, vestibular induced eye movements, head and eye coordination, visual-vestibular interaction, vestibulospinal mechanisms, central processing of vestibular signals, neurochemistry of the vestibular system and basic mechanisms of compensation. A chapter reviewing vestibular-autonomic mechanisms would have nicely completed this part. Some chapters contain quite a few references to animal data and experiments on basic mechanisms done on humans in normal and in micro-gravity conditions as well as the mathematical models developed to conceptualise the results. This reflects the importance of basic science in the understanding of these disorders and the impact of engineers and physicist in this field. The second part puts a good and well justified emphasis on history taking and bedside examination of the dizzy patient before describing standard techniques of laboratory investigations and imaging. Some chapters are devoted to the presentation of tests in evolution. The third part describes the vestibular disorders and takes about half the volume of the book. Reviewed are the classical, peripheral and central, vestibular disorders as well conditions less frequently reviewed such as migraine, basal ganglia disorders, psychophysiological vertigo, motion sickness and psychiatric aspects of vertigo. A chapter on cervical aspects of vertigo is unfortunately not included. The last part reviews therapy of vertigo by drugs, rehabilitation and surgical options for difficult vertigo in selected cases. The book is clearly structured. It allows easily a targeted review of specific questions. The language is clear and many illustrations are provided. The book is useful for students entering the vestibular field and as a reference source for clinicians, technicians and therapists with a special interest in vertigo and imbalance. It should not be missing in the library of all those working in the fields of neurology, otolaryngology, head and neck surgery and neurosurgery who regularly deal with patients suffering from vertigo.
Cephalalgia, Oct 1, 2005
Peer reviewe
Revue Neurologique, Jun 1, 2014
This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Commit... more This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms. Symptoms that qualify for a diagnosis of vestibular migraine include various types of vertigo as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window of between 5minutes and 72hours.
Journal of vestibular research, Dec 18, 2022
This paper describes the Bárány Society Classification OverSight Committee (COSC) position on Cer... more This paper describes the Bárány Society Classification OverSight Committee (COSC) position on Cervical Dizziness, sometimes referred to as Cervical Vertigo. This involved an initial review by a group of experts across a broad range of fields, and then subsequent review by the Bárány Society COSC. Based upon the so far published literature, the Bárány Society COSC takes the view that the evidence supporting a mechanistic link between an illusory sensation of self-motion (i.e. vertigo-spinning or otherwise) and neck pathology and/or symptoms of neck pain-either by affecting the cervical vertebrae, soft tissue structures or cervical nerve roots-is lacking. When a combined head and neck movement triggers an illusory sensation of spinning, there is either an underlying common vestibular condition such as migraine or BPPV or less commonly a central vestibular condition including, when acute in onset, dangerous conditions (e.g. a dissection of the vertebral artery with posterior circulation stroke and, exceedingly rarely, a vertebral artery compression syndrome). The Committee notes, that migraine, including vestibular migraine, is by far, the commonest cause for the combination of neck pain and vestibular symptoms. The committee also notes that since head movement aggravates symptoms in almost any vestibular condition, the common finding of increased neck muscle tension in vestibular patients, may be linked as both cause and effect, to reduced head movements. Additionally, there are theoretical mechanisms, which have not been explored, whereby cervical pain may promote vaso-vagal, cardio-inhibitory reflexes and hence by presyncopal mechanisms, elicit transient disorientation and/or imbalance. The committee accepts that further research is required to answer the question as to whether those rare cases in which neck muscle spasm is associated with a vague sense of spatial disorientation and/or imbalance, is indeed linked
Handbook of Clinical Neurology, 2016
History taking is an essential part in the diagnostic process of vestibular disorders. The approa... more History taking is an essential part in the diagnostic process of vestibular disorders. The approach to focus strongly on the quality of symptoms, like vertigo, dizziness, or unsteadiness, is not that useful as these symptoms often coexist and are all nonspecific, as each of them may arise from vestibular and nonvestibular diseases (like cardiovascular disease) and do not permit to distinguish potentially dangerous from benign causes. Instead, patients should be categorized if they have an acute, episodic, or chronic vestibular syndrome (AVS, EVS, or CVS) to narrow down the spectrum of differential diagnosis. Typical examples of disorders provoking an AVS would be vestibular neuritis or stroke of peripheral or central vestibular structures, of an EVS Menière's disease, benign paroxysmal positional vertigo, or vestibular migraine and of a CVS long-standing uni- or bilateral vestibular failure or cerebellar degeneration. The presence of triggers should be established with a main distinction between positional (change of head orientation with respect to gravity), head motion-induced (time-locked to head motion regardless of direction) and orthostatic position change as the underlying disorders are quite different. Accompanying symptoms also help to orient to the underlying cause, like aural or neurologic symptoms, but also chest pain or dyspnea.
Acta otorrinolaringológica española, 2016
This paper presents diagnostic criteria for Menière&a... more This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes 2 categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low-to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20min and 12h. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20min to 24h.
Journal of vestibular research, Nov 1, 2012
This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Commit... more This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms. Symptoms that qualify for a diagnosis of vestibular migraine include various types of vertigo as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window of between 5 minutes and 72 hours.
Journal of vestibular research, Feb 22, 2023
On page 215, under section 3, "VI-implantation criteria", where it reads: Reduced horizontal angu... more On page 215, under section 3, "VI-implantation criteria", where it reads: Reduced horizontal angular VOR gain ≤ 0.1 upon sinusoidal stimulation on a rotatory chair (0.1 Hz, Vmax = 50 • /sec) and a phase lead > 68 • (time constant < 5 sec) Should be changed to: Reduced horizontal angular VOR gain ≤ 0.1 upon sinusoidal stimulation on a rotatory chair (0.1 Hz, Vmax = 50 • /sec) and a phase lead ≥ 15 • (time constant ≤ 6 sec)
Hno, Aug 2, 2017
Der M. Menière ist eine multifaktorielle Erkrankung, an deren Entstehung genetische und Umweltfak... more Der M. Menière ist eine multifaktorielle Erkrankung, an deren Entstehung genetische und Umweltfaktoren beteiligt sind. Histopathologische Studien zeigen, dass die Erkrankung mit einem Endolymphhydrops einhergeht [1],obwohldieserper se nicht alle klinischen Charakteristika erklären kann, wie z. B. die progrediente Hörminderung oder die Häufigkeit der
Journal of vestibular research, Jan 11, 2022
This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Commit... more This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). It contains a literature update while the original criteria from 2012 were left unchanged. The classification defines vestibular migraine and probable vestibular migraine. Vestibular migraine was included in the appendix of the third edition of the International Classification of Headache Disorders (ICHD-3, 2013 and 2018) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included in a later version of the ICHD, when further evidence has accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms. Symptoms that qualify for a diagnosis of vestibular migraine include various types of vertigo as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window of between 5 minutes and 72 hours.
Neurology, Jan 16, 2020
Visual snow is a long-recognized clinical phenomenon, first described by Liu et al.1 in 1995. In ... more Visual snow is a long-recognized clinical phenomenon, first described by Liu et al.1 in 1995. In this case series, persistent positive visual phenomena were depicted as being “extremely similar in their simplicity, quality, and involvement of the entire visual field.”1 Patients reported seeing “diffuse small particles, such as TV static, snow, lines of ants, dots, and rain, that lasted for months to years.”1 No underlying structural, drug-related, psychiatric, or epileptic cause for the visual perceptions was identified in this seminal publication; moreover, treatments were unhelpful.
Springer eBooks, 1995
The pathophysiological basis of the abnormal head posture in spasmodic torticollis, the most comm... more The pathophysiological basis of the abnormal head posture in spasmodic torticollis, the most common form of focal dystonia, is unknown. The disorder is thought to be one of the extrapyramidal system, although the literature on its neuropathology is still inconclusive (Tarlov, 1970; Fahn et al., 1988). Several studies have suggested an involvement of the central vestibular system in spasmodic torticollis (Bronstein and Rudge, 1986; Diamond et al., 1988). It is not clear, however, whether the abnormalities observed are secondary to the abnormal head posture, or imply a causative disruption of the vestibular brainstem pathways in this disorder.
Hno, Mar 19, 2020
Klassifikationen mit klaren Definitionen von Erkrankungen dienen in erster Linie der Kommunikatio... more Klassifikationen mit klaren Definitionen von Erkrankungen dienen in erster Linie der Kommunikation unter Kollegen in Forschung und Klinik und sind eine Voraussetzung für epidemiologische und therapeutische Studien, die weltweit verstanden und angewandt werden können. Sie beeinflussen aber auch die tägliche klinische Arbeit, indem sie die gedankliche Herangehensweise und das praktische Vorgehen verbessern. Die Ausarbeitung von Definitionen ist besonders bei Erkrankungen erforderlich, für die es keine definitiv bestätigende Untersuchung gibt oder bei denen sich das klinische Erscheinungsbild und die Untersuchungsergebnisse verschiedener Syndrome stark überlappen [2].
Journal of Clinical Epidemiology
Journal of Vestibular Research
Neuro-Ophthalmology, 2000
Horizontal and vertical components of spontaneous nystagmus in the dark were assessed in 40 healt... more Horizontal and vertical components of spontaneous nystagmus in the dark were assessed in 40 healthy subjects with monocular computerised video-oculography. Five different static head-in-space positions were used: sitting upright, face up, right ear down, left ear down, and face down; the head-on-trunk position being kept the same in each position. In the sitting position, four subjects (10%) had downbeat nystagmus (slow-phase velocity [SPV] 0.7 °/s, SD 0.27) and 12 (30%) had upbeat nystagmus (SPV 2.58 °/s, SD 1.38). In the supine position, three subjects (7.5%) had downbeat nystagmus (SPV 5.60 °/s, SD 6.72) and 25 (62.5%) had upbeat nystagmus (SPV 3.86 °/s, SD 4.54). The direction of nystagmus frequently changed with changes in head position. In 15 subjects, the behaviour of the vertical nystagmus was investigated during a slow 1.2 °/s, 360° revolution in pitch. All subjects had nystagmus at some point and the slow-phase velocity was modulated sinusoidally suggestive of gravitational modulation by otolithic signals with an offset towards upbeat nystagmus. Normal subjects have a physiological spontaneous nystagmus of low velocity in the dark, often upbeating, which is under the modulation of otolith input.
Journal of the Neurological Sciences, 1997
Recent pathological evidence suggests that this syndrome is due to a vasculitis that affects the ... more Recent pathological evidence suggests that this syndrome is due to a vasculitis that affects the small vessels of the brain, retina, and membranous labyrinth. Treatment depends on the presentation. For the devastating form (psychiatric/neurological), treatment includes intravenous steroids, immunoglobulin therapy, and cyclophc-sphamide. For less severe forms, including recurrent branch retinal artery occlusions, treatment is uncertain. Anticoagulants are not effective.
European Journal of Neurology, 2009
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Papers by Alexandre Bisdorff