Vestibular disturbance

In the vestibnlar organ, the initial hair cell damage occurs in the apex of the cristae and the striolar regions of the maculi. Hair cell loss then progresses toward the periphery of the vestibular receptor organ with type I hair cells affected earlier than the type 11 hair cells. Vestibular disturbances from systemic aminoglycoside administration present as severe unsteadiness that becomes worse in the dark, bnt an objective clinical assessment is difficult. In contrast to the situation in the cochlea, regeneration of vestibular hair cells has been observed in mammalian species. ... 

The same molecules used to treat allergies and cold symptoms have many other uses. Antihistamines are particularly effective as antiemetics in suppressing nausea associated with gastrointestinal illnesses. They can also be used to treat the symptoms of motion sickness or even vestibular disturbances (vertigo). Because of their ability to induce sedation, antihistamines are widely used in over-the-counter sleep aids. 

Vestibular disturbances, especially motion sickness, appear to involve muscarinic cholinergic transmission. Scopolamine is often effective in preventing or reversing these disturbances. 

Capreomycin is nephrotoxic and ototoxic. Tinnitus, deafness, and vestibular disturbances occur. The injection causes significant local pain, and sterile abscesses may occur. 

Capreomycin is nephrotoxic and ototoxic. Tinnitus, deafness, and vestibular disturbances occur. 

Prochlorperazine is widely used for its anti-emetic activity and its effectiveness in suppressing dizziness due to labrintine disorder. Oral bioavailability is very low, due to extensive intestinal and hepatic frrstpass metabolism. Furthermore, the oral route is impractical in patients with nausea and vestibular disturbance, who have been demonstrated to have impaired gastric emptying. 

Minocycline differs from other tetracyclines in that its antibacterial spectrum includes Neisseria meningitidis and it has been used for meningococcal prophylaxis. It is well absorbed from the gut, even after a meal, partly metabolised in the liver and partly excreted in the bile and urine (t/ 15 h). Dose reduction is not necessary when renal function is impaired 200 mg initially is followed by 100 mg 12-hourly. Minocycline but not other tetracyclines may cause a reversible vestibular disturbance with dizziness, tinnitus and impaired balance, especially in women. 

It is common to see evidence of iofendylate residues for many years after myelography. The residue problem extends to the skull and it is common to find symptomless deposits of iofendylate there after myelography however, in several patients residues in the skull have apparently caused convulsions (SEDA-14, 424). They can also be associated with persistent headache (SEDA-8, 430) and perhaps with the development of vestibular disturbances many years later (SEDA-17, 538). 

Odkvist LM, Larsby B, Tham R, et al. 1979. On the mechanism of vestibular disturbances caused by industrial solvents. Adv Otorhinolaryngol 25 167-172. 

Besides the specific uses discussed, the general therapeutic uses of antihistaminics include allergic reactions such as urticaria, allergic rhiiutis, motion sickness, vestibular disturbances, and the nausea and vomiting associated with pregnancy. 

Some Hj antagonists, notably dimenhydrinate and meclizine, often are of benefit in vestibular disturbances such as Meniere s disease and in other types of true vertigo. Only promethazine has usefulness in treating the nausea and vomiting subsequent to chemotherapy or radiation thercq y for malignancies however, other effective antiemetic drugs are available (see Chapter 37). 

A prospective, single-centre study assessing once daily intravenous tobramycin dosing to treat pulmonary exacerbations of CF noted two cases (8%) of transient vestibular disturbance, without any significant nephrotoxicity. Vestibular disturbance appeared to be an early indicator of tobramycin toxicity [18 ]. Cessation of therapy or dose reduction with careful monitoring should be considered in patients experiencing vestibular symptoms. 

Transient blindness Vestibular disturbance Focal neurological deficit Coma... 

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