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A vestibular schwannoma (VS), also called acoustic neuroma, is a benign tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. The tumor originates when Schwann cells that form the insulating myelin sheath on the nerve malfunction.
The most common cerebellopontine angle (CPA) tumor is a vestibular schwannoma affecting cranial nerve VIII (80%), followed by meningioma (10%). The cranial nerves affected are (from most common to least common) : VIII (cochlear component), VIII (vestibular component), V Acoustic neuroma/vestibular schwannoma
Bruns nystagmus is an unusual type of bilateral nystagmus most commonly occurring in patients with cerebellopontine angle tumours.It is caused by the combination of slow, large amplitude nystagmus (gaze paretic nystagmus) when looking towards the side of the lesion, and rapid, small amplitude nystagmus (vestibular nystagmus) when looking away from the side of the lesion. [1]
Similar to the sensory organization test, the visual pathway would then be removed by closing the eyes. If the proprioceptive and vestibular pathways are intact, balance will be maintained. But if proprioception is defective, two of the sensory inputs will be absent and the patient will sway then fall. Similar to the Romberg Test, the patient ...
It is the area of integration between proprioceptive, and vestibular inputs, to aid in unconscious maintenance of balance and posture. The inferior olivary nucleus aids in complex motor tasks by encoding coordinating timing sensory information; this is decoded and acted upon in the cerebellum .
Other sensory modalities exist, for example the vestibular sense (balance and the sense of movement) and proprioception (the sense of knowing one's position in space) Along with Time (The sense of knowing where one is in time or activities). It is important that the information of these different sensory modalities must be relatable.
The receptor for the sense of balance resides in the vestibular system in the ear (for the three-dimensional orientation of the head, and by inference, the rest of the body). Balance is also mediated by the kinesthetic reflex fed by proprioception (which senses the relative location of the rest of the body to the head). [22]
Recent research has shown that damage to the medial vestibulospinal tract alters vestibular evoked myogenic potential in the sternocleidomastoid muscle (SCM), [12] [13] which are involved in head rotation. The vestibular evoked myogenic potential is an assessment of the sacculo-collic reflex and a test of function in otolithic organs.