An osteoma of the middle ear presenting with the Tullio phenomenon
. Skull Base 2003 ; 13: 113-7.
Other causes of vertigo include cerebellar infarction (3% of patients with vertigo), (20) sound-induced vertigo (Tullio phenomenon), (21) obstructive sleep apnea, (22) and systemic sclerosis.
TABLE 1 Types of dizziness and potential causes (3) Presyncope * Dysrhythmia * Vasovagal syncope * Orthostatic hypotension * Hypoglycemia * Hypoxia * Hyperventilation Vertigo * Benign paroxysmal positional vertigo * Labyrinthitis * Vestibular migraine * Meniere's disease * Genetic causes * Acoustic neuroma * Age-related vestibular loss * Cerebellar infarction * Tullio phenomenon * Obstructive sleep apnea * Systemic sclerosis * Diabetes Disequilibrium Atypical ("light-headedness") * Panic attack * Early hyperventilation * Toxin exposure (eg, diphenylarsinic acid, pregabalin, paint thinner) TABLE 2 HINTS: Is the cause of the patient's vertigo central or peripheral?
The typical symptoms of SSCD include vertigo, disequilibrium, autophony, conductive hearing loss, hyperacusis of bone conduction, and pulsatile tinnitus, as well as typical signs such as the Tullio phenomenon (intense sound induced vertigo) and the Hennebert sign (pressure-induced vertigo).
In addition, the Tullio phenomenon and Hennebert sign were found in 6 patients.
At the same time, the Tullio phenomenon and Hennebert sign disappeared in most of the patients except patients No.
Click-evoked vestibular activation in the Tullio phenomenon
. J Neurol Neurosurg Psychiatry.
A close case history determined that the dizziness was evoked by loud sounds (Tullio phenomenon) and the oscillopsia was related to intense exertion.
The investigated parameters included spontaneous nystagmus, head-shaking nystagmus, positional nystagmus during the Dix-Hallpike and head-roll maneuvers, nystagmus with the Valsalva maneuver, the Tullio phenomenon after hyperventilation and exposure to 3 kHz at 110 dB, and eye movements after mastoid vibration at 100 Hz.
The physiologic underpinnings of the Tullio phenomenon were first described in 1929, when Tullio noted that experimentally induced fenestrations in the bony capsule of the lateral semicircular canals of pigeons caused the canals to be sound-responsive, inducing vestibular activation (11,12).
The Tullio phenomenon is seen in a range of clinical contexts, including congenital deafness, Meniere disease, suppurative middle ear disease, and spirochetal infections, such as syphilis or Lyme disease.
An otic capsule dehiscence opens up a third window into the inner ear, and clinical findings such as a low-frequency bone conduction hearing loss, dizziness, vertigo, or Tullio phenomenon
have been reported [2,7].