Evaluation of vestibulocochlear nerve and optic nerve involvement in chronic obstructive pulmonary disease by using evoked potential study

Anitcheady, K (2018) Evaluation of vestibulocochlear nerve and optic nerve involvement in chronic obstructive pulmonary disease by using evoked potential study. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION: The term chronic obstructive pulmonary disease (COPD) was introduced to bring together a variety of clinical syndromes associated with destruction of and airflow obstruction. The terms chronic obstructive airways disease(COAD) and chronic obstructive lung disease (COLD) have been used as synonyms in different parts of the world and chronic obstructive pulmonary diseases (COPD) has been defined by the Global Initiative for chronic obstructive lung disease (GOLD) as “a disease stage characterized by air flow limitation that is not fully reversible”. Chronic obstructive pulmonary diseases includes: (i) emphysema defined as the permanent abnormal distension of the air spaces distal to the terminal bronchioles accompanies by destruction of their wall without fibrosis. (ii) chronic bronchitis defined on the presence of chronic productive cough on most days for 3 months in each of two consecutive years. (iii) small air way disease in which small bronchioles are narrowed. Excluded from this definition is Bronchial Asthma , chronic Bronchitis and emphysema were frequently coexist since they share common etiological factors and after many years chronic bronchitis get complicated by emphysema. AIM OF THE STUDY: To evaluate the visual evoked potential (VEP) and brainstem auditory evoked potential (BAEP) abnormalities in COPD patient and its correlation with C-reactive protien (CRP) as a part of multi system disorder. MATERIALS AND METHODS: 40 study group with chronic obstructive pulmonary diseases and 40 control group between the age group of 30-60 years were included in this study based on criteria defined in the global initiative for chronic obstructive lung disease (gold) 2004- guidelines. Patients with chronic neuropathy without COPD diabetes mellitus, chronic alcoholism, uremia, cystic fibrosis, sarcoidosis, leprosy, malignancy, history of intake of neurotoxic drugs, hearing and visual impairment were excluded. Informed written consent from the study and control group were obtained. RESULT: There was significant prolongation of (P100) over the right eye in COPD patients compared with controls. BAEP recording shows significant prolongation of latency of wave I, II, III, IV and V over the left ear. The indices of spirometry FVC, FEV FEV1/FVC, were significantly decreased in COPD patients and CRP were significantly increased in COPD patients when compared with control. CONCLUSION: • Smoking, airway obstruction and long lasting COPD leading to hypoxemia, hypercapnia and respiratory acidosis which may affect the ponto-medullary portion of the brain. This study confirm that there were subclinical VEP and BAEP impairment resulted from COPD illness, which were related to the severity and disease duration. • optic and auditory nerves are commonly affected in COPD which represent an additional problem to physical effect of COPD, and of course both will reflect more impairment in quality of life. So early discovery and correction of these factors might decrease disabilities and help in improvement of quality of life of COPD patients. • The findings from this study indicate that impairment of VEP and BAEP occurred in association with mild chronic respiratory insufficiency. Therefore, the respiratory condition must be taken into account when evaluating VEP and BAEP. • We found that the levels of CRP in stable COPD were not different as compared to control subjects. These results if confirmed in a larger study, which also excludes patients with comorbidities related to chronic inflammation, could contribute to a better understanding of CRP concentrations in COPD patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: visual evoked potential (VEP) ; brainstem auditory evoked potential (BAEP) ; C-Reactive Protein ; Chronic obstructive pulmonary disease ; Hypoxemia.
Subjects: MEDICAL > Physiology
Depositing User: Subramani R
Date Deposited: 16 Aug 2018 17:28
Last Modified: 17 Aug 2018 04:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/9273

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