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Double-data rate (DDR) RAM doubles the rate of speed at which standard SDRAM can process data That means DDR is roughly twice as fast as standard RAM The standards available for DDR RAM are PC 1600, PC 2100, and PC2700 This new labeling refers to the total bandwidth of the memory, as opposed to the old standard, which listed the speed rating (in MHz) of the SDRAM memory in this case, the PC66, PC100, and the PC133 The numeric value in the PC66, PC100, and PC133 refers to the MHz speed that the memory operates at

Gravity Figure 15-5 Dix-Hallpike maneuver to elicit benign positional vertigo (originating in the right ear) The maneuver begins with the patient seated and the head turned to one side at 45 degrees (A), which aligns the right posterior semicircular canal with the sagittal plane of the head The patient is then helped to recline rapidly so that the head hangs over the edge of the table (B), still turned 45 degrees from the midline Within several seconds, this elicits vertigo and nystagmus that is right beating with a rotary (counterclockwise) component An important feature of this type of peripheral vertigo is a change in the direction of nystagmus when the patient sits up again with his head still rotated If no nystagmus is elicited, the maneuver is repeated after a pause of 30 s, with the head turned to the left Treatment with the canalith repositioning maneuver is shown in Fig 15-6

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FIGURE 8-2

Utriculus Superior canal Figure 15-6 Bedside maneuver for the treatment of a patient with benign paroxysma positional vertigo affecting the right ear The presumed position of the debris within the labyrinth during the maneuver is shown on each panel The maneuver is a fourstep procedure First, a Dix Hallpike test is performed with the patient s head rotated 45 degrees toward the (affected) right ear and the neck slightly extended with the chin pointed slightly upward This position results in the patient s head hanging to the right (Panel A) Once the vertigo and nystagmus provoked by this maneuver cease, the patient s head is rotated about the rostral caudal body axis until the left ear is down (Panel B) Then the head and body are further rotated until the head is almost face down (Panel C) The vertex of the head is kept tilted downward throughout the rotation The patient should be kept in the nal, facedown position for about 10 to 15 seconds With the head kept turned toward the left shoulder, the patient is brought into the seated position (Panel D) Once the patient is upright, the head is tilted so that the chin is pointed slightly downward

the eighth cranial nerve by an adjacent blood vessel and have reported that decompression of the nerve provides lasting relief of symptoms

The common and serious ototoxic effects of the aminoglycoside antibiotics have already been mentioned both on the cochlear hair cells, with loss of hearing, and, often independently, on the vestibular labyrinth Prolonged exposure to these agents can produce a bilateral vestibulopathy without vertigo Instead, there tends to be a disequilibrium associated with oscillopsia The symptoms are especially troublesome when the patient moves Often the disequilibrium is not discovered until a bedfast patient tries to walk Less well appreciated is the occurrence of a slowly progressive vestibulopathy for which no cause can be discerned The latter disorder affects men and women alike, with onset in middle or late adult life The main abnormalities are unsteadiness of gait, which is worse in the dark or with eyes closed, and oscillopsia, which occurs with head movements and is particularly noticeable when walking Vertigo and hearing loss are notably absent, as are other neurologic abnormalities The bilateral vestibular loss can be documented with caloric and rotational testing Baloh and colleagues, in a report of 22 patients with bilateral idiopathic vestibulopathy of this type, found that a signi cant proportion (9 of 22 cases) had a prior history of prolonged episodes of vertigo consistent with the diagnosis of bilateral sequential vestibular neuronitis

Video RAM (VRAM) is a specialized type of memory that is used only with video adapters The video adapter is one of the computer s busiest components, so to keep up with video requirements, many adapters have an on-board micro-microprocessor and special video RAM The adapter can process requests independently of the CPU, then store its results in the VRAM until the CPU retrieves it VRAM is much faster than EDO RAM and is capable of being read from and written to at the same time The result is better and faster video performance Because VRAM includes more circuitry than regular DRAM, VRAM modules are slightly larger The term Video RAM refers to both a specific type of memory and a generic term for all RAM used by the video adapter (much like the term DRAM, which is often used to denote all types of memory that are dynamic) Faster versions of video memory have been introduced, including WRAM

Vestibular Neuronitis (Labyrinthitis)

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