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TULLIO PHENOMENON WITH TORSION OF THE EYES AND SUBJECTIVE TILT OF THE VISUAL SURROUND
Author(s) -
Deecke L.,
Mergner T.,
Plester D.
Publication year - 1981
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1981.tb30908.x
Subject(s) - phenomenon , torsion (gastropod) , tilt (camera) , optometry , psychology , physics , medicine , anatomy , geometry , mathematics , quantum mechanics
A 44-year-old male patient had an acoustic trauma three years previously, after which he suffered from vertigo and tilting of the environment to the right when uttering the vowels u or e. At such times, a tonic eye torsion to the left, which lasted throughout the utterance, was observed under Frenzel's glasses along with head tilt to the left. The phenomenon could be elicited experimentally by right-ear stimulation with low-frequency noise (mean frequency, 125 Hz; 90 dB), as well as by constant pressure. The patient also reported observing the phenomenon with loud noises, nose blowing, obstruction of his right external meatus with the finger, and with altitude pressure changes in a car. This suggests that the phenomenon is elicited via the eardrum and the ossicular chain. Since lateral head tilt and counterrolling were tonic and without nystagmus, it is unlikely that one of the semicircular canals is involved as in usual Tullio cases. Rather, the otoliths may play a role in pathogenesis. Possible causative mechanisms are discussed along with the relevant literature.