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Horizontal Linear Vestibulo‐Ocular Reflex Testing in Patients with Peripheral Vestibular Disorders
Author(s) -
LEMPERT THOMAS,
GRESTY MICHAEL A.,
BRONSTEIN ADOLFO M.
Publication year - 1999
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.1749-6632.1999.tb09188.x
Subject(s) - vestibular system , utricle , vestibulo–ocular reflex , reflex , medicine , audiology , peripheral , linear acceleration , vertigo , vestibular nerve , nystagmus , visual acuity , ophthalmology , physics , anesthesia , surgery , acceleration , classical mechanics
A bstract : Horizontal eye movements in response to lateral head translation [linear vestibulo‐ocular reflex (LVOR)] in normal subjects and in patients with bilateral vestibular failure ( n = 14), unilateral vestibular nerve section ( n = 9), and benign positional vertigo ( n = 14), were studied.2 LVORs were elicited in darkness by step acceleration (0.24 g) of the whole body along the interaural axis. Results and conclusions: (1) in patients with bilateral vestibular failure, LVORs were either absent or abnormal with asymmetries, diminished velocities, and prolonged latencies. Measurements of dynamic visual acuity during linear self‐motion showed decreased performance in patients at 1.0 and 1.5 Hz, which correlated with absent or delayed LVORs. These findings demonstrate the functional role of LVORs for dynamic visual acuity. (2) Early after vestibular nerve section, LVORs were diminished or absent with head acceleration toward the operated ear and normal in the opposite direction. After 6‐10 weeks, responses were symmetrical again. Thus, a single utricle appears to be polarized with respect to the LVOR early after unilateral vestibular loss generating mostly contraversive responses. (3) Patients with benign positional vertigo showed mostly normal LVORs, which can be explained by minor utricular damage or central compensation of a chronic unilateral deficit.