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Otorinolaringologia 1998 June;48(2):57-61

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Comparative research on directional preponderance of nystagmus evoked by thermic stimulation and impulsive stop test

Taborelli G., Meloni A., Melagrana A., D’Agostino R.

From the Otorhinolaryngology Department “Giannina Gaslini” Institute, Genoa, Italy


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Background. We ­have decid­ed to ­observe: 1) wheth­er a “Directional pre­pon­der­ance of pro­voked nys­tag­mus” may also be obtained using a rotatory-acceleratory stimulation lower than that adopted by Arslan (700-900°/sec2); 2) whether a“Directional pre­pon­der­ance of pro­voked nys­tag­mus” detect­ed by ther­mic stim­u­la­tion may be ­observed ­also by the before cited test.
Methods. We ­observed 41 ver­tig­i­nous ­patients: 13 (32%) suf­fer­ing ­from periph­er­al ves­tib­u­lar pathol­o­gy and 28 (68%) ­from cen­tral ves­tib­u­lar pathol­o­gy. All ­patients ­first under­went ther­mic stim­u­la­tion ­based on the mod­i­fied Fitzgerald-Hallpike’s meth­od (250 cc in 40 sec at 44 and 30°) and ­then bilat­er­al impul­sive neg­a­tive angu­lar accel­er­a­tion (360°/sec2 ­stop ­test). To ­observe a sig­nif­i­cant “Directional pre­pon­der­ance of pro­voked nys­tag­mus” the for­mu­la of Jonkees (1953) was tak­en ­into ­account.
Results. A “Directional pre­pon­der­ance of pro­voked nys­tag­mus” was detect­ed in i6 out of 41 cas­es exam­inat­ed (39%). In 12 cas­es the pre­pon­der­ance was to the ­right, in 4 cas­es, to the ­left. We ­obtained a “Directional pre­pon­der­ance of pro­voked nys­tag­mus” in 3 cas­es out of the 13 suf­fer­ing ­from periph­er­al ves­tib­u­lar pathol­o­gy and in 13 cas­es out of the 28 suf­fer­ing ­from cen­tral ves­tib­u­lar pathol­o­gy.
Conclusions. The ­results ­obtained ­show ­that ­even an impul­sive ­stop ­test (360°/sec2) of ­much less­er impor­tance ­than the ­test ­used by Arslan (700°-900°/sec2) may be effi­ca­cious­ly ­used to evi­dence a pos­sible “Directional pre­pon­der­ance of pro­voked nys­tag­mus” (­since it can deter­mine a val­u­able 2nd ­phase in the nys­tag­mus). “Directional pre­pon­der­ance of pro­voked nys­tag­mus” so a exists in periph­er­al ­forms, but our inves­ti­ga­tion has con­firmed ­that the phe­nom­e­non may be ­observed, accord­ing to Filippi’s ­reports in dif­fer­ent cen­tral path­o­log­i­cal ­states with­out a reli­able ­sign for a pre­cise top­o­graf­ic delim­i­ta­tion of the ­lesion.

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