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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 1998 June;48(2):57-61
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
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.