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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

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


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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