Multiple sclerosis. The value of clinical vestibular examination

A clinical vestibular examination was carried out on 82 patients with multiple sclerosis (MS) selected on McAlpine's criteria. Spontaneous nystagmus, positional nystagmus or pathological caloric test were found in 49 (60%) patients. Pathological horizontal optokinetic nystagmus occurred in 47 (57%) patients. In 36 cases horizontal optokinetic nystagmus was pathological to both sides, in 28 cases combined with a pathological vertical optokinetic nystagmus, indicative of diffuse intracerebral lesions. Lesions in the central vestibular system and in the optokinetic pathways were frequently discovered in early or atypical cases of MS.