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Related Experiment Videos

[Posturography in unilateral peripheral vestibular deficiency].

P L Ghilardi1, B Fattori, A Casani

  • 1Istituto di Clinica Otorinolaringoloiatrica, Università di Pisa.

Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-Facciale
|July 1, 1990
PubMed
Summary

Evaluating vestibular function requires assessing both the vestibulo-ocular reflex (VOR) and the vestibulospinal reflex (VSR). Sensitization tests significantly improve the detection of VSR deficits in unilateral peripheral vestibular lesions.

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Area of Science:

  • Neurology
  • Otolaryngology
  • Vestibular System Function

Background:

  • Vestibular function assessment traditionally focuses on the vestibulo-ocular reflex (VOR).
  • The vestibulospinal reflex (VSR) is crucial for maintaining erect posture under static and dynamic conditions.
  • Unilateral peripheral vestibular lesions (UVL) can impair VSR function, affecting postural stability.

Purpose of the Study:

  • To evaluate the efficacy of computerized stabilometry with sensitization tests in assessing VSR function in UVL patients.
  • To compare the compensation dynamics between VOR and VSR.
  • To identify subclinical VSR deficits using specific sensitization maneuvers.

Main Methods:

  • Sixty-one patients with UVL underwent electrooculography and computerized stabilometry.

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  • Stabilometry was performed under baseline conditions (eyes open/closed) and with sensitization tests: head retroflexion (OCR) and head shaking (OC-HST).
  • Postural sway was quantified using statokinesigram (L and S parameters) and stabilogram parameters (frequency and oscillation amplitude).

    • Main Results:

    • VOR compensation was observed in 47.5% of patients, while static postural alterations were found in 31.1%.
    • Postural alterations increased to 50.8% upon introduction of sensitization tests.
    • Sensitization tests revealed VSR deficits in 'false negative' cases, highlighting their diagnostic value and reducing the apparent variance in compensation between VOR and VSR.

    Conclusions:

    • Comprehensive vestibular assessment must include VSR evaluation alongside VOR.
    • Computerized stabilometry with sensitization tests (OCR, OC-HST) enhances the detection of VSR impairments in UVL.
    • Sensitization tests are effective in identifying subclinical VSR deficits, improving diagnostic accuracy and guiding treatment.