The mechanism of physiological height vertigo. I. Theoretical approach and psychophysics

A theory is presented supporting a geometrical explanation of physiological height vertigo as a 'distance vertigo' created by visual destabilization of posture when the distance between the observer and visible stationary contrasts becomes critically large. Though height vertigo is generally regarded as a psychopathological process, we hypothesize that it might instead result from an intersensory mismatch when visual information is at variance with vestibular and proprioceptive inputs. Psychophysical experiments confirming the hypothesis revealed that: 1) height vertigo is clearly related to body position, being the greatest in the upright stance; 2) it is the eye-object distance rather than the direction of gaze which is critical; 3) there is a saturation of height vertigo magnitude. Subjective vertigo increases with increasing altitude only below 20 metres. Physiological 'distance vertigo' must be distinguished from psychological 'acrophobia'. Its postural consequences may be ameliorated by strategies gleaned from knowledge of its mechanism such as providing nearby stationary contrasts in the peripheral visual field.