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Static and dynamic posturography in patients with vestibular and cerebellar lesions
R W Baloh1, K M Jacobson, K Beykirch
1Department of Neurology, University of California-Los Angeles School of Medicine, 90095-1769, USA. rwbaloh@ucla.edu
Objective:
To assess the diagnostic usefulness of posturography in 2 well-defined patient groups with impaired balance.
Patients:
Ten control subjects, 10 patients with bilateral vestibular loss, and 10 patients with cerebellar atrophy.
Outcome Measures:
Amplitude, velocity, and frequency of sway in the anteroposterior and medial-lateral directions on a static platform, on foam, and on a moving platform.
Results:
Both patient groups consistently had increased sway compared with controls, particularly when standing on foam or on a moving platform with eyes closed. Sway amplitude and velocity were increased about the same amount. The Romberg ratio (sway with eyes closed/sway with eyes open) did not reliably differentiate patients from controls or the 2 patient groups from each other. Some patients with cerebellar atrophy exhibited a characteristic body tremor at about 3 Hz in the anteroposterior direction.
Conclusions:
Although sway amplitude and velocity were consistently increased in patients with bilateral vestibular loss and patients with cerebellar atrophy, none of the posturography measurements reliably distinguished the 2 patient groups. The finding of increased frequency of sway in the anteroposterior direction in patients with cerebellar atrophy was of limited value since the tremor was visible at the bedside.