PubMed · 5418433
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E Dienstbier, J Balík, O Fischer. 1970. [Electrooculography and glaucoma].. https://pubmed.ncbi.nlm.nih.gov/5418433/
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The development of visual and vestibular control of smooth gaze adjustments was studied longitudinally in 3- to 18-week-old infants. Eye and head movements were measured with electro-oculography (EOG) and an optoelectronic system, respectively. The infant was placed in a chair providing full support to the trunk but allowing relatively free head movements. The chair was positioned at the center of a striped-patterned drum. The chair and the drum were oscillated sinusoidally, either individually or in synchrony at 0.25 Hz. When the drum oscillated around the infant (the optokinetic response condition, OKR), the gain of both smooth eye and head tracking components was low up to 6 weeks of age, after which the eye gain increased dramatically and the lag decreased. The most substantial increase in head gain was observed at 13-18 weeks of age. When only the chair was oscillated (visual VOR, VVOR), the compensatory eye gain was high at 3 weeks and the head contributed significantly to the compensation (vestibulocollic reflex, VCR). The head gain increased significantly at 13-18 weeks of age as in the OKR case. When the drum and the chair were oscillated synchronously (inhibition of VOR, VORINHIB), the compensatory eye gain was significantly lower than in the VVOR, indicating suppression of VOR. This effect was considerable at 3 weeks. However, VCR was not suppressed but comparable to the VVOR condition at all ages studied. In summary, we found that the vestibular control of smooth gaze adjustment functions earlier than the visual control. At 2 months, the visual control improves dramatically and at 3-4 months head participation increases considerably. The eye gain in the VORINHIB condition could be well predicted by vector addition of the eye position signals in the OKR and VVOR conditions.
BACKGROUND: It has long been a goal to develop a means to measure squint angles in three dimensions simultaneously. A three-dimensional binocular method is naturally needed especially with surgical procedures that affect three dimensions of ocular motility. METHODS: Special modifications of a videographic method provide simultaneous online data on the three-dimensional position of the eyes. The interocular difference is equal to the amount of squint, depending on the direction of gaze, head-tilt/direction of gravity, and convergence. RESULTS: The method introduced provides three-dimensional and binocular documentation of ocular movements. This could lead to improved pre- and postsurgical examination, especially of rotational disturbances, and it could also offer an objective means for comparing the results of various surgical procedures.
OBJECTIVES: The current gold standard for diagnosis of benign paroxysmal positional vertigo (BPPV) is the Dix-Hallpike maneuver. However, because of fatigability, the Dix-Hallpike is often falsely normal. The objective of this study was to evaluate the utility of vestibular autorotation testing in the diagnosis of BPPV. METHODS: The charts of 210 patients at a tertiary referral center for vertiginous disorders were reviewed. All patients underwent clinical evaluation, Dix-Hallpike testing, audiometry, electronystagmography, and vestibular autorotation testing. The vestibular autorotation results of patients with BPPV were compared with the findings in patients with non-BPPV vestibular disorders. The sensitivity and specificity of vestibular autorotation testing in diagnosing BPPV were calculated. RESULTS: Ninety-one patients (42.9%) had BPPV, 76 patients (36.2%) had vertigo of uncertain cause, 28 (13.3%) had unilateral vestibular hypofunction, 9 patients (4.3%) had Meniere's disease, and 2 patients (1.0%) had perilymphatic fistula. Patients with BPPV were 3.32 times more likely to have a normal horizontal gain (95% CI = 1.54-7.19). A normal horizontal gain is 85% sensitive but only 36% specific for BPPV. Patients with BPPV were 1.9 times more likely to have vertical phase lead (95% CI = 0.95-3.93). Patients with BPPV were 2.20 times more likely to have both normal horizontal gain and vertical phase lead (95% CI = 1.03-4.69) The sensitivity of the combination of normal horizontal gain and vertical phase lead on vestibular autorotation testing is 87% specific but only 25% sensitive in the diagnosis of BPPV. CONCLUSION: A normal horizontal gain or vertical phase lead on vestibular autorotation testing in a vertiginous patient is suggestive of but not exclusive to a diagnosis of BPPV. The combination of a normal horizontal gain and vertical phase lead on vestibular autorotation testing is highly suggestive of the diagnosis of BPPV. Adjuvant use of these parameters in vestibular autorotation testing may prove to be helpful in the diagnosis of BPPV.