[Quantitative analysis of vestibulo-ocular reflex and optokinetic reflex electronystagmography in patients with unilateral loss of vestibular function]

Abstract

Objective: To study changes of the vestibular function in the process of vestibular compensation.

Methods: The electronystagmography recording of spontaneous nystagmus(SN) with tests for vestibulo-ocular reflex (VOR) and optokinetic reflex (OKR) were performed in 105 patients with unilateral loss of vestibular function, the results were analysed quantitatively.

Results: (1) Twenty-one patients with courses from 3 days to 6 years presented a SN directed towards the intact side, with an average slow phase velocity (ASPV) of 7.12-12.07 degrees/s. (2) The intensity of VOR nystagmus as a response to the warm-cold water stimulation to the intact ear was lower than that of normal subjects. (3) By 0.167 Hz, 90 degrees sinusional oscillation stimulation, the ASPVs of the patients' VOR nystagmus directed towards the intact and affected sides were lower than that of the normal. A predominance of VOR nystagmus rotation towards the intact side was found in patients with courses < or = 5 years. There was no predominance of VOR nystagmus found in patients with courses > 5 years. (4) There was no significant difference between the optokinetic nystagmus (OKN) intensity of the normal persons and that of patients with lesions outside the cerebellopontine angle and with tumors in cerebellopontine angle which was < 2.5 cm in diameter. The OKN intensity of patients with tumors in cerebellopotine angle with diameters > or = 2.5 cm was lower than that of normal subjects. A predominance of OKN towards the intactside was found in these patients.

Conclusion: The vestibular function is in inhibitory and the vestibular system becomes rebalanced due to this inhibition in the process of vestibular compensation.