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Short latency responses in the averaged electro-oculogram elicited by vibrational impulse stimuli applied to the skull: could they reflect vestibulo-ocular reflex function?

V Bahl

¹ Zvolen Hospital, Department of Neurology, Laboratory of Clinical Neurophysiology, Zvolen, Slovak Republic
² Technical University in Zvolen, Faculty of Wood Sciences and Technology, Department of Physics and Applied Mechanics, Zvolen, Slovak Republic

Correspondence to:
Correspondence to:
P Jombík
Hosp. Zvolen, Department of Neurology, Lab Clin Neurophysiol, 96089 Zvden, SK; bahyl{at}vsld.tuzvo.sk

Objectives: To investigate whether vibrational impulse stimuli applied to the skull can be used to evoke the vestibulo-ocular reflex (VOR) and detect vestibular lesions.

Methods: Twenty four patients with unilateral vestibular loss (UVD), five with bilateral vestibular loss, two with ocular palsies, and 10 healthy subjects participated. Vibrations of the skull were induced with head taps and with a single period of 160 Hz tone burst on the inion, vertex, and the mastoids while the patients viewed a distant target. Several patients were also examined while viewing a near target, with eccentric gaze and in tilted postures. Responses were recorded by EOG.

Results: Responses occurred between 5 ms and 20 ms and seemed to be compensatory to the second phase of the sine wave of vibration impulse and were greatly diminished/absent in patients with bilateral VD and ocular palsies. The patients with UVD had asymmetrical responses in the vertical EOG with stimuli applied on the inion and vertex, with enhancement of the response amplitude on the side of vestibular loss and/or diminution on the healthy side. The asymmetry ratios between the healthy subjects and patients with UVD, and among patients with UVD were statistically significant. Some gaze and positional influences could be demonstrated consistent with otolithic reflexes.

Conclusion: If the asymmetric responses to skull vibration in UVD result from passive oscillatory movements of the orbital tissues they may reflect the otolith mediated sustained skew torsion. Conversely, if generated by active eye movements, their likely origin is a phasic VOR.

Abbreviations: a/lVOR, angular/linear vestibulo-ocular reflexes; BVD, bilateral vestibular loss; CFA, craniofacial asymmetries; EOG, electro-oculography; UVD, unilateral vestibular dysfunction VCR, vestibulo-collic reflex

Keywords: vestibulo-ocular reflex; unilateral vestibular dysfunction; impulse vibrational stimuli

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