Diagnostic value of vibration-induced nystagmus obtained by combined vibratory stimulation applied to the neck muscles and skull of 300 vertiginous patients.
On subjects with unilateral vestibular dysfunction, the application of a vibratory stimulation (100 Hz) to the two mastoids and the vertex, and to the right and left dorsal neck muscles produces a nystagmus directed towards the good ear in 85% of patients. Fixation must be suppressed by Frenzel's glasses or video nystagmoscopy. To be significant this nystagmus must appear in at least 3 of the 5 vibratory stimulated sites. On healthy subjects nystagmus is present in 6% of cases but never in those below 30 years. In subjects affected by central vertigo, nystagmus was elicited in 10% of cases and in subjects suffering from vertigo of unknown origin in 6% of cases. Vibration nystagmus which stops immediately after stimulation differs from head shaking nystagmus which is present in only 34% of unilateral vestibular dysfunctions. Vibration occasionally produces a pseudo-caloric nystagmus which persists after stimulation. We believe that vibratory stimulation is a useful test, quick and easy to perform. In conjunction with questionnaires, clinical examination, positional testing and the results of audiometry, it gives an immediate indication of a peripheral lesion when the vertigo is seen for the first time. With unilateral deafness, a positive test leads one to suspect an acoustic neuroma. Conversely if the test becomes negative after a vestibular neuritis when it was initially positive, it is a sign of recovery.
Michel
J
J
Centre ORL, 4 Avenue Jean Perrot, F-38100 Grenoble, France.
Dumas
G
G
Lavieille
J P
JP
Charachon
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002150:Caloric Tests; D002648:Child; D003638:Deafness / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008575:Meniere Disease / Q000175:diagnosis; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000175:diagnosis; D009760:Nystagmus, Physiologic; D010812:Physical Stimulation; D011795:Surveys and Questionnaires; D014717:Vertigo / Q000175:diagnosis* / Q000209:etiology; D015837:Vestibular Diseases / Q000175:diagnosis*; D020338:Vestibular Neuronitis / Q000175:diagnosis; D014732:Vibration