Effects of Ocular Fixation on Rotation Nystagmus in Damped Pendular Rotation Test

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Effects of ocular fixation on pendular rotation nystagmus were investigated in sixty-five patients. There were twenty-five with peripheral vestibular or vestibulo-cochlear disorders, seventeen with central vestibular disorders, five with congenital nystagmus, sixteen patients over sixty years old with vertigo in whom peripheral vestibular disorders were ruled out, however, the causes were unknown.<BR>Damped pendular rotation test (DPRT) was performed both under darkness and employing mental arithmetic and under ocular fixation. Patients were asked to look at a red lamp thirty-five cm from their eyes and which was fixed on the rotating chair. These findings were related to those of caloric vestibular suppression test (VST) by Takemori and those of optokinetic pattern test (OKP), eye tracking test (ETT) and spontaneous nystagmus.<BR>Thirteen out of seventeen with central vestibular disorders and five with congenital nystagmus showed loss of visual suppression during ocular fixation in DPRT, while in cases of peripheral lesions, visual suppression was observed. Loss of visual suppression during ocular fixation in DPRT was often seen in cases of brainstem and cerebellar lesions. In brainstem lesions, rotation nystagmus was evoked during ocular fixation, while no nystagmus was seen in darkness with eyes open. In cerebellar lesions, rotatory nystagmus was partly suppressed or decreased during ocular fixation. These findings coincide with findings in cases of VST in caloric nystagmus. Nystagmus enhancement during ocular fixation in DPRT may be related to an increase in slow phase velocity in caloric VST, as seen in cases of brainstem lesions. Relationships between the direction of the visual suppression during ocular fixation in DPRT and the side of the lesion were not apparent.<BR>Ocular fixation test in DPRT has a diagnostic value not only for central lesions, but for differentiating brainstem lesion from cerebellar lesion with the findings in DPRT under darkness. The findings under ocular fixation in DPRT are closely related to those of VST in cases of caloric nystagmus.
日本めまい平衡医学会の論文

Effects of Ocular Fixation on Rotation Nystagmus in Damped Pendular Rotation Test

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