電気性眼振,直立動揺の診断的意義
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Galvanic nystagmus and the sway of the body center of gravity (galvanic body sway) were used to differentiate between otoliths and semicircular canal lesions in patients with bilateral loss of labyrinthine excitability.<BR>Methods. Galvanic stimulation was performed by the biaural-bipolar method. (1) Galvanic nystagmus induced by application of a direct current of 3 mA for 60 seconds was counted macroscopically. (2) The subject was instructed to stand on a stabilometer, and galvanic body sway was examined by galvaniza-tion at 1 mA for 6 seconds.<BR>Results. One patient did not show any galvanic nystagmus. but had normal galvanic body sway. Two patients had opposite results. Clinical symptoms and other balance tests, such as the standing test, suggest that galvanic nystagmus reflects mainly the reaction of the semicircular canal system and body sway mainly the reaction of the otolith system.<BR>Such phenomena are explained as follows : First, it is considered that although both the canal system and the otolith system can cause ocular reflexes and spinal reflexes, the main role of the canal system is to cause nystagmus, while that of the otolith system is to cause spinal reflexes. Second, in the canal system, the kinetic reaction is superior, with a high threshold for galvanic stimulation, which makes it difficult to observe spinal reflexes from the canal system, while in the otolith system the tonic reaction is superior, causing spinal reflexes at a low threshold.<BR>The results indicate that it is possible to differentiate lesions of the semicircular canal system from those of the otolith system by analyzing galvanic nystagmus and body sway.
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