Head Tilt Posturography: Clinical Value in Peripheral Labirinthine Disorders

Acute vestibular injury, such as vestibular neuritis (VN), can produce a profound alteration in balance manifested by perception disorder and impaired control of postural adjustment and execution of movements. Stabilometry assesses posture balance through the quantification of body oscillations from the orthostatic position in a force platform. It involves monitoring center of pressure (COP) displacement to the lateral direction (X) and anterior-posterior direction (Y). In our study we investigated the postural control of patients affected by VN. We analyzed 30 subjects: 15 patients constituted the case group affected by VN were compared with 15 healthy volunteers. A static posturography was made within 6-24 hours of symptoms onset. Our purpose was to assess the use of posturography Fourier Frequency analysis with head tilt for the detection of peripheral vertigo destabilization. Fourier spectral analysis of body sway reveals that, independently from visual control, patients exhibit a significantly higher level of low/middle frequency oscillations on the frontal plane. The macular stimulation by head tilt increases significantly the difference in all analyzed parameters: there are significant differences of body oscillation in the patients vs controls on X and Y planes, the latter evident only in head tilt tests. The head tilt seems to show an antero-posterior plane destabilization otherwise not evident.