The vestibular system is important for the development of normal movement reactions, motion tolerance, and motor control for postural alignment, balance, and vision. A vestibular system that is damaged by disease or injury in childhood can have a major impact on a child’s development. In addition, the emergence of vestibular lesions may also lead to cognitive deficits,...

A 48-year-old man presented with vertigo, unsteadiness, nausea, and vomiting that developed subacutely when he was at work. Hearing was preserved. Apart from left displacement during the Fukuda stepping test, nothing relevant was found through neurologic examination (see video on the Neurology Web site at www.neurology.org). Head impulse test (HIT) was positive on the left side. Asymmetry of th...

Horizontal head-shaking may induce nystagmus in peripheral as well as central vestibular lesions. While the patterns and mechanism of head-shaking nystagmus are well established in peripheral vestibulopathy, they require further exploration in central vestibular disorders. To define the characteristics and mechanism of head-shaking nystagmus in central vestibulopathies, we investigated spontane...

The perceived orientation of objects, gravity, and the body are biased to the left. Whether this leftward bias is attributable to biases in sensing or processing vestibular, visual, and body sense cues has never been assessed directly. The orientation in which characters are most easily recognized--the perceived upright (PU)--can be well predicted from a weighted vector sum of these sensory cue...

OBJECTIVES The aim of this study was to investigate the differences in clinical manifestations of in two groups of vestibular neuritis (VN) patients with or without unidentified bright objects (UBOs). METHODS A prospective, observational study with 46 patients diagnosed with VN between May 2013 and November 2013 was executed. A caloric test, a cervical vestibular-evoked myogenic potentials (c...

OBJECTIVE To evaluate the clinical pathophysiology of oculomotor changes in a patient presenting with a spontaneous semicircular horizontal canal plug. PATIENT A 42-year-old man with acute spontaneous vertigo with spinning and persistent left-horizontal nystagmus, intensity but not direction dependent on head orientation with respect to gravity, indicating a benign paroxysmal positional verti...

According to Alexander's law (AL), the slow phase velocity of nystagmus of vestibular origin is dependent on horizontal position, with lower velocity when gaze is directed in the slow compared with the fast phase direction. Adaptive changes in the velocity-to-position neural integrator are thought to cause AL. Although these changes have been described for the horizontal neural integrator, nyst...

OBJECTIVE Vestibular evoked myogenic potential (VEMP) is a clinical test used in the diagnosis of vestibular diseases. VEMP uses several stimulants to stimulate the vestibular system and measure myogenic potentials. The aim of this study was to compare the effects of tone burst, click, and chirp stimulation in VEMP on the latency and amplitude of myogenic potentials. MATERIALS AND METHODS We ...

Vibration-induced nystagmus, as clinical sign, was recently introduced in outpatient clinical practice for the study and evaluation of otoneurological patients. This response, which can only be evoked by bone conducted vibratory stimulation in the mastoid region or at the location on the forehead in the midline at the hairline, was essentially designed for patients with persistent unilateral ve...

BACKGROUND A vestibulospinal test known as the Fukuda stepping test (FST) has been suggested to be a measure of asymmetrical labyrinthine function. However, an extensive review of the performance of this test to identify a peripheral vestibular lesion has not been reported. PURPOSE The purpose of this study was to evaluate the sensitivity and specificity of the standard FST and a head shaking...