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THE CALORIC EYE TRACKING PATTEAN TEST:VISUAL SUPPRESSION AND POSSIBILITY OF SIMPLIFIED DIFFERENTIAL DIAGNOSIS BETWEEN PERIPHERAL AND CENTRAL VERTIGO E. Sakata 1,2 , K. Ohtsu 1 1ENT-Department, Tokyo Rosai Hospital 2ENT Department, University of Tokyo School of Medicine pp.187-196
Published Date 1976/2/1
DOI https://doi.org/10.11477/mf.1406203846
  • Abstract
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In patients who complain of vertigo or who haveequilibrium disorders, it is often difficult to de-termine the etiology of the disorder, that is to de-termine whether it is dependent on a peripheralor central vestibular disorder. To attempt to de-termine the etiology in these cases, we divised anew method, the caloric eye tracking pattern test(CETP-Test).

Seventeen normal subjects and 161 patients weretested. The latter group included 33 with peripheraldisorders such as Meniere's disease, benign paroxy-smal positional nystagmus, and others, and 128 withcentral disorders such as vertebral basilar arteryinsufficiency, cervical vertigo, and others, weretested. The cases of central disorders were limitedto those patients whose eye tracking pattern beforethe caloric stimulation was normal.

In normal subjects and in patients with peripheraldisorders, it is well known that caloric nystagmushas little influence on the eye tracking pattern.In contrast, in patients with central vestibular dis-orders, caloric nystagmus evokes abnormalities onthe eye tracking pattern, either superimposed orsaccades, despite the fact that the eye trackingpattern before the caloric stimulation is normal.

First we administer the eye tracking test usinga target which moves horizontally at 0.3 cycle persecond. Next, we perform the caloric test on theright ear, using 20c. c. of ice water for 10 seconds.During the evoked caloric nystagmus we administerthe eye tracking test once again. The eye trackingpattern is recorded for 20 seconds beginning 50seconds after the start of the ice water injection.The procedure repeated on the left ear. The resultson each case are presented as three patterns ofENG-recording.

We may state that in normal subjects and inpatients with peripheral vestibular disorders, visualsuppression of caloric nystagmus remains functional.Caloric induced nystagmus does not affect theCETP. In patients with central vestibular disorders,visual suppression of caloric nystagmus does notfunction properly because of defects in the visualsuppression mechanism. Therefore, caloric nystag-mus greatly influences the CETP. Consequently,the CETP may not be smooth when CETP test isadministered to patients with central vestibulardisorders. We may say also that the visual sup-pression to the vestibular nystagmus is evokedmore strongly by pursuing a moving visual stimulusthan by gazing a stational target.

These results allow for a differential diagnosisbetween peripheral and central disorders.


Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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