Skull vibration-induced nystagmus in vestibular neuritis

Abstract

Background

As described by Dumas, an 80–100 Hz vibration applied to the mastoid produces a horizontal nystagmus, with quick phases beating away from the affected side in patients with unilateral vestibular loss (UVL).

Aim/objectives

To elucidate the characteristics of skull vibration-induced nystagmus (SVIN) in patients suffering from vestibular neuritis and how these characteristics are related to information provided by the video head impulse test (vHIT).

Material and methods

Sixty-three patients were enrolled to perform a vHIT to measure the gain in both ears. SVIN was induced with stimulation at 30 Hz, 60 Hz, and 100 Hz. The slow phase velocity (SPV) of the SVIN was measured.

Results

The SVIN test was positive in 25/63 patients at 30 Hz, 36/63 at 60 Hz and 46/63 at 100 Hz. Mean gain difference between both ears to obtain a positive SVIN at 30 Hz was observed to be 0.38 ± 0.25, decreasing to 0.35 ± 0.23 at 60 Hz, and 0.31 ± 0.24 at 100 Hz (p = .025). We found a significant positive linear correlation between the gain asymmetry measured using horizontal vHIT and SPV in SVIN at 100 Hz.

Conclusions and significance

There is a close relationship between the difference in the gains of both ears as measured using VHIT and the SPV of the nystagmus induced by SVIN at 100 Hz.

Chinese abstract

背景：如Dumas所述, 对乳突施加80-100 Hz的振动会产生水平眼球震颤, 快速相位从单侧前庭损失（UVL）患者的患侧跳开。

目的：阐明前庭神经炎患者的颅骨振动诱发的眼球震颤（SVIN）的特征以及这些特征与视频头脉冲测试（vHIT）提供的信息有何关系。

材料和方法：纳入63例患者, 对其两只耳朵进行vHIT测试。在30 Hz、60 Hz和100 Hz的刺激下诱导SVIN。测量了慢相速度（SPV）的SVIN。

结果： 63位患者中有25位在30 Hz、36位在60 Hz和46位在100 Hz的SVIN测试为阳性。观察到在30 Hz下获得阳性SVIN的两只耳朵之间的平均增益差为0.38±0.25, 在60 Hz时降至0.35±0.23, 在100 Hz时降至0.31±0.24（p¼.025）。我们发现, 在100 Hz的SVIN中, 使用水平vHIT和SPV测量的增益不对称性之间存在显著的正线性相关。

结论与意义：使用VHIT测量双耳的增益差异和在100 Hz下SVIN诱发的眼球震颤的SPV之间, 两者密切相关。

Keywords:

• Vertigo
• vestibular system
• otology/neurotology

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded b/y Grant [GRS 1634/A/17] from Gerencia Regional de Salud. Junta de Castilla y León, España.