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Vibration-induced shift of the subjective visual horizontal - A sign of unilateral vestibular deficit

Karlberg, Mikael LU ; Aw, Swee T; Halmagyi, G Michael and Black, Ross A (2002) In Archives of Otolaryngology - Head & Neck Surgery 128(1). p.21-27
Abstract
Background: Vibration to the head or neck excites vestibular and neck muscle spindle afferents. Can such vibrations improve the sensitivity of the subjective visual horizontal (SVH) test to chronic unilateral deficit of the vestibular system? Design: Controlled experimental study. Setting: Tertiary referral center. Patients and Controls: Thirteen healthy subjects and 23 patients with chronic unilateral vestibular deficits after vestibular neurectomy or neurolabyrinthitis. Results of head-impulse test showed unilateral loss of function of all 3 semicircular canals in 14 patients and loss of anterior and lateral semicircular canals in 9 patients. Intervention: Unilateral vibration (92 Hz; 0.6-mm amplitude) applied to sternocleidomastoid... (More)
Background: Vibration to the head or neck excites vestibular and neck muscle spindle afferents. Can such vibrations improve the sensitivity of the subjective visual horizontal (SVH) test to chronic unilateral deficit of the vestibular system? Design: Controlled experimental study. Setting: Tertiary referral center. Patients and Controls: Thirteen healthy subjects and 23 patients with chronic unilateral vestibular deficits after vestibular neurectomy or neurolabyrinthitis. Results of head-impulse test showed unilateral loss of function of all 3 semicircular canals in 14 patients and loss of anterior and lateral semicircular canals in 9 patients. Intervention: Unilateral vibration (92 Hz; 0.6-mm amplitude) applied to sternocleidomastoid muscle (SCM) or mastoid bone. Main outcome Measure: Results of SVH test (in degrees). Results: Without vibration, 13 of 23 patients and all healthy subjects had SVH of less than 3degrees (sensitivity, 43%; specificity, 100%). During vibration to the ipsilesional SCM, SVH increased to greater than 3' in 21 of 23 patients but in only I of 13 healthy subjects (sensitivity, 91%; specificity, 92%). The patient group had significantly greater SVH shifts to the ipsilesional side than did healthy subjects in response to SCM and mastoid bone vibration on either side. The SVH shift during vibration to the ipsilesional SCM was significantly greater than that during vibration to the contralesional muscle (P<.001) or to the mastoid bone on either side (P<.05). The vibration-induced SVH shift was significantly greater in those patients with loss of 3 semicircular canals than in those with loss of 2 (P<.01). Conclusions: The sensitivity of the SVH test to chronic unilateral vestibular deficits can be improved by applying vibration to the SCM. The magnitude of vibratory SVH shift is related to the extent of unilateral deficit of the otolithic organs, vertical canals, or both. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Otolaryngology - Head & Neck Surgery
volume
128
issue
1
pages
21 - 27
publisher
American Medical Association
external identifiers
  • pmid:11784249
  • wos:000173211900003
  • scopus:0036142507
ISSN
1538-361X
language
English
LU publication?
yes
id
8406ae02-3133-4d37-baf9-1e0e40cc04e1 (old id 346267)
alternative location
http://archotol.ama-assn.org/cgi/content/abstract/128/1/21
date added to LUP
2007-11-07 13:01:17
date last changed
2017-09-24 03:32:41
@article{8406ae02-3133-4d37-baf9-1e0e40cc04e1,
  abstract     = {Background: Vibration to the head or neck excites vestibular and neck muscle spindle afferents. Can such vibrations improve the sensitivity of the subjective visual horizontal (SVH) test to chronic unilateral deficit of the vestibular system? Design: Controlled experimental study. Setting: Tertiary referral center. Patients and Controls: Thirteen healthy subjects and 23 patients with chronic unilateral vestibular deficits after vestibular neurectomy or neurolabyrinthitis. Results of head-impulse test showed unilateral loss of function of all 3 semicircular canals in 14 patients and loss of anterior and lateral semicircular canals in 9 patients. Intervention: Unilateral vibration (92 Hz; 0.6-mm amplitude) applied to sternocleidomastoid muscle (SCM) or mastoid bone. Main outcome Measure: Results of SVH test (in degrees). Results: Without vibration, 13 of 23 patients and all healthy subjects had SVH of less than 3degrees (sensitivity, 43%; specificity, 100%). During vibration to the ipsilesional SCM, SVH increased to greater than 3' in 21 of 23 patients but in only I of 13 healthy subjects (sensitivity, 91%; specificity, 92%). The patient group had significantly greater SVH shifts to the ipsilesional side than did healthy subjects in response to SCM and mastoid bone vibration on either side. The SVH shift during vibration to the ipsilesional SCM was significantly greater than that during vibration to the contralesional muscle (P&lt;.001) or to the mastoid bone on either side (P&lt;.05). The vibration-induced SVH shift was significantly greater in those patients with loss of 3 semicircular canals than in those with loss of 2 (P&lt;.01). Conclusions: The sensitivity of the SVH test to chronic unilateral vestibular deficits can be improved by applying vibration to the SCM. The magnitude of vibratory SVH shift is related to the extent of unilateral deficit of the otolithic organs, vertical canals, or both.},
  author       = {Karlberg, Mikael and Aw, Swee T and Halmagyi, G Michael and Black, Ross A},
  issn         = {1538-361X},
  language     = {eng},
  number       = {1},
  pages        = {21--27},
  publisher    = {American Medical Association},
  series       = {Archives of Otolaryngology - Head & Neck Surgery},
  title        = {Vibration-induced shift of the subjective visual horizontal - A sign of unilateral vestibular deficit},
  volume       = {128},
  year         = {2002},
}