Impaired Visual Suppression of Manually Rotated Vestibuloocular Reflex Indicates the Need of Further Evaluation by MRI and MRA in Patients with Vertigo

Abstract

OBJECTIVE: MRI and MRA are accepted as valuable methods for diagnosing vertigo, although they are costly and time-consuming. Thus, some indicator of the necessity of a detailed evaluation by MRI and MRA is desirable.

STUDY DESIGN AND SETTING: To assess the usefulness of an impairment of the visual suppression (VS) as an indicator, the relation between abnormal findings on MRI and/or MRA and impairment of the VS of manually rotated vestibuloocular reflex (VOR) was retrospectively examined in 40 consecutive patients suffering from vertigo.

RESULTS: 12 of 23 patients with a low VS% were found to have a pathologic condition on MRI and/or MRA, however, no abnormality was found in any of the patients with a normal VS%. The rates of abnormality on MRI and/or MRA significantly differed between the 2 groups (X ², P = 0.0004).

CONCLUSION: The VS% is thought to be a good indicator of the need for further evaluation by MRI and MRA in vertiginous patients.

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References

Silvoniemi

Laurikainen

Johansson

. Electronystagmographic findings in patients with acute cerebral vascular disease and vertigo. Acta Otolaryngol Suppl 2000;543:41–3.

Schick

Brors

Koch

. Magnetic Resonance imaging in patients with sudden hearing loss, tinnitus and vertigo. Otol Neurotol; 2001;22:808–12.

Held

Fellner

. Correlation of 3D MRI and clinical findings in the patients with sensorineural hearing loss and/or vertigo. Clin Imaging 1998;22:309–22.

Welsh

Lewin

Vertigo: Analysis by magnetic resonance imaging and angiography. Ann Otol Rhinol Laryngol 2000;109:239–48.

Seo

Tominaga

Sakagami

Relationship between neurological asymptomatic vertigo and the vertebrobasilar system as revealed by magnetic resonance angiography. ORL J Otorhinolaryngol Relat Spec 2000;62:63–7.

Welsh

Jaffe

. Syndromal vertigo identified by magnetic resonance imaging and angiography. Laryngoscope 1996;106:1144–51.

Baloh

Honrubia

Clinical neurophysiology of the vestibular system. Philadelphia: F.A. Davis; 1979. pp. 44–73.

Takemori

Visual suppression test. Ann Otol Rhinol Laryngol 1977;86:80–5.

Fukushima

Corticovestibular interactions: Anatomy, electro-physiology, and functional considerations. Exp Brain Res 1997;117:1–16.

10.

Funabiki

Naito

Matusda

. A new vestibulo-ocular reflex recording system designed for routine vestibular clinical use. Acta Otolaryngol (Stockh) 1999;119:413–9.

11.

Murai

Naito

Funabiki

. Visual suppression testing during manual sinusoidal rotation. Equilibrium Res 2001;60:234–40.

12.

Paige

Vestibuloocular reflex and its interactions with visual following mechanisms in the squirrel monkey. II. Response characteristics and plasticity following unilateral inactivation of horizontal canal. J Neurophysiol 1983;49:152–68.

13.

Takemori

Visual suppression of vestibular nystagmus after cerebellar lesions. Ann Otol Rhinol Laryngol 1975;84:318–26.