Electronystagmographic criteria in neuro-otological diagnosis. 1. Peripheral lesions.

Korres, Stavros

doi:10.1136/jnnp.41.3.249

Cited by 3 publications

(5 citation statements)

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“…It is apparent from these results and those described in the previous paper (Korres, 1978) that the electronystagmographic studies of spontaneous nystagmus applied in the manner described reveal patterns of response characteristic of the level of the causative lesion with a highly acceptable degree of confidence; 60% in peripheral lesions, 64% in acoustic neuromata with brain stem involvement, and 70% in high brain stem lesions. The particular patterns associated with each group and dependent upon the different effects of eye closure or darkness have been summarised in Table 1.…”

Section: Discussionsupporting

confidence: 68%

“…The preceding paper (Korres, 1978) has dealt with and confirmed the finding of a characteristic electronystagmographic pattern of response associated with lesions of the peripheral vestibular system. The present communication is concerned with the establishment of similar criteria in terms of localisation in central vestibular lesions, with a view to determining in particular their generality in selected groups of patients.…”

mentioning

confidence: 67%

“…In both groups the pattern of spontaneous nystagmus with and without optic fixation was examined in relation to the clinical and operative findings including a full neuro-otological examination. Details of method are given in the earlier paper (Korres, 1978). The findings in the two groups will be considered separately.…”

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confidence: 99%

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Electronystagmographic criteria in neuro-otological diagnosis. 2. Central nervous system lesions.

Korres¹

1978

Journal of Neurology, Neurosurgery & Psychiatry

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Characteristically the nystagmus takes on a sawtooth waveform with a fast component in one direction followed by a slow component in the other, and on direct observation of the eyes is, in general, indistinguishable in appearance irrespective of the underlying pathology. An important exception stems from the fact that, since nystagmus of peripheral origin is consistently unidirectional, any nystagmus that changes direction with change in gaze deviation must be central in origin. By contrast a spontaneous nystagmus beating in only one direction can be either of peripheral or central origin. As long ago as 1917, however, Holmes noted that removal of optic fixation had a striking effect upon the character of the nystagmus according to the level of the causative lesion, and used this to good effect in the differential diagnosis of labyrinthine and cerebellar lesions.More recently, with the advent of electronystagmography which has facilitated the accurate recording of eye movements either with eye closure or in total darkness, various authors have elaborated on Holmes's observations in respect of the identification of spontaneous nystagmus result-

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Section: Discussionsupporting

confidence: 68%

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confidence: 67%

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Electronystagmographic criteria in neuro-otological diagnosis. 2. Central nervous system lesions.

Korres¹

1978

Journal of Neurology, Neurosurgery & Psychiatry

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“…This is possibly because fixation is removed when most patients close their eyes during CT scanning. In the absence of any nystagmus in the light, the appearance of a unidirectional nystagmus with eye closure or in darkness, or an increase of nystagmus present in the light by eye closure or in darkness [ 30 ]. Because the patient has less time to move during the acquisition, fast scanners reduce motion artifacts.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of any nystagmus in the light, the appearance of a unidirectional nystagmus with eye closure or in darkness, or an increase of nystagmus present in the light by eye closure or in darkness [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The “Vestibular Eye Sign”—“VES”: a new radiological sign of vestibular neuronitis can help to determine the affected vestibule and support the diagnosis

et al. 2023

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Introduction Nystagmus is a valuable clinical finding. Although nystagmus is often described by the direction of its quick phases, it is the slow phase that reflects the underlying disorder. The aim of our study was to describe a new radiological diagnostic sign called “Vestibular Eye Sign”—VES. This sign is defined as an eye deviation that correlates with the slow phase of nystagmus (vestibule pathological side), which is seen in acute vestibular neuronitis and can be assessed on a CT head scan. Materials and methods A total of 1250 patients were diagnosed with vertigo in the Emergency Department at Ziv Medical Center (ED) in Safed, Israel. The data of 315 patients who arrived at the ED between January 2010 and January 2022 were collected, with criteria eligible for the study. Patients were divided into 4 groups: Group A, “pure VN”, Group B, “non-VN aetiology”, Group C, BPPV patients, and Group D, patients who had a diagnosis of vertigo with unknown aetiology. All groups underwent head CT examination while in the ED. Results In Group 1, pure vestibular neuritis was diagnosed in 70 (22.2%) patients. Regarding accuracy, VES (Vestibular Eye Sign) was found in 65 patients in group 1 and 8 patients in group 2 and had a sensitivity of 89%, specificity of 75% and a negative predictive value of 99.4% in group 1—pure vestibular neuronitis. Conclusion VN is still a clinical diagnosis, but if the patient undergoes head CT, we suggest using the “Vestibular Eye Sign” as a complementary sign. As per our findings, this is a valuable sign on CT imaging for diagnosing the pathological side of isolated pure VN. It is sensitive to support a diagnosis with a high negative predictive value.

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The influence of physostigmine on visual-vestibular interaction in hereditary ataxias.

Tijssen¹,

Endtz²,

Goor³

1985

Journal of Neurology, Neurosurgery & Psychiatry

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Electronystagmographic criteria in neuro-otological diagnosis. 1. Peripheral lesions.

Cited by 3 publications

References 5 publications

Electronystagmographic criteria in neuro-otological diagnosis. 2. Central nervous system lesions.

Electronystagmographic criteria in neuro-otological diagnosis. 2. Central nervous system lesions.

The “Vestibular Eye Sign”—“VES”: a new radiological sign of vestibular neuronitis can help to determine the affected vestibule and support the diagnosis

The influence of physostigmine on visual-vestibular interaction in hereditary ataxias.

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