Clin Exp Otorhinolaryngol.  2008 Jun;1(2):63-74. 10.3342/ceo.2008.1.2.63.

Nystagmus as a Sign of Labyrinthine Disorders: Three-Dimensional Analysis of Nystagmus

• Yagi T

• KMID: 1486056
• DOI: http://doi.org/10.3342/ceo.2008.1.2.63

Abstract

In order to diagnose the pathological condition of vertiginous patients, a detailed observation of nystagmus in addition to examination of body equilibrium and other neurotological tests are essential. How to precisely record the eye movements is one of the goals of the researchers and clinicians who are interested in the analysis of eye movements for a long time. For considering that, one has to think about the optimal method for recording eye movements. In this review, the author introduced a new method, that is, an analysis of vestibular induced eye movements in three-dimensions and discussed the advantages and limitations of this method.

Keyword

Nystagmus; Three-dimensional analysis; Labyrinthine disorders; Equilibrium; Vertigo

MeSH Terms

Eye
Eye Movements
Humans
Vertigo

Figure

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  Fig. 1 Positioning test through infrared CCD camera. The examiner observes the patient's eye movements on a TV monitor.

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  Fig. 2 The simplified schematic representation of scleral search coil method. A uniform alternating magnetic field (vertical arrows) induces an alternating voltage in the eye coil, the amplitude of which is proportional to the sine of the angle between the plane of eye coil and direction of magnetic field (θ).

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  Fig. 3 Infrared CCD camera attached to the specially designed goggle. The goggle for observing the positional and positioning nystagmus through infrared CCD cameras in complete darkness (A) and in light using infrared reflection mirrors (B).

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  Fig. 4 Calculation of the horizontal, vertical, and torsional eye movements. The horizontal and vertical eye movements are calculated from the path of the center of the pupil (large +) and the torsional eye movements are calculated from the relation between the several iris striations (small +) and the center of the pupil (large +).

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  Fig. 5 The printout charts of horizontal (A) and vertical (B) saccades using the high-speed camera of 240 Hz sampling rate.

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  Fig. 6 The average amplitude changes of horizontal, vertical, and torsional eye movements in relation to the head position during a pendular rotation. The filled circles, filled squares, and open diamonds represent the average amplitude of horizontal, vertical, and torsional eye movements, respectively.

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  Fig. 7 The hydraulic driven spherical dome for examining the off vertical axis rotation (OVAR). The seen of outside (A) and the inside (B) of the dome.

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  Fig. 8 The eye movements during OVAR (A) and traces of the eye position after removing the saccades using computer program (B).

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  Fig. 9 The phase of the modulation component (MOC) in relation to the head position (A) and the fitting with least square sinusoids (B). The clear bias component (BIC) is seen in the horizontal eye movement.

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  Fig. 10 The three dimensional representation of the velocity vectors of the pressure nystagmus which are recorded from the eleven patients with lateral semicircular canal fistulae due to the cholesteatoma. The velocity vectors of nystagmus in these patients (thin black lines) are well aligned with the anatomical axis of the horizontal canal (circles on the surface of the sphere) with a standard deviation.

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  Fig. 11 The axes of the slow phase of nystagmus in a patient showed good alignment to the posterior canal axis both in sitting and head hanging positions (upper line) and that of a patient who exhibited good alignment in head the head hanging position and poor alignment in the sitting position to the posterior canal (lower line). A, B, and C indicate the view of eye from the front, the side, and the above, respectively. LPC: left posterior canal, RPC: right posterior canal.

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  Fig. 12 Three-dimensional representation of the cough-induced nystagmus in a patient with superior semicircular canal ehiscence syndrome. The right side view of the eyeball during cough (A) and same the cough-induced nystagmus as recorded on a different date rom that from A (B).

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