Korean J Otolaryngol-Head Neck Surg.  2006 Sep;49(9):897-903.

Clinical Significance of Vibration-Induced Nystagmus in Unilateral Peripheral Vestibular Loss

• Koo JW
• Moon IJ
• Hong SL
• Moon SY
• Choi KD
• Kim JS

Abstract

BACKGROUND AND OBJECTIVES
Vibration-induced nystagmus(VIN) may be a useful bedside sign for detecting vestibular imbalance. However, the clinical significance of VIN remains unclear. The aim of this study is to analyze the lateralizing value of VIN in patients with unilateral vestibular deficit after acute vestibular functional loss.
SUBJECTS AND METHOD
Forty patients with peripheral vestibular loss of acute etiology were included. Patients assuming fluctuating or slowly aggravating vestibular dysfunction were excluded. VIN was induced by applying 100 Hz vibratory stimuli to both mastoids side by side. Direction and intensity of horizontal nystagmus were analyzed by using video-oculography. Post-head shaking nystagmus(HSN), caloric test and vestibular evoked myogenic potential(VEMP) were also performed. Age matched 25 healthy volunteers were included for control.
RESULTS
Of the 40 patients, 37(92.5%) showed contralesional VIN whereas only one exhibited ipsilesional nystagmus. Two patients(2.5%) did not develop VIN. Immediate HSN was present in 31(77.5%) patients. VIN and HSN were present in the same direction in 24 patients and in the opposite direction in 5. The intensity of VIN showed significant correlations with the intensity of HSN and the degree of canal paresis on bithermal caloric test, whereas it did not depend on the presence of VEMP.
CONCLUSION
VIN is mostly contralesional in peripheral vestibulopathies. VIN may be a simple and useful clinical sign for indicating lateralization in fixed vestibular loss.

Keyword

Nystagmus; Vibration; Caloric test; Evoked potential; Vestibular disease

MeSH Terms

Caloric Tests
Evoked Potentials
Healthy Volunteers
Humans
Mastoid
Nystagmus, Pathologic
Paresis
Vestibular Diseases
Vibration