1978 Volume 37 Issue 1 Pages 19-26
Long-term observations on equilibrium disturbances in patients with unilateral and bilateral loss of labyrinthine excitability were undertaken. The purpose of the study was to elucidate the peculiarity of equilibrium disturbances when the compensatory adjustments are inefficient and clarify how the labyrinthine reflexes function in the daily behavior of humans.
The study included 6 patients with unilateral loss of labyrinthine excitability and 5 with bilateral loss of labyrinthine excitability.
Questioning and equilibrium related examinations were performed at regular intervals for periods of more than 5 years after the incidence of the loss of labyrinthine excitability.
Equilibrium disturbances continuing more than 5 years were as follows :
(1) Those with unilateral loss of labyrinthine excitability
On questioning, the patients complained of disturbances of body balance in standing and walking in the dark. On the standing test, the patients could not maintain Mann's and one-leg standing. Writing and stepping deviation were not remarkable. Spontaneous nystagmus under the Frenzel's glasses continued. The optokinetic nystagmus was normal.
(2) Those with bilateral loss of labyrinthine excitability
On questioning, the patients complained of disturbances in visual fixation while walking and running (jumbling phenomenon) and disturbances of standing and walking in the dark. The standing test with eyes open was within normal limits but that with eyes closed indicated moderate to marked disturbances of righting function. Staggering gait was observed in the stepping test. The optokinetic nystagmus was normal, showing visual fixation when the stationary position was not disturbed.
The results indicate that the vestibulo-ocular reflexes in humans play an active part in visual fixation during movements with periodic head motion such as walking and running and that the most important role of the vestibulo-spinal reflexes is the righting reflexes which aid in maintaining standing posture.
