Han G C, Cha H E, Hwang S H
Department of Otolaryngology-Head and Neck Surgery, Gil Hospital, Gachon Medical School, Incheon, South Korea.
Acta Otolaryngol Suppl. 2001;545:94-6.
The head tilt suppression test has been known to be a diagnostic tool to distinguish between centrally originating dizziness and peripheral vertigo, as the latter enhances the natural spontaneous firing rate of the velocity storage system and decreases the time constant; however, the otolith organ is now considered to be a cause of head tilting effect. Therefore we questioned whether the head tilt suppression test is still worth differential diagnostic tool. We measured the time constant and initial eye velocity of pre- and post-rotatory nystagmus in a velocity step test in nine healthy adults. The time constant was significantly affected by head tilting (p = 0.001), pre- and post-rotatory nystagmus (p = 0.020) and the compounding interaction between them (p < 0.000). The initial eye velocity was also significantly affected by pre- and post-rotatory nystagmus (p = 0.016) and the compounding interaction (p < 0.000), but not by head tilting (Wilks' Lambda = 0.054). The head tilt suppression test is a useful method for the differential diagnosis of vertiginous patients. It is affected by pre- and post-rotatory nystagmus and their interaction, however, other central parameters in vestibular function testing should also be considered in order to obtain an exact differential diagnosis.
头位倾斜抑制试验一直被认为是一种区分中枢性头晕和周围性眩晕的诊断工具，因为后者会提高速度储存系统的自然自发放电率并缩短时间常数；然而，耳石器官现在被认为是头位倾斜效应的一个原因。因此，我们质疑头位倾斜抑制试验是否仍然是一种有价值的鉴别诊断工具。我们在9名健康成年人的速度阶梯试验中测量了旋转前后眼震的时间常数和初始眼速度。时间常数受到头位倾斜（p = 0.001）、旋转前后眼震（p = 0.020）以及它们之间的复合相互作用（p < 0.000）的显著影响。初始眼速度也受到旋转前后眼震（p = 0.016）和复合相互作用（p < 0.000）的显著影响，但不受头位倾斜的影响（威尔克斯λ = 0.054）。头位倾斜抑制试验是一种用于眩晕患者鉴别诊断的有用方法。它受到旋转前后眼震及其相互作用的影响，然而，为了获得准确的鉴别诊断，还应考虑前庭功能测试中的其他中枢参数。
