Vestibulospinal function in two syndromes with spontaneous attacks of vertigo: evaluation by posturography.

Two vestibular syndromes comprising attacks of spontaneous vertigo were studied and disturbance of the vestibulospinal reflex was evaluated. Patients with Menière's disease were examined between attacks and patients with a sudden unilateral vestibular loss syndrome at least 3-4 weeks after the initial attack. Posturography, (recording and analysing the postural sway) was used to evaluate the influence of these disorders upon the vestibulospinal reflex. In 50% of the patients, the postural sway was disturbed compared with the performance of a normal control group. Menière's disease had a more pronounced effect on the posturographic results, whereas for the unilateral vestibular loss syndrome the rotation tests showed more asymmetry. It is obvious that the effect upon the vestibulospinal reflex cannot be deduced from the rotational test results. Indeed in a large number of patients discordance between rotational test results and posturography was seen. The presence or absence of attacks during the previous year in patients with Menière's disease had no influence on the presence of abnormal posturographic results. If other complaints of dizziness were mentioned by the patient, posturography was nearly always abnormal. It is evident that a complete evaluation of such patients must include information obtained by posturography.