Bronstein A M, Faldon M, Rothwell J, Gresty M A, Colebatch J, Ludman H
MRC Human Movement and Balance Unit, National Hospital for Neurology and Neurosurgery, London.
Acta Otolaryngol Suppl. 1995;520 Pt 1:209-11. doi: 10.3109/00016489509125231.
A 55 year old female with idiopathic Tullio phenomenon is presented. Binocular, scleral search eye coil recordings demonstrated a predominantly torsional left-beating and vertical down-beating nystagmus in response to sound intensities over 100 dB HL to the left ear, increasing in amplitude and slow phase velocity with sound intensity and removal of visual fixation. The vertical ocular movement was conjugate, i.e. without skew deviation. Neuro-imaging, all other neuro-otological features, including ipsilateral-contralateral stapedius muscle reflexes, and surgical exploration of the middle ear, were normal. Click-evoked vestibulo-collic potentials were normal from the right ear but showed low threshold (70 dB) and increased amplitude from the left. There was no evidence that the Tullio phenomenon in this patient arises from stapes footplate hypermobility. The findings suggest that some cases of the Tullio phenomenon may be due to a hyperexcitability of the normal vestibular response to sound.
本文报告了一名55岁患有特发性图利奥现象的女性患者。双眼巩膜探查眼线圈记录显示，左耳听到强度超过100 dB HL的声音时，主要出现向左扭转和垂直向下跳动的眼球震颤，随着声音强度增加以及去除视觉固视，震颤幅度和慢相速度增大。垂直眼球运动是共轭的，即无斜视角偏差。神经影像学检查、所有其他神经耳科特征，包括同侧-对侧镫骨肌反射，以及中耳手术探查均正常。右耳点击诱发的前庭-颈电位正常，但左耳显示阈值低（70 dB）且幅度增加。没有证据表明该患者的图利奥现象源于镫骨足板活动过度。这些发现提示，部分图利奥现象病例可能是由于正常前庭对声音的反应过度兴奋所致。
