Robertson D D, Ireland D J
Department of Otolaryngology, University of Manitoba, Winnipeg, Canada.
Am J Otol. 1996 Sep;17(5):743-8.
Tonic ocular torsions can arise from a variety of central or peripheral, vestibular, and nonvestibular lesions. However, the role of tonic ocular torsions in neurotology has been limited to surgical patients after unilateral vestibular deafferentation. By using 12 patients with a spectrum of well-defined unilateral peripheral vestibular lesions confirmed by electronystagmography (ENG), we identified a link between ipsiversive tonic ocular torsion compensation and vestibulospinal compensation, as measured by computerized dynamic posturography. In the context of ENG findings and posturography, the differential diagnosis of ocular torsions may be localized to the otoliths by using a decision matrix. Specifically, conditions of absent vision and sway-referenced support on computerized dynamic posturography associated with concurrent static ocular torsional abnormalities may suggest an otolith disorder. Furthermore, static ocular torsion assessment provides another important window on central vestibular compensation.
紧张性眼扭转可由多种中枢性或外周性、前庭性和非前庭性病变引起。然而，紧张性眼扭转在神经耳科学中的作用仅限于单侧前庭去传入术后的手术患者。通过对12例经眼震电图（ENG）证实患有一系列明确单侧外周前庭病变的患者进行研究，我们发现了同向性紧张性眼扭转代偿与前庭脊髓代偿之间的联系，这是通过计算机动态姿势描记法测量的。结合ENG检查结果和姿势描记法，通过使用决策矩阵，眼扭转的鉴别诊断可能定位于耳石。具体而言，在计算机动态姿势描记法中，视力缺失和与并发静态眼扭转异常相关的摇摆参考支持的情况可能提示耳石紊乱。此外，静态眼扭转评估为中枢前庭代偿提供了另一个重要窗口。
