Room tilt illusion. A central otolith dysfunction.
Room tilt illusion. A central otolith dysfunction.
复制标题
房间倾斜错觉。
DOI：
10.1001/archneur.1996.00550120071018
复制
发表时间：
1996
影响因子：
--
通讯作者：
I. Abeywardena
中科院分区：
文献类型：
--
作者：
I. Abeywardena
背景
我们报告了 3 名因脑干病变导致持续性倾斜偏差的患者在接受前庭刺激后出现突然的 90 度房间倾斜错觉 (RTI)。房间倾斜错觉是视觉周围环境的短暂倾斜知觉，一侧甚至上下颠倒，这通常与脑干病变有关。尽管其病理生理原因尚不清楚，但 RTI 表明耳石通路受损，如偏斜偏差中所报告的那样。
方法
作为对有耳石功能障碍症状的患者随访的一部分，对 3 名脑干病变患者进行了重新检查。使用转椅进行前庭功能登记，包括用于耳道刺激的地球垂直轴旋转和用于耳石刺激的离垂直轴旋转（OVAR）。还进行了主观视觉垂直（SVV）的测量。
结果
3 名偏斜患者经 OVAR 记录耳石眼反射受损，2 名患者 SVV 受损。在每个方向的 OVAR 刺激后，当房间被照亮时，3 名患者报告了 RTI。
结论
耳石动眼神经（偏斜和耳石眼反射受损）和知觉（SVV 和 RTI 倾斜）疾病的共存表明存在常见的耳石功能障碍。然而，RTI 在前庭刺激后和房间被照亮时特别发生。因此，我们认为 RTI 反映了动态视觉耳石不匹配。
BACKGROUND
We report a sudden 90 degrees room tilt illusion (RTI) following vestibular stimulation in 3 patients with persistent skew deviation caused by a brain stem lesion. Room tilt illusion is a transient tilt perception of the visual surrounding, on its side or even upside down, that is often reported with brain stem lesions. Although its pathophysiologic cause is not well known, the RTI suggests an impairment of otolith pathways, as reported in skew deviation.
METHODS
The 3 patients with brain stem lesions were reexamined as part of a follow-up of patients with signs of otolith dysfunction. A registration of vestibular function was performed with a rotatory chair, including earth-vertical axis rotation for canal stimulation and off-vertical axis rotation (OVAR) for otolith stimulation. Measurement of the subjective visual vertical (SVV) was also performed.
RESULTS
The otolith-ocular reflex registered by OVAR was impaired in the 3 patients with skew deviation and the SVV in 2 patients. After each direction of OVAR stimulation, the 3 patients reported an RTI as the room was illuminated.
CONCLUSIONS
The coexistence of otolith oculomotor (skew deviation and impaired otolith-ocular reflex) and perceptual (tilt of SVV and RTI) disorders suggests a common otolith dysfunction. However, an RTI occurred specifically after vestibular stimulation and when the room was illuminated. We thus suggest that RTI reflects a dynamic visuo-otolith mismatch.