Testing of vestibular function by active head movements.

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The vestibular system of the inner ear is responsible for our sense of balance and for maintaining clear vision and stable posture during head movements. This complex interdependent sensory system is comprised of three paired semicircular canals for sensing head rotations and two paired otolith organs for sensing head position and linear movements of the head. A major goal of our research programs is to develop simple tests which can be used in the clinic or at the bedside to diagnose specific deficits of each vestibular sensory region. Most present clinical tests only test the part of the system concerned with horizontal head rotations but there are many other sensory regions in the inner ear whose functional status needs to be evaluated, especially those regions concerned with signalling linear head movements and head position - the otolith sensory regions. The usual principle in vestibular testing is to move the person's head and measure the eye movement which occurs in response to that passive movement. One of our recent observations suggest that it may be possible to measure vestibular functioning during active head movements. Active testing does not require expensive, invasive testing systems and could be carried out in the clinic. This project will compare the eye movement response to active and passive head movements in the same patients. We will test both the angular and linear sensing systems by asking patients to rotate their head or slide it laterally, recording the head movement stimulus and eye movement response. Two groups of patients will be studied; those who have recovered well and those who are poorly recovered after unilateral vestibular loss. The outcome will, we hope, be safe simple low cost tests which will evaluate the functional status of all the inner ear sensory regions and yet be clinically practical. They may provide the answer as to why some patients do not recover well after unilateral loss whereas others do.