TESTING OTOLITH FUNCTION
TESTING OTOLITH FUNCTION
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DOI：
10.3109/03005369209077880
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发表时间：
1992-01-01
期刊：
影响因子：
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通讯作者：
BRONSTEIN A M
中科院分区：
文献类型：
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作者：
GRESTY M A;BRONSTEIN A M
耳石信号有助于：（1）方向和线性运动的感知，（2）响应于头部的线性加速度而产生补偿性眼球运动，以及（3）参与运动和平衡的协调。这些功能的测试被证明有助于识别临床疾病：（1）对重力方向的评估，通过调整视觉垂直来估计，表明外周或中央水平的耳石功能紊乱，并且可以通过在电动转盘上离心期间进行估计来增强该测试的灵敏度。对平行秋千的自我运动阈值的估计可确定周围功能的整体减少或单侧丧失，中枢疾病有待研究。 (2) 耳石眼部对线性头部平移的反射可用于证明外周功能的整体完整性并揭示中枢异常。对头部转动倾斜的反向转动反应和眼睛的睫状体偏差的测量表明功能不对称，具有一定的偏侧化价值，特别是在中央病变中。全局功能和不对称性也可以通过“头部偏心”旋转测试来评估，该测试向角度刺激添加切向线性加速度。线性加速度通过添加耳石组件来增强耳道响应。 (3) 四肢对突然跌倒的表面肌电图 (EMG) 反应的潜伏期和幅度（可在受试者悬挂在铰链床上时记录）表明总体外周功能异常，并可将中枢神经系统运动通路疾病偏侧化。结论是，耳石功能的一些测试可用于指示周围耳石功能的整体丧失，其他测试能够侧化明显的功能丧失，并且所有耳石功能测试都有可能提供有关中枢疾病的信息。它们都必须在临床背景下进行解释，不幸的是，尚未证明它们对部分功能障碍（尤其是单侧功能障碍）敏感。
Otolithic signals contribute to: (1) perception of orientation and linear motion, (2) generate compensatory eye movements in response to linear acceleration of the head and (3) participate in the co-ordination of movement and balance. Tests of these functions shown to be useful in identifying clinical disorders have been reviewed: (1) Evaluation of orientation to gravity, as estimated by adjustment of the visual vertical, indicates deranged otolith function at a peripheral or central level and the sensitivity of this test can be enhanced by performing estimates during centrifugation on a motorized turntable. Estimation of thresholds of self motion on a parallel swing identifies global reduction or unilateral loss of peripheral function, with central disorders awaiting study. (2) Otolith ocular reflexes to linear head translation can be used to demonstrate overall integrity of peripheral function and reveal central abnormalities. Counter-rolling responses to head roll-tilt and measurements of cyclodeviation of the eyes demonstrate functional asymmetries, with some lateralizing value, particularly in central lesions. Global function and asymmetries may also be evaluated by 'head eccentric' rotational testing, which adds a tangential linear acceleration to the angular stimulus. The linear acceleration enhances the canal response by adding an otolith component. (3) Latency and amplitude of surface electro-myography (EMG) responses in the limbs to sudden falls, which can be recorded with the subject suspended on a hinged bed, indicate gross peripheral abnormality of function and can lateralize disorders of CNS motor pathways. It is concluded that some tests of otolith function can be of use in indicating global loss of peripheral otolith function, others are capable of lateralizing a marked loss of function and all have the potential to give information about central disorders. They all have to be interpreted within the clinical context and, unfortunately, none have yet been shown to be sensitive to partial, particularly unilateral, dysfunction.