3-Dimentional analysis for the vertical semicircular canal- and the otolithic-ocular reflexes and those influences to the spatial orientation

头部倾斜位置的摆动旋转试验。对正常人和良性阵发性位置性眩晕（BPPV）患者进行了向后60°，向左或向右旋转45°的旋转。以0.1 Hz的频率旋转360°（最大速度=114°/sec）。我们用这个测试程序来评估垂直半规管的兴奋性。使用红外线CCD摄像机和个人计算机系统，诱发性眼球震颤进行了分析。头后倾60°，再向右旋转，第一次向右旋转眼球时，所有受试者均出现向上和顺时针旋转性眼球震颤。当头部向左旋转45°时，可见向下、顺时针旋转性眼球震颤。随着第一次眼球向左旋转，所有的眼球震颤方向都颠倒了。当头部旋转45°时，可出现由头部旋转引起的向上和顺时针旋转性眼震 ...更多信息 左后半规管兴奋，右前半规管兴奋，右后半规管旋转引起的下向和逆时针旋转性眼球震颤。当头颅旋转45°时，顺时针旋转引起的向下和顺时针旋转眼震应代表左前半规管兴奋，顺时针旋转引起的向上和逆时针旋转眼震应代表右后半规管兴奋。BPPV的发病率通过分析旋转试验引起的眼球震颤来确定。在眩晕患者中，前半规管眼震与后半规管眼震的最大慢相眼速度（mx SPEV）差异有统计学意义（P<0.05）。患耳后半规管的兴奋性低于前半规管。尽管如此。眩晕、眼球震颤消失，兴奋性差异改善。目前的结果表明，一些功能恶化的后半规管在BPPV的情况下，这表明机械（倾倒质量）和有机（周边终末器官）参与导致发病。关于本研究，在头部从直立位置向前倾斜30°的情况下，在有和没有旋转刺激的两种条件下，主观视觉垂直（SVV）均正常。外半规管似乎不影响SVV。而在旋转刺激条件下，刺激后半规管时SVV发生偏移，尤其是刺激后半规管对侧的SVV偏移更大。我们的结论是垂直半规管影响空间方向，如SVV。少

Pendular rotation test in a head-tilted position. 60° backward and rotated 45° either to the right or left, was performed in normal healthy subjects and patients with benign paroxysmal positional vertigo (BPPV). They were rotated 360° at the frequency of 0.1 Hz (the maximal speed=114°/sec). We evaluated the excitability of vertical semicircular canals by this test procedure. Using an infra-red CCD camera and a personal computer system, evoked nystagmus was analyzed. When the head was tilted backward in 60°, and then rotated to the right, and with the first pendullar rotation was given to his right, upward and clockwise rotatory nystagmus was seen in all subjects. When the head was rotated 45° to the left, downward, clockwise rotatory nystagmus was seen. With the first pendullar rotation to the left, all nystagmic directions were reversed. It is conceivable that when the head was rotated 45° rightward, upward and clockwise rotatory nystagmus evoked by the rightward rotation was represen … More ting excitation of the left posterior semicircular canal, and downward and counterclockwise rotatory nystagmus by the leftward rotation was indicating excitation of the right anterior semicircular canal. When the head was rotated 45° leftward, downward and clockwise rotatory nystagmus by the rightward rotation should represent excitation of the left anterior semicircular canal, and upward and counterclockwise rotatory nystagmus in the leftward rotation indicated excitation of the right posterior semicircular canal. The morbidity of BPPV was determined by analyzing nystagmus elicited by the rotation test. So far as the patients had vertigo, we found a statistically significant difference (P<0.05) in the maximal slow-phase eye velocity (mx SPEV) between nystagmus from the anterior semicircular canal and nystagmus from the posterior semicircular canal. The excitability of the posterior semicircular canal in the affected ear was lower than that of the anterior semicircular canal. Nevertheless. while vertigo and nystagmus disappeared, the difference of the excitability was improved. The present result indicates some functional deterioration of the posterior semicircular canal in BPPV cases, which suggests a mechanical (dumping by mass) and organic (peripheral end organ) participation in causing morbidity. Regarding the present study, in the head tilted forward at an angle of 30° from the upright position, subjective visual vertical (SVV) was normal on the both conditions with and without the rotatory stimulus. It seems that the lateral semicircular canal doesn't influence SVV.On the other hand, SVV was deviated during the posterior canal excited on the condition with the rotatory stimulus, especially, which was much deviated on the opposite side to the excited posterior canal. We conclude that the vertical semicircular canal influences the spatial orientation such as the SVV. Less