Clinical Usefulness of Electro-Oculography in Differentiating the? Vertigo of Central Origin from that of the Peripheral

J Korean Neurol Assoc > Volume 12(3); 1994 > Article

Journal of the Korean Neurological Association 1994;12(3): 498-505.

중추성 및 말초성 현훈의 감별에 대한 전기안구운동검사의 임상적 ?유용성

김승현, 김주한,김명호

한양대학교 신경과.

Clinical Usefulness of Electro-Oculography in Differentiating the? Vertigo of Central Origin from that of the Peripheral

Seung-Hyun Kim, M.D., Ju-Han Kim, M.D., Myung-Ho Kim, M.D

Department of Neurology, College of Medicine, Hanyang University

Abstract

The study wasdesigned for the evaluation of diagnostic usefulness of standard electro-oculography (EOG) battery in differentiating the vertigo of central origin from that of peripheral one. Twelve patients of definite posterior fossa lesion proved by MRI or CT scan were selected as a central group and fourteen patients of peripheral vestibulopathy as a peripheral group. Using our laboratory standard methods of EOG battery, age-matched normal valuse of bithermal caloric responses(fixation supperssion, vestibular paresis, and directional preponderance) and the gains of pursuit and optokinetic nystagmus were obtained. Abnormal vestibular paresis was found in 21 patients of the peripheral group, but in only one patient of the central. Directional preponderance did not show significant difference between the peripheral and central group (p<0.01). In peripheral group, the fixation suppression index (percent change in slow-phase velocity with visual fixation during the period of maximum intensity of caloric nystagmus) was 56.8+8.3%, p>0.01). However, failure of fixation suppression was noted in eleven patients of central group and its mean value of 92.6+7.3%, which was significant statistical difference compared with peripheral and control group (p<0.01 respectively). Defective suppression of caloric nystagmus was more remarkable when the direction of caloric nystagmus was induced toward the lesion site. Such findings were demonstrated in six patients of eight patients with definits unilateral cerebellar hemispheric lesions. In addition, the gains of pursuit and optokinetic nystagmus were significantly reduced in the patients showing defctive fixation suppression compared with whom showed normal pattern of fixation suppression (p<0.01). Therefore, fixation suppression, vestibular paresis, and the gains of pursuit and optokinetic nystagmus would be useful diagnostic paremeters in differntiaging the vertigo of central origin from that of the peripheral.