Unilateral peripheral semicircular canal lesion and off-vertical axis rotation

Off vertical axis rotation (OVAR) is a stimulus that can be used to assess the otolith-ocular reflex. However, experimental data suggest that isolated unilateral lesion of the lateral semicircular canal (SCC) nerve could modify responses to OVAR. Thus, to determine what nystagmus variables are not affected by SCC dysfunction and might be used as indices of otolithic disease, responses to OVAR were compared in 39 healthy controls and in 19 patients suffering from acute unilateral vestibular neuritis (VN), without any sign of otolith dysfunction. Horizontal and vertical slow phase velocities (SPV) were measured during earth vertical axis rotation (EVAR), and during OVAR at a tilt angle of 9 degrees and rotation velocity of 60 degrees/s. During OVAR, horizontal SPV consists of a sinusoidal modulation superimposed on a sustained bias opposite to the rotation. Vertical SPV consists of a sinusoidal modulation without bias. In patients, the bias shows directional preponderance (DP) toward the healthy side, strongly correlated to EVAR nystagmus DP. II would therefore simply reflect an imbalance, produced by the unilateral peripheral vestibular lesion, between right and left vestibular nuclei activity. On the other hand, vertical and horizontal modulations are not significantly different in patients and controls. Since the cause and the site of VN are not known, we cannot be sure that patients had pure SCC deafferentation. However, as all of them had SCC paresis it is concluded that OVAR modulations are not affected by a strong dysfunction of the pathways issued from the SCCs.