CC BY-NC-ND 4.0 · Laryngorhinootologie 2020; 99(S 02): S302
DOI: 10.1055/s-0040-1711234
Abstracts
Otology

Vestibular hyperexcitability - a new nosologic entity ?

Karl-Friedrich Hamann
1   Gaertner-Klinik München
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Introduction It is well known, that vibratory stimulation can provoke nystagmus in cases of a peripheral vestibular sidedifference. The nystagmus beats to the side of better excitability. In some vertiginous patients an alternating nystagmus appears during normal stimulation frequencies, which changes the direction depending on the side of stimulation. It could be considered as a sign of vestibular hyperexcitability. This phenomenon appears also in normal subjects, but only, when very high frequencies are applied. The question is, if vestibular hyperexcitability is a nosologic entity or is a symptom of different diseases.

Methods In 500 patients with different vestibular pathologies and a control group of 20 healthy subjects vibration stimuli were applied on the mastoid of each side. If a nystagmus with changing direction appeared, the etiology was determined due to the diagnosis.

Results In 20 healthy subjects no nystagmus could be induced by 40 Hz vibrations, exceptionally with higher frequencies an alternating nystagmus appeared. In patients showing an alternating nystagmus vestibular migraine was the most frequent diagnosis, less common phobic vertigo, mal du débarquement or central pathologies.

Discussion and conclusions: If an alternating nystagmus appears by vibration stimulation of 40 Hz, it is not a sign of a new nosologic entitiy, but a sign of vestibular hyperexcitability, which can be observed in different central-vestibular diseases.

Poster-PDF A-1474.PDF



Publication History

Article published online:
10 June 2020

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