Direction Of Nystagmus Research Articles

NYSTAGMUS IN A ZOSTER OTICUS CASE

Observation was made on a woman aged 49, with typical herpetic eruptions around the cavum conche of her right auricle accompanied by a facial paralysis and a slight labyrinthine inefficiency, both the latter on the right side, and showing, as vestibular symptoms, a horizontal nystagmus of medium degree (12/5) towards left, biabex walking towards right, and a tendency to spontaneous falling also towards tight.In the functional examinations made, the results obtained were almost normal. Necessary treatments were continued and the herpetic eruptions disappeared after two weeks and the facial paralysis was gradually gone in one month in the order of, first in the eye-branch, then the nose-branch, and lastly the mouth branch.But the spontaneous nystagmus showed aspectsdifferent from the satisfactory course the nervous symptoms had taken. During the first ten days of inception the movement was towards, left, but the direction then changed and from the thirteenth day to the twenty-fifth day movements towards right were observed. After twenty-seven days the direction changed again to the left and the symptoms, gradually assuming a regular course, almost disappeared after a month and a half.The most interesting point in this instance is the repeated change in the direction of the spontaneous nystagmus. While an ordinary course of neurisis was followed in the case of the facial and the trigeminal nerves, showing paralytic symptoms first and then gradually recovering normal sensitiveness, two reactions, increase and decrease in the labyrinthine muscletones which cause nystagmus, were observed in the course taken by the spontaneous nystagmus in the case of the vestibular nerves, differing from the common convalescence phenomena, as described above.Such sudden change cannot be explained by a simple neuritis. It is not easily possibl to explain such phenomena except those attributable to the disturbance of vasomoter nerves generated in their regions. Contrary to the fact that the facial and the trigeminal nerves respond merely with paralysis, to the variation of bloodvesseltones caused by the disturbance of vasomotor nerves the vestibular nerves are considered to delicately respond with the strengthening and weakening of tension.The singularity of the vestibular nerve is considered to lie in such points and zoster oticus is usually explained by a neuritis acustica. But the present author is of a different opinion. At least the patient in this instance is considered to be a case of disturbance of vasomotor nerves affecting not only the acoustic nerve regions but also the facial and the trigeminal nerve regions. The herpetic eruptions can also be considered to have been caused by the disturbance of the vasomotor nerves of the affected region.

THE GALVANIC FALLING REACTION IN PATIENTS WITH VERIFIED INTRACRANIAL NEOPLASMS

Augustine 1 in 1803 demonstrated that stimulation of the ear region by the galvanic current produced falling. By 1874, as a result of the investigations of Purkinje, Hitzig, 1 Breuer 2 and others, it had been demonstrated that closure of the galvanic circuit through the labyrinth produced anodal falling and nystagmus toward the cathode, and that opening of the circuit caused a reversal of the direction of both nystagmus and falling. Further clinical and experimental observations regarding galvanic stimulation by Neumann, 3 Barany, 3 MacKenzie, 4 Alexander 5 and a host of other investigators resulted in confusing and controversial evidence regarding the value of galvanic stimulation of the ear. The impression gained by many otologists was that when a small amount of current was used the stimulation was limited to the labyrinth. The contradictory clinical results obtained by galvanic stimulation of the labyrinth has caused its infrequent application, and observations

On the Direction of the Nystagmus which Appears on removal of one Labyrinth

On the Direction of the Nystagmus which Appears on removal of one Labyrinth