[Classification of optokinetic after-nystagmus and its topographical-diagnostic significance in man]

Human optokinetic after-nystagmus: variability in serial test results

Test-retest variability of values for directional asymmetry in primary and secondary horizontal optokinetic after-nystagmus (OKAN I and OKAN II, respectively) was studied in 16 apparently healthy subjects. OKAN was induced by 60 s of whole-field optokinetic stimulation at speeds of 60 degrees/s and 90 degrees/s in either direction (left and right), each subject being tested on the same respective weekday once a week for 4 consecutive weeks. Values for directional asymmetry were calculated as the relative side-difference between response to drum rotation toward the right and toward the left. The subjects manifested considerable variation in values for directional asymmetry in OKAN I. This suggests prediction of a given individual's true value for directional asymmetry in OKAN I to require several measurements. On the other hand, 15/16 subjects manifested no asymmetry in OKAN II (the 16th subject was a further investigation found to have significant asymmetric caloric responses). As both OKAN I and OKAN II are known to reflect asymmetric vestibular function it is suggested that studying OKAN II may require fewer measurements of directional asymmetry, compared with studying OKAN I, when assessing the course of peripheral vestibular asymmetry.

Galvanically induced asymmetric optokinetic after-nystagmus

The effect of an asymmetric vestibular input on the symmetry of horizontal optokinetic after-nystagmus (OKAN) was studied in twenty healthy subjects. Optokinetic nystagmus (OKN) was elicited by a whole-field optokinetic drug, rotating at 90 degrees/s, and eye-movements were recorded by a DC electro-oculographic technique (EOG). The ratio of OKAN following right and left-beating OKN respectively was computed. An asymmetric vestibular input was generated by a continuous bi-polar, bi-aural galvanic stimulus (1 mA) to the vestibular nerves during the optokinetic stimulation and the recording of the OKAN. During galvanic stimulation the relation between left and right-beating OKAN was asymmetric, compared with the OKAN found after optokinetic stimulation only. The galvanic stimulus caused a preponderance for OKAN with the fast phase beating toward the cathode. Thus, the small vestibular asymmetry induced by the galvanic stimulus, which was not strong enough to produce nystagmus by itself, caused an asymmetric OKAN. These findings suggest that examination of OKAN may be of value to detect small vestibular asymmetries in peripheral vestibular disorders in man.

Clinical considerations concerning horizontal optokinetic nystagmus

During recent decades a vast amount of literature concerning horizontal optokinetic nystagmus has emerged, regarding which--and especially as regards our own work--this report is intended to consider the clinical value of optokinetic nystagmus.