The Diagnostic Importance of the Galvanic Test in Otoneurology

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Abstract
Bipolar, binaural stimulation of the human vestibular system causes nystagmus. This perstimulatory nystagmic reaction can even be elicited if the vestibular endorgan is destroyed but it will be considerably diminished or even abolished if the peripheral neuron is damaged. Spontaneous vestibular nystagmus of peripheral origin is always suppressed by galvanic stimulation whereas central vestibular spontaneous nystagmus will hardly change its pattern. In supratentorial vestibular lesions, located subcortically or even cortically, the liminar and supraliminar galvanic reaction may show a very characteristic pattern thus contributing valuable information with respect to the differential diagnosis of peripheral and central vestibular disorders. The most important diagnostic value of this test, if it is performed under nystagmographic control (PENG), is based on the fact, that the presence of a normal galvanic response depends entirely upon the integrity of the neuronal elements of the vestibular ganglion and upon the conductivity of the vestibular nerve. It is, therefore, at present the only diagnostic method allowing the differentiation of an endorgan lesion from a lesion of the peripheral vestibular neuron.

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