Studies of Cristospinal Reflexes (Laterotorsion):III. Patterns of Cristoocular and Cristospinal Reflexes in Clinical Oto-neurology

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Abstract
A comparative study of caloric nystagmus, vertigo and laterotorsion was made in normal subjects and in patients with peripheral labyrinthine lesions, Ménière's disease, meningo-encephalitis and brain tumors. Variations were found in the patterns of behaviour in the various lesions. As examples: in Ménière's disease nystagmus and vertigo decreased in their responses to caloric stimulation but laterotorsion remained normal, while meningoencephalitis showed a normal response of nystagmus but a decrease in laterotorsion. This induced us to consider the hypothesis that cristo-ocular and cristospinal reflexes have different mechanisms modulating them despite the common origin of their stimulus. The possibility of different receptor cells and neurons for the cristo-ocular and the cristo-spinal reflexes was also discussed. A better resistance of the units involved in the vestibulo-spinal reflex would then also explain the normal caloric laterotorsion in Ménière cases. A pilot study of brain tumors indicated that different localities of the tumors produce different patterns of behaviour of nystagmus, vertigo and laterotorsion.