Pierluigi Ghilardi

Assessment of Head Shaking Test in Neuro-Otological Practice

The head shaking test (HST) is an important test in neuro-otological diagnosis. In our study of 277 patients complaining of dizziness we verified this importance. The results thus obtained were compared with the results recorded in 73 normal subjects. Head shaking nystagmus was observed in 73 patients. Of these 73 cases, 42 involved central diseases and 31 cases involved peripheral diseases. Head shaking nystagmus was observed in 7 subjects of the control group. A highly significant correlation was noted between head shaking nystagmus and positional nystagmus, between head shaking nystagmus and the caloric test and between head shaking nystagmus and all the other spontaneous types of nystagmus that were investigated (eyes open in light/gaze straight ahead; eyes open behind Frenzels glasses; eyes closed; eyes open in darkness). No correlation was found between head shaking nystagmus and cervical nystagmus and positioning nystagmus. The sensitivity of head shaking nystagmus, in comparison with other types of spontaneous nystagmus, was found to be slightly higher in cases with peripheral lesions than in those with central lesions. These data confirm the diagnostic importance of this simple test. It is also important to keep in mind that the HST has no importance for topodiagnostic purposes.

Menière's disease: role of antibodies against basement membrane antigens.

Recently, high levels of anti‐collagen II (CII) antibodies have been found in a significant percentage of patients with Menieres disease (MD). An immune response against other collagens (C) present in the basal membranes has also been suggested by the presence of anti‐CIV and anti‐laminin antibodies in a number of instances of progressive systemic sclerosis (PSS) and Raynauds phenomenon (RP).

Posturography and vertigo

Traumatic damage to the soft tissue in the neck may cause the onset of vertigo and dizziness in a large number of cases [13, 31, 47, 49]. The attacks of vertigo and dizziness may last for months after the injury, although these usually decrease significantly as the neck pain subsides. The dizzy Symptoms which follow even a rather light case of whiplash injury (WI) are usually described in nonspecific terms such as lightheadedness, offbalance, and floating and only a small percentage of patients have a Sensation of spinning or rotatory vertigo [ 1 ].