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

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.