Vestibular contributions to the Romberg test: Testing semicircular canal and otolith function.
head impulses
romberg test
vestibular evoked myogenic potentials
vestibular function
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
11
04
2021
accepted:
20
05
2021
pubmed:
24
6
2021
medline:
21
10
2021
entrez:
23
6
2021
Statut:
ppublish
Résumé
Normal stance relies on three sensory inputs: vision, proprioception and vestibular function. The Romberg test, trying to stand with feet together and eyes closed, is familiar to every medical student as a test of distal proprioceptive impairment. It remains the best known of Romberg's many remarkable contributions to clinical neurology. In Romberg's time almost nothing was known about the function of the vestibular system. We now know that standing with the eyes closed on a compliant rather than a firm surface is more a test of vestibular than proprioceptive function. Peripheral vestibular function tests in clinical use today all rely on measurements of oligosynaptic brainstem reflexes. Short-latency eye rotations in response to rapid, brief head rotations (head impulses) give an accurate, robust and reproducible measure of the function of any and each of the six semicircular canals. Short-latency evoked potentials from sternomastoid and inferior oblique muscles in response to loud clicks or skull taps (vestibular evoked myogenic potentials) give an accurate and reproducible measure of the function of each and any of the four otolith organs. In the present paper, we briefly review what is now known about the anatomy and physiology of the peripheral receptors and brainstem pathways mediating these reflexes and examine how this knowledge can help interpret the Romberg test.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3211-3219Informations de copyright
© 2021 European Academy of Neurology.
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