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Original Articles
February 1961

Directional Preponderance in Temporal Lobe Disease

Arch Otolaryngol. 1961;73(2):139-144. doi:10.1001/archotol.1961.00740020145002

Directional preponderance is a readiness for nystagmus to occur to one side more than to the other.

In 1911, Bauer and Leidler2 showed that after extirpation of one cerebral hemisphere in the rabbit the postrotational horizontal nystagmus to the side of the lesion was much stronger than to the normal side. In 1923, it was demonstrated by Dusser de Barrene and de Kleyn10 that removal of one cerebral hemisphere in the rabbit led to "Nystagmusbereitschaft" toward the side of ablation. Later, in 1927, de Kleyn and Versteegh8 reported its presence in patients suffering from lesions of one cerebral hemisphere, using alternate hot and cold caloric stimulation of the labyrinths. In a case with "Nystagmusbereitschaft" to the right, for instance, hot water in the right ear and cold water in the left ear elicit more marked reactions than do hot water in the left ear and cold water

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