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March 1969

Nystagmus: Diagnostic Significance of Recent Observations

Author Affiliations

Palo Alto, Calif; Hochschule Ulm, Germany; Palo Alto, Calif

From the Division of Otolaryngology, Stanford University, Palo Alto, Calif (Drs. Fredrickson and Goode) and the Department of Neurology, MedNaturwissenschaften, Hochschule, Germany (Dr. Kornhuber).

Arch Otolaryngol. 1969;89(3):504-511. doi:10.1001/archotol.1969.00770020506012

THERE ARE a number of new concepts of diagnostic significance concerning the vestibular and oculomotor systems derived from laboratory and clinical data. This information results in a revision of previously held ideas concerning such things as vestibular directional preponderance in temporal lobe lesions, the origin and prognosis of positional nystagmus, and the diagnostic value of various types of spontaneous nystagmus.

Some of the more pertinent laboratory findings will be discussed initially in order to provide a logical framework for the clinical comments to follow.

Cortical Vestibular Projection Area and Somatosensory-Vestibular Integration in the Cortex and the Vestibular Nucleus.—The cortical vestibular projection area had, until recently, been demonstrated only in the cat.1 Since it was found to lie in the vicinity of the second somatic area immediately next to the primary acoustic region, one could only surmise as to where its position might be in primates. Based upon clinical

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