Equilibrium And Vertigo

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To determine the integrity of the pons, we examine the responses obtained from the vertical semicircular canals. These are tested when the ear is douched with the head in the so-called "upright" position. If the chart shows a normal rotary nystagmus with vertigo, past-pointing and falling, it suggests uninvolved pathways in the pons and middle cerebellar peduncle of the side douched. The cerebellum may be considered as not the seat of any gross- lesion, if stimulation of either ear or any canal... produces a past-pointing of both arms in both directions. " With the chart critically examined in this manner and all the possible points of involvement along the nerve tracts in mind, w^e attempt to find one location the involvement of which would satisfactorily account for all of the impaired responses. Thus, when the stimulation of all the semicircular canals of both sides.
296 EQUILIBRIUM AND VPTRTIGO IJi'oduces no vertigo whatever or impaired vertigo, instead of assum- ing the presence of a great many lesions, it is more reasonable to suppose that there is one lesion at a point where all the fibres concerned in vertigo come together.


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