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Brain, Vol. 115, No. 3, 647-673, 1992
© 1992 Guarantors of Brain


research-article

NEUROLOGY OF OTOLITH FUNCTION PERIPHERAL AND CENTRAL DISORDERS

MICHAEL A. GRESTY1, ADOLFO M. BRONSTEIN1, THOMAS BRANDT2 and MARIANNE DIETERICH2

1MRC Human Movement and Balance Unit, National Hospital for Neurology and Neurosurgery London, UK 2Neurologische Klinik, Ludwig-Maximilians-Universitãt München Munich, Germany

Correspondence to: Correspondence to: Dr M. A. Gresty, the National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG. UK.

The otolith organs detect gravitoinertial forces acting on the head providing signals to the brain which are essential for spatial orientation, sensing motion and organizing motor behaviour. Although the pathophysiology of otolithic dysfunction is poorly understood, a disorder of otolith function, at a peripheral or central level, may be suspected when a patient describes symptoms of false sensations of linear motion or tilt or shows signs of specific derangements of ocular motor and postural, orienting and balancing responses. When disorientation is severe the patient may describe symptoms which sound bizarre, raising doubts over the organic basis of the disease. Our recognition of an otolithic disorder and understanding ótolithic involvement in a wider neurological context may be guided by knowledge of otolith physiology and of the characteristics of the few proven otolithic syndromes.

Received January 2, 1992. Revised February 24, 1992. Accepted March 2, 1992.


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