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In order to record and analyze the rapid eye movement non-invasively in human subjects, a four times high-speed video camera (4TC) with a new computer software was developed and utilized. Nine healthy volunteers and four patients with vestibular dysfunction participated in this study. Caloric stimulation was applied to the healthy subjects and the eye movements were recorded using a standard camera (SC) and a 4TC. In four patients, the positional and/or positioning nystagmus was recorded using SC and 4TC. Analysis of the eye speed of the quick phase of nystagmus was performed manually from the print out of the chart. The quick phase of the caloric nystagmus was adequately analyzed from the data using 4TC. However, using SC the sampling rate was not sufficiently enough for this purpose, as prospected. The adaptability of the 4TC in clinical examination is exactly similar to that of SC, because of the size and weight of the camera. Although the time taken to analyze eye movements using 4TC is about four times longer than that using SC, this system is quite useful and adequate for analyzing the quick eye movements in vestibular nystagmus, in an out-patient clinic set up.

Objective: The stabilization of both the horizontal (H) and vertical (V) eye movements during voluntary fixation is believed to depend upon the visual feedback system in the upright position. However, ocular stability in the tilted position has been less well investigated. Therefore, in the present study, we examined the gaze stability of healthy human subjects in the three dimensions in the tilted position using a video image analysis system (VIAS)., Methods: In 10 healthy human subjects, the eye movements were recorded after fixating the eye on a target in an upright position and also in the tilted position. The standard deviations of the eye movements in the three dimensions were calculated to evaluate the stability of the movements., Results: In the tilted position, there were no significant changes in the horizontal and vertical eye movements as compared those in the upright position. However, the standard deviation of the torsional (T) segment was significantly larger in the tilted position, compared to that in the upright position., Conclusion: From these results, we speculate that, a combination of otolith and somatosensory inputs play a major role in maintaining the stability of eye movements.

Abstract: Objective: Based on the hypothesis that the origin of nystagmus is from the posterior canal (PC), the nystagmus in the head hanging and sitting position should be mirror images. To clarify the anatomical origin of positioning nystagmus in BPPV patients, we analyzed the positioning nystagmus of benign paroxysmal positioning vertigo (BPPV) patients three-dimensionally. Methods: Twenty-six patients with BPPV participated in this study. The positioning nystagmus was recorded in complete darkness from the patient''s left eye by means of an infrared CCD camera. We performed three-dimensional analysis of nystagmus using video image analysis system (VIAS). Subsequently, the rotation axis of the 3D eye movements of the positioning nystagmus was calculated. Results: Among the 26 patients tested, 20 patients demonstrated the axes of nystagmus in good or relatively good alignment to the PC axis. However, in 11 of these 20 patients there was poor alignment of the axis of nystagmus in the sitting position to the PC axis. In addition, six patients showed axes of nystagmus with poor alignment to the PC in the head hanging position. Among them, two patients exhibited axes of nystagmus in good alignment with the anterior canal, in spite of diagnosis of these patients as PC BPPV by experienced examiner based on the positioning nystagmus test. Conclusion: These results demonstrated that only one-third of patients who were diagnosed as BPPV, could be diagnosed as true BPPV which originates from a PC pathology. Besides the possibility that the pathology may originate from the AC, it is still unclear which part of the inner ear may be the candidate site of origin of the pathology of BPPV in the other 15 patients. [Copyright &y& Elsevier]