New insights into positional alcohol nystagmus using three-dimensional eye-movement analysis

M Fetter, Thomas Haslwanter, M Bork, J Dichgans

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)

Abstract

The semicircular canals selectively transduce angular velocity and are normally insensitive to gravity and linear acceleration. In acute alcohol intoxication, however, the cupula becomes lighter than the endolymph, rendering it sensitive to gravity (buoyancy hypothesis). This results in positional alcohol nystagmus (PAN) and rotatory vertigo. We evaluated PAN in 8 normal subjects by means of three-dimensional eye-movement analysis in an attempt to clarify if the buoyancy mechanism is sufficient to explain PAN. Forty minutes after intake of 0.8 g of alcohol/kg of body weight, the subjects were positioned such that the lateral canals were earth vertical. They were then rotated in the plane of the lateral canals about an earth- horizontal axis to either 45°or 90°, right or left ear down, and eye movements were recorded for 40 seconds in each position. The spatial analysis of the responses showed that in addition to the nystagmus induced by the buoyancy of all six cupulae, alcohol intoxication also causes a vertical velocity offset (in all subjects, slow phase down) that is independent of the orientation of the subject in space. The offset may represent a toxic effect on central vestibular pathways, producing a tone imbalance of the vertical vestibulo-ocular reflex.

Original languageEnglish
Pages (from-to)216-223
Number of pages8
JournalAnnals of Neurology
Volume45
Issue number2
DOIs
Publication statusPublished - Jan 1999

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