Abnormal vestibular responses to vertical head motion in cerebellar ataxia.

Falls pose an important problem to neurologists caring for patients with cerebellar disorders. Normal human gait is characterized by prominent up-and-down linear head movements (vertical translations). Thus, we asked whether patients with cerebellar gait ataxia showed abnormal responses of otolithic vestibuloocular reflexes to this motion. Compared with healthy subjects, all cerebellar patients showed impaired otolith-ocular responses. Neurologists often test the rotational vestibuloocular reflexes in cerebellar patients, but our results indicate that vestibular responses to vertical linear motion are severely affected. Impairment of the corresponding otolith-spinal reflexes may contribute substantially to falls.