Horizontal vestibulo-ocular reflex after acute peripheral lesions.

We studied the dynamics of the horizontal vestibulo-ocular reflex using a broad range of sinusoidal rotational stimuli in 14 patients with acute unilateral peripheral vestibular lesions. From plots of slow phase velocity (SPV) versus stimulus velocity (phase shifts removed) we calculated the DC offset and gain to ampullopetal (AP) and ampullofugal (AF) stimulation of the remaining intact labyrinth. DC offset values were highly correlated with spontaneous nystagmus SPV values for all frequencies (0.0125-0.8 Hz) and amplitudes (30-120-deg/sec) of stimulation. Mean AP gain values were consistently higher than mean AF values with the greatest difference occurring at low frequencies of stimulation. Saturation nonlinearities were present with AF stimulation at high amplitudes. These findings can be explained by dynamic asymmetries at the level of the primary and secondary vestibular neurons.