Vestibulo-spinal control differs in patients with reduced versus distorted vestibular function.

Abnormal vestibular function disrupts a subject's reference to gravity (earth) vertical, and prevents resolution of conflicting or inaccurate visual and somatosensory spatial references. However, errors which patients make when attempting to resolve conflicting visual and somatosensory orientation inputs during upright stance differed markedly in patients with (1) symmetric or asymmetric reduced vestibular function, (2) benign paroxysmal positional nystagmus and vertigo, and (3) a combination of distorted and reduced function. Objective characterization of spatial orientation systems and compensatory strategies under altered sensory conditions is an essential first step toward identifying optimal treatment methods for each of these three types of vestibular deficient patients.