Vestibulospinal Reflexes: X. Theoretical and Clinical Aspects of the Stepping Test

Abstract

IN 1950, a commission, appointed by the Collegium Otorhinolaryngologicum¹ to simplify and standardize vestibular tests, recommended that vestibulospinal reflexes be included in the routine testing of vestibular function, to be used equally with the nystagmus tests. The reason for testing the vestibulospinal reflexes was partly the greatly increasing number of patients with vertigo referred to the ear, nose, and throat departments and partly the wish for better differential diagnostic means of demonstrating the site of the lesions. My studies^2-9 were started for the purpose of elucidating the vestibulospinal reflexes in the lower limbs, as little investigation of this aspect had been done, and the results were not consistent. Anatomy and Physiology Before summarizing the method and the most important results, brief mention will be made of some anatomical and neurophysiological factors. The vestibular system—its peripheral parts, ie, the receptor organs in the labyrinth, and the vestibular nerve