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Acta Otolaryngol. 2014 Mar;134(3):233-7. doi: 10.3109/00016489.2013.861925. Epub 2013 Dec 23.

Is a pulling sensation in the anteroposterior direction associated with otolith dysfunction?

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  • 1Department of Otolaryngology, Hyogo College of Medicine , Hyogo.



A pulling sensation in the anteroposterior direction is suggested to originate from a dysfunction of the otolith organs.


Previous study with vestibular evoked myogenic potential (VEMP) confirmed that a falling sensation (in an up or down direction) and a lateral tilt sensation (in a right or left direction) were caused by otolith lesions. The purpose of this study was to clarify whether a pulling sensation in the anteroposterior (forward or backward) direction originates from otolith dysfunction.


The otolith function was assessed by cervical and ocular VEMPs (cVEMPs and oVEMPs) in 12 patients who complained of a forward or backward pulling sensation. cVEMPs were evaluated by the asymmetry ratio (AR) of the amplitude of the p13-n23 wave and the peak latencies of the p13 and n23 waves. oVEMPs were evaluated by the AR of the amplitude of the n1-p1 wave and the peak latency of the n1 and p1 waves.


Abnormal ARs on cVEMP were observed in 7 of 12 patients. Nine of 12 patients had abnormal oVEMP results including 3 bilateral absent responses. Most (10 of 12) patients had abnormal cVEMP and/or oVEMP results. The latency of each detected wave was within the normal ranges.

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