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Curr Opin Neurol. 2006 Feb;19(1):21-5.

Function tests of the otolith or statolith system.

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Division of Balance Disorders, Department of ENT, University Hospital Maastricht, Maastricht Research Institute Brain and Behaviour, Maastricht University, The Netherlands.



This review aims to provide an overview of recent advances in tests to evaluate otolith function over the last 2 years.


Over the last 2 years, many papers have focused on the application of the vestibular evoked myogenic potentials (VEMP). Several aspects are under survey: a search for optimal stimuli, search for normative data, search for which labyrinthine function losses and what kind of pathologies induce abnormal VEMPs. The review shows that some fundamental problems still have to be solved to improve reproducibility and to increase sensitivity. Other research and modelling is performed to find out how the brain distinguishes tilts from translations. Several papers support routine implementation of subjective visual vertical (SVV) measurements (in rest and during centrifugation) in the standard vestibular test battery. Interesting reports mention short latency vestibulo-ocular reflex induced by taps and short auditory stimuli. One report mentions the impact of otolith dysfunction upon spontaneous nystagmus and head shaking nystagmus.


Although validation is still needed and in progress, the state of the art laboratory should consider the following tests for an evaluation of otolith function as relevant: slow tandem gait, VEMP, SVV during centrifugation.

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