Skull Vibration-Induced Nystagmus Test

Dear Colleagues,

Background: The skull vibration-induced nystagmus test is a vestibular test introduced into common clinical practice in 1999, mainly used as a first-line examination. Its clinical value has been underlined and developed by numerous groups in Europe (Hamann, Nuti, Manzari, Modugno, Perez, Batuecas, Zamora, Dumas), Asia (Park, Lee, Hang, Koo, Kim, Ohki) and Australia (Karlberg, Curthoys).

Consensus criteria for the test are currently needed: the characteristics of the vibrators vary, the frequencies used are not always clarified, and the protocols and procedures are variable (results are sometimes provided for one side and sometimes for both sides; the location and duration of the stimulus are variable).

The objective of the current issue is to provide a consensual protocol and common criteria for positivity (to improve reproducibility and establish a corner value for the slow phase velocity, as well as to synthesize the current knowledge about its physiological background) to realize its full value in clinical practice (including the exploration of common UVL pathologies such as VN, MD and V Schwannomas, or less common pathologies, with controls after intratympanic gentamicin, surgery or Cochlear implantation).

We aim to demonstrate its potential in distinguishing central from peripheral patients, determining the side of a lesion or indicating incomplete bilateral areflexia with unilaterally very high frequencies.

A few issues remain regarding the main structures involved in the SVIN response: why do we observe a clear VIN at 100 Hz and not at 500 Hz in UVL patients (vestibular neurectomies and translabyrinthine approaches), since canals respond at 100 Hz and the Otolith structures respond at 100 Hz but still more clearly at 500 Hz? Both these structures are stimulated by vibrations at these frequencies as demonstrated in animal models. This question needs to be addressed and further explored (is there a possible role of converging neurons?).

A special chapter will be dedicated to discussing the value of cervical muscle stimulations over cranial vibrations and their possible clinical consequences.

We thank the authors contributing to this Special Issue, who will share their high levels of expertise in the field.

Dr. Georges Dumas
Prof. Dr. Sébastien Schmerber
Prof. Dr. Philippe P. Perrin
Guest Editors

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• Skull vibrations
• Nystagmus induced by vibrations
• SVIN criteria of validity
• Optimal conditions for SVINT
• SVIN clinical interest
• SVIN physiological background