TY - JOUR
T1 - Treatment of vestibular disorders with weak asymmetric base-in prisms
T2 - An hypothesis with a focus on Ménière's disease
AU - Bos, Jelte E.
AU - Lubeck, Astrid J.A.
AU - Vente, P. Eric M.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - BACKGROUND: Regular treatments of Ménière's disease (MD) vary largely, and no single satisfactory treatment exists. A complementary treatment popular among Dutch and Belgian patients involves eyeglasses with weak asymmetric base-in prisms, with a perceived high success rate. An explanatory mechanism is, however, lacking. OBJECTIVE: To speculate on a working mechanism explaining an effectiveness of weak asymmetric base-in prims in MD, based on available knowledge. METHODS: After describing the way these prisms are prescribed using a walking test and its effect reported on, we give an explanation of its underlying mechanism, based on the literature. RESULTS: The presumed effect can be explained by considering the typical star-like walking pattern in MD, induced by a drifting after-image comparable to the oculogyral illusion. Weak asymmetric base-in prisms can furthermore eliminate the conflict between a net vestibular angular velocity bias in the efferent signal controlling the VOR, and a net re-afferent ocular signal. CONCLUSIONS: The positive findings with these glasses reported on, the fact that the treatment itself is simple, low-cost, and socially acceptable, and the fact that an explanation is at hand, speak in favour of elaborating further on this treatment.
AB - BACKGROUND: Regular treatments of Ménière's disease (MD) vary largely, and no single satisfactory treatment exists. A complementary treatment popular among Dutch and Belgian patients involves eyeglasses with weak asymmetric base-in prisms, with a perceived high success rate. An explanatory mechanism is, however, lacking. OBJECTIVE: To speculate on a working mechanism explaining an effectiveness of weak asymmetric base-in prims in MD, based on available knowledge. METHODS: After describing the way these prisms are prescribed using a walking test and its effect reported on, we give an explanation of its underlying mechanism, based on the literature. RESULTS: The presumed effect can be explained by considering the typical star-like walking pattern in MD, induced by a drifting after-image comparable to the oculogyral illusion. Weak asymmetric base-in prisms can furthermore eliminate the conflict between a net vestibular angular velocity bias in the efferent signal controlling the VOR, and a net re-afferent ocular signal. CONCLUSIONS: The positive findings with these glasses reported on, the fact that the treatment itself is simple, low-cost, and socially acceptable, and the fact that an explanation is at hand, speak in favour of elaborating further on this treatment.
KW - after-image
KW - efference
KW - Ménière's disease
KW - oculogyral illusion
KW - prisms
KW - re-afference
KW - star-walk
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85048117812&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048117812&partnerID=8YFLogxK
U2 - 10.3233/VES-170630
DO - 10.3233/VES-170630
M3 - Article
AN - SCOPUS:85048117812
SN - 0957-4271
VL - 27
SP - 251
EP - 263
JO - Journal of Vestibular Research: Equilibrium and Orientation
JF - Journal of Vestibular Research: Equilibrium and Orientation
IS - 5-6
ER -