Treatment of vestibular disorders with weak asymmetric base-in prisms: An hypothesis with a focus on Ménière's disease

Jelte E. Bos*, Astrid J.A. Lubeck, P. Eric M. Vente

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)251-263
Number of pages13
JournalJournal of Vestibular Research: Equilibrium and Orientation
Volume27
Issue number5-6
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • after-image
  • efference
  • Ménière's disease
  • oculogyral illusion
  • prisms
  • re-afference
  • star-walk
  • treatment

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