The Auto-Tilt Test in patients with positional vertigo and Menière's disease.

As a new method of testing the righting reflex, which has been considered to be closely related to the otolith function, we used the Auto-Tilt Test (ATT) on 24 patients with positional vertigo, on 5 patients with Meniere's disease before and after cochlearendolymphatic shunt, and on 10 normal subjects. The subject is required to stand on an electrically driven tilt board with an autoregulating switch in hand, and to perform bilateral tilt swings of 5 degrees and 10 degrees wearing a helmet with a Head Inclinometer or tilt sensor. The result of this test in patients with positional vertigo revealed the patients had an abnormal labyrinthine reflex and significantly excessive tilt in the return swing from the side of the lesion. In addition, we consistently observed an inaccurate righting reflex, coupled with a diminished sensation of tilt, on the side of the lesion. The results in Meniere's disease patients, followed up before and after surgery, showed that the depressed righting reflex toward the affected side and the tendency to list to the healthy side before surgery, improved after surgery.