Clinical course of a severe vertigo attack in patients with Ménière's disease or delayed hydrops investigated by a new dynamic equilibrium examination (Foulage test)

We designed a new dynamic equilibrium examination on a stabilometer, involving lifting up of only the heels alternately, two steps per second, over a total of 120 steps, guided by an electric metronome operating at 120 BPM (beats per minute), with the eyes open and closed. The total locus length (L) and the environed area (A) were measured. This unique stepping test was named the "Foulage test" and we suggested demonstrated in two previous studies that FT (= 120 A/L) is useful for quantitative measurement of the body sway. To ascertain the usefulness of FT as a useful dynamic equilibrium parameter, we examined 20 patients of Meniere's disease and one with delayed hydrops, and compared the FT at the first examination carried out at the onset of a severe vertigo attack with that at the last examination, improved to normal condition. The FT decreased significantly in the 'eyes closed' condition (p<0.01 Wilcoxon's test). With the eyes open, it did not improve entirely, but in 11 patients with nystagmus, it decreased significantly (p<0.05). The dynamic Romberg rate (closed-eye FT/open-eye FT) also decreased (p<0.01). After a severe vertigo attack, three conceptual periods are suggested based on a combination of the FT values obtained with the eyes open or closed. During the first period, the open-eye FT is abnormally high, therefore, the dynamic Romberg rate should not is not? be unexpectedly high even if the closed-eye FT is higher. It seemed to be paradoxical as a severe labyrinthine disorder. [?] During the subsequent 2^nd period, the open-eye FT improves to normal, while the closed-eye FT still remains high, so that the dynamic Romberg rate is high. The closed-eye-FT decreases progressively each day and this period is maintained for about one month. During the final 3^rd period, both the FT values are normal and the dynamic Romberg rate is low. This study suggested that the Foulage test can be useful for quantitative determination of the body sway in patients of Meniere's disease and delayed hydrops quantitatively and is also useful to follow up the course after a vertigo attack.