CCG Computerized Craniocorpography.
Test of Unterberger and Fukuda
Craniocorpography (GCC) is an objective and quantitative method for the study of vestibulospinal function and equilibration.
The GCC consists of the PHOTOGRAPHIC REGISTRY on an instant film of the movements of the head and the body during the tests of Romberg, Unterberger and Fukuda. An image of the displacements of the center of gravity and of the correction body movements is obtained on the instant developing photographic plate. In this way, the GCC allows simple, quick and economic registration of vestibulospinal reactions.
Both the Romberg test for static position maintenance, as those of Unterberger, and Fukuda were subject to a subjective criterion of observation and interpretation. In contrast, CCG is a method of objective exploration of the balance and function of the vestibulospinal system; Together with anamnesis and routine ENT examination, is useful for the screening of patients with vestibular alterations and has great expert value.
The CCG occupies a prominent place in routine tests of patients whose work forces them to stay at heights and can also be used to detect simulators that seek to take advantage of a symptom, vertigo, absolutely subjective and unprovable.
Causes of dizziness and imbalance. The cranioocorpógrafia consists of several elements: Polaroid camera, static convex mirror, platform and reference system for the valuation.
To photograph the movements of the subject and to analyze them, a conventional helmet of the construction industry is placed on the head with signaling pilots in its front and back. Two other pilots are clamped to the patient’s shoulders. The four reference bulbs receive a low voltage energy from a battery attached to the inside of the helmet. As the mirror is in the INVERTED position, the representation that is obtained from the shoulders in the photograph is interchanged, so that the right side of the photo corresponds to the left shoulder and vice versa.
The CCG is performed with the room in the dark, eyes closed and covered with a black mask to avoid any possibility of vision.
First we do the Romberg, standing the subject standing with our feet together and performing the Jendrassik maneuver for 1 to 3 minutes. The diaphragm is kept open all the time so that the luminous traces of all movements of the body and of the head are printed on the plate. With this test the static equilibrium is investigated; Allows to objectify the movements of the subject forward and backward, sideways and calculate the angle of torticollis, when it exists.
Then the Unterberger test or sustained gait test is performed, useful for investigating dynamic balance. The patient is invited to perform between 80 and 90 steps per minute without moving from the site, keeping the arms extended in pronation.
After 30 to 40 steps, the visual image of the environment is forgotten and it begins to depend only on the vestibular and proprioceptive systems, which also disappear to leave only the vestibulospinal to keep in balance.
The corporal displacements and their correction are photographed and later valued, by means of a template, attending to the following parameters:
A) In the Romberg, the anteroposterior and lateral oscillations of the body, whose photographic imprint gives us an image of the amplitude of the center of gravity, are valued for the static balance. The normal test is considered if the photooptic representation is punctual. We speak of discrete ataxia when the oscillation in anteroposterior and lateral sense does not surpass the 8 cm; Above this figure a severe ataxia is considered.
Vertigo and dizziness, treatment. The widening of the center of gravity, without predominating a particular direction, usually translates ataxia and central vestibular disorder. In peripheral vestibular syndromes the enlargement of the center of gravity is always originated by repeated oscillations of the body in the same direction and translate the correction of the spontaneous displacements towards the side with less labyrinthine tone.
- B) In the test of Unterberger, according to Dr. Claussen, other parameters are valued for dynamic equilibrium, namely:
- Side oscillation
- Length of the deviation
- Angular deflection
- Rotation angle.
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