Reprinted from Annals of Otology, Rhinology

Recently we developed an analog model to simulate Alexander's law in nystagmus secondary to dysfunction of a semicircular canal. Alexander's law is based on the observation that the amplitude of the nystagmus grows with increasing gaze in the direction of the fast phase and diminishes with gaze in the opposite direction. To investigate the assumptions made in the model, we conducted quantitative ex­ perimental studies on the effect of gaze on caloric-induced nystagmus in human subjects. A weak stimulus (water at 26.5°C and 240 mllmin) was administered for several minutes which caused the development of jerk nystagmus. Both the average slow phase velocity and frequency reached a steady state at about three minutes after the start of irrigation and remained stable until the flow of water was stopped. To investigate the effect of gaze, each subject was asked to hold gaze at various positions from center, to the right, to the left, and to repeat the cycle. Results indicated that the slow phase velocity of the nystagmus was greatest in the direction of the fast phase and de­ creased approximately linearly with gaze in the other direction in accordance with Alexander's law. Frequency was not a function of gaze. We speculate as to the biological advantages of the brainstem neural circuitry responsible for Alexander's law.