Tullio phenomenon

   The eponym Tullio phenomenon refers to the Italian physiologist Pietro Tullio (1881-1941), who is credited with having been the first to describe the physiological correlate of a rare syndrome in which vestibular signs and symptoms are provoked by auditory stimulation. These signs and symptoms may present in the form of vertigo, postural imbalance, "oscillopsia, nystagmus, ocular tilt or any other vestibular symptom during exposure to auditory stimuli of a high intensity. Such auditory stimuli may stem from music or other loud environmental sounds, but also from one's own voice. The Tullio phenomenon has generally been described as a comorbid condition in Meniere's disease. Pathophysiologically, it is associated with an abnormally low threshold for click-evoked vestibulocollic responses, as well as with dehiscence of the roof of the anterior (superior) semicircular canal. Etiologically, it is associated primarily with perilymph fistu-lae, traumata, infectious disease (such as Lyme disease and syphilis), neoplasms (such as osteo-mata), and vestibulofibrosis. A congenital variant has also been described. Conceptually, the Tullio phenomenon bears a certain similarity to phenomena such as "synaesthesia, the "reflex hallucination, the " creative hallucination, the " functional hallucination, and the Proust phenomenon (involving odours which evoke autobiographical memories, named after the French author Marcel Proust (1871-1922)). In all these examples, " cross-activation can be conceived as a possible neurophysiological substrate.

   References

   Tullio, P. (1929). Das Ohr und die Entstehung der Sprache und Schrift. Berlin: Urban & Schwarzenberg. Watson, S.R.D., Halmagyi, G.M.,

   Colebatch, J.G. (2000). Vestibular hyper-sensitivity to sound (Tullio phenomenon). Structural and functional assessment. Neurology, 54, 722.