Comparative study between the caloric vestibular and the video-head impulse tests in unilateral Menière’s disease

Cordero-Yanza, Jonathan Andrés; Vázquez, Edna Verónica Arrieta; Hernaiz-Leonardo, Juan Carlos; Sánchez, Jimena Mancera; Palestina, Mario Sabas Hernández; Pérez‐Fernández, Nicolas

doi:10.1080/00016489.2017.1354395

Cited by 37 publications

(33 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…-Caloric tests: This is an objective test to demonstrate peripheral vestibular dysfunction. It is based on aural stimulation with different temperatures to evaluate horizontal semicircular canal function, 69,70 and it can confirm unilateral vestibular hypofunction in up to 75% of unilateral MD cases. 71 -Vestibular evoked myogenic potentials (VEMPs): This is a test that uses cervical or ocular muscles reflexes evoked by a loud noise in the ear or high-frequency vibration, which helps to evaluate the function of the saccule (cVEMP) and utricle (oVEMP).…”

Section: Vestibular Function Testsmentioning

confidence: 99%

See 1 more Smart Citation

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Pérez-Carpena

Lopez-Escamez

2019

Semin Neurol

View full text Add to dashboard Cite

Meniere's disease (MD) is a set of uncommon disorders with core phenotype of tinnitus, episodic vertigo, and sensorineural hearing loss. MD shows a genetic predisposition and a family history is found in 10% cases, with an autosomal dominant inheritance pattern. It is a multifactorial condition whose onset and development are triggered by the combined effect of genetic and environmental factors. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, endolymphatic hydrops does not fully explain the persistence of tinnitus, hearing loss progression, or the frequency of vertigo attacks.There are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, adding more complexity to the phenotype. This “extended phenotype” can make the diagnosis and clinical management more complex, but it could also lead to a better characterization, understanding, and treatment of MD patients.We have conducted a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management.

show abstract

Section: Vestibular Function Testsmentioning

confidence: 99%

“…The VOR gain is used to track vestibular function during follow-up. 70,75 Blood Tests Nonspecific tests can be used to evaluate vascular risk factors, thyroid dysfunction, or autoimmunity. 58 The tests include:…”

Section: Vestibular Function Testsmentioning

confidence: 99%

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Pérez-Carpena

Lopez-Escamez

2019

Semin Neurol

View full text Add to dashboard Cite

show abstract

“…Thanks to the introduction of video-head impulse test (vHIT) in clinical practice, high-frequency VOR measurements for semicircular canals can be easily assessed (29,30). This new clinical device has been widely used to measure SC function, in both peripheral and central vestibular disorders (31)(32)(33)(34)(35)(36). Recently, it has been assumed that vestibulo-ocular reflex (VOR) for the affected SC may be impaired in BPPV resulting in pDBN, providing possible key data for differential diagnosis (37).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Using the Video-Head Impulse Test to Detect the Involved Canal in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus

et al. 2020

View full text Add to dashboard Cite

Positional downbeat nystagmus (pDBN) represents a relatively frequent finding. Its possible peripheral origin has been widely ascertained. Nevertheless, distinguishing features of peripheral positional nystagmus, including latency, paroxysm and torsional components, may be missing, resulting in challenging differential diagnosis with central pDBN. Moreover, in case of benign paroxysmal positional vertigo (BPPV), detection of the affected canal may be challenging as involvement of the non-ampullary arm of posterior semicircular canal (PSC) results in the same oculomotor responses generated by contralateral anterior canal (ASC)-canalolithiasis. Recent acquisitions suggest that patients with persistent pDBN due to vertical canal-BPPV may exhibit impaired vestibulo-ocular reflex (VOR) for the involved canal on video-head impulse test (vHIT). Since canal hypofunction normalizes following proper canalith repositioning procedures (CRP), an incomplete canalith jam acting as a "low-pass filter" for the affected ampullary receptor has been hypothesized. This study aims to determine the sensitivity of vHIT in detecting canal involvement in patients presenting with pDBN due to vertical canal-BPPV. We retrospectively reviewed the clinical records of 59 consecutive subjects presenting with peripheral pDBN. All patients were tested with video-Frenzel examination and vHIT at presentation and after resolution of symptoms or transformation in typical BPPV-variant. BPPV involving non-ampullary tract of PSC was diagnosed in 78%, ASC-BPPV in 11.9% whereas in 6 cases the involved canal remained unidentified. Presenting VOR-gain values for the affected canal were greatly impaired in cases with persistent pDBN compared to subjects with paroxysmal/transitory nystagmus (p < 0.001). Each patient received CRP for BPPV involving the hypoactive canal or, in case of normal VOR-gain, the assumed affected canal. Each subject exhibiting VOR-gain reduction for the involved Castellucci et al. vHIT in Positional Downbeat Nystagmus canal developed normalization of vHIT data after proper repositioning (p < 0.001), proving a close relationship with otoliths altering high-frequency cupular responses. According to our results, overall vHIT sensitivity in detecting the affected SC was 72.9%, increasing up to 88.6% when considering only cases with persistent pDBN where an incomplete canal plug is more likely to occur. vHIT should be routinely used in patients with pDBN as it may enable to localize otoconia within the labyrinth, providing further insights to the pathophysiology of peripheral pDBN.

show abstract

“…In this test, the abnormal rate was the lowest in the H-SC plane, suggesting that the H-SC is less likely to be involved in MD progression. SC dysfunction in MD was reported most frequently locating in the P-SC (47,62), and VOR gain reduction of S-HC occurred more frequently than H-SC (62,63). In our study, vertical vHIT were indispensable despite lack of low-frequency function assessment in vertical SCs.…”

Section: Discussionmentioning

confidence: 47%

A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests

Huang

Zhou

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

To date, no widely accepted criteria exist to quantify the severity of Menière's disease (MD) by using vestibular tests. This study aimed to compare association of hearing loss and vertigo severity with association of accurate assessments of vestibular function and the vertigo severity. The severity of vertigo was documented by a comprehensive medical history with number of vertigo attacks in the past 6 months and a Dizziness Handicap Inventory (DHI) questionnaire. The involvement of vestibular organs was verified by audio-vestibular tests in 80 definite MD patients. Correlations between DHI scores, number of vertigo attacks in the past 6 months, audio-vestibular function, and the number of involved vestibular end organs were evaluated. We show that there are no significant differences in either severity of vertigo or laboratory results across the degree of hearing loss. Furthermore, the number of involved vestibular end organs was significantly correlated with vestibulo-ocular reflex gain in anterior and posterior canal video head impulse test (vHIT), interaural asymmetry ratio in vestibular-evoked myogenic potentials (VEMPs), and number of vertigo attacks in the past 6 months and DHI score. The vestibulo-ocular reflex gain in the rotatory chair test (RCT) was significantly correlated with the DHI Physical scores and number of involved vestibular end organs at 0.08 Hz. These results indicate that hearing loss is a poor indicator of vertigo severity in MD whereas the number of involved vestibular end organs may serve as an objective measure for MD progress. A battery of vestibular tests targeting different sensor organs is a complementary method for evaluating inner ear deficits and may aid in "grading" the severity of MD.

show abstract

Comparative study between the caloric vestibular and the video-head impulse tests in unilateral Menière’s disease

Abstract: Our study shows that patients with MD can have functional deficit involving the vertical semicircular canals, which cannot be detected by the CVT alone. Therefore, both tests should be used in a complementary fashion.

Cited by 37 publications

References 19 publications

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Feasibility of Using the Video-Head Impulse Test to Detect the Involved Canal in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus

A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests

Contact Info

Product

Resources

About