Comparison of the results of caloric and video head impulse tests in patients with Meniere’s disease and vestibular migraine

Yılmaz, Mahmut Sinan; Eğilmez, Oğuz Kadir; Kara, Ahmet; Güven, Mehmet; Demir, Deniz; Elden, Sena Genç

doi:10.1007/s00405-020-06272-5

Cited by 26 publications

(35 citation statements)

References 18 publications

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“…[ 14 ] In this study, the prevalence of pathologic vHIT, low VOR gain as well as refixation saccades, was lower than that of previous studies. [ 17 , 18 ] This may be explained by the lower proportion (12.2%) of patients in Ménière stage IV in this study, as abnormal vHIT results occurred in higher stage of MD. [ 24 , 25 ] Another possible explanation was the effect of course duration.…”

Section: Discussionmentioning

confidence: 80%

“…[ 26 , 27 ] Recently, other studies reported the Pattern III can also be found in MD patients. [ 12 , 17 ] The exact mechanism is unknown and might be ascribed to the selective damage of vestibular hair cells. The clinical significance of Pattern III in MD patients requires further investigations.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the caloric test, vHIT is a low-sensitivity, high-specificity test for detecting horizontal VOR pathology. [ 17 ] Recent studies have found that in MD patients, the reduced caloric response, rather than vHIT response, is correlated with the severity of ELH (as demonstrated by gadolinium-enhanced MRI of the inner-ear). [ 6 , 31 ] Because of the fluctuating nature of MD, the vestibular hair cell population driving the response could vary depending on the condition of the disease and the type of hair cell involved.…”

Section: Discussionmentioning

confidence: 99%

“…[ 13 – 16 ] Nevertheless, the incidence of this caloric-horizontal vHIT dissociation in MD varies greatly in the literatures. [ 13 , 17 , 18 ] This variation may be explained by study population, instrument and procedure of vestibular tests. Until now, to our knowledge, no study has investigated the related factors regarding to the concordant and dissociated response of caloric-horizontal vHIT in patients with MD.…”

Section: Introductionmentioning

confidence: 99%

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Vestibulo-ocular reflex tests may reflect unilateral Ménière disease progression

Zhou¹,

Leng²,

Liu³

2020

Medicine

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Vestibular disorders can manifest several patterns of horizontal vestibulo-ocular reflex (VOR) impairment, which can be detected by caloric test and video head impulse test (vHIT). Several studies have examined the patterns of caloric-vHIT response in Ménière disease (MD). The purpose of this study was to investigate the diversity of caloric-vHIT response and its related factors in unilateral MD patients. We also explore the possibility of assessing the progression of unilateral MD by using the horizontal VOR tests. Ninety-eight patients with unilateral MD were enrolled and underwent a battery of audio-vestibular evaluations, including the pure tone audiogram, caloric test, and horizontal vHIT. Some patients received the electrocochleography and glycerol test. The combined results of caloric test and horizontal vHIT were categorized qualitatively into 4 patterns: Pattern I: normal caloric and vHIT responses; Pattern II: abnormal caloric and normal vHIT responses; Pattern III: normal caloric and abnormal vHIT response; and Pattern IV: abnormal caloric and vHIT responses. The abnormal caloric results were semi-quantitatively subdivided into sub-patterns as mild, moderate, and severe abnormality. The associations between these patterns/sub-patterns and related factors were analyzed. Pattern I was found in 35 cases (35.7%), Pattern II in 57 (58.2%), and Pattern IV in 6 (6.1%). No patient had Pattern III. No significant differences were found between the patterns/sub-pattern distribution and age, electrocochleography, and glycerol test results. Disease duration was not associated with the pattern distribution, while remained a relation with sub-pattern distribution. The pattern/sub-pattern distribution varied significantly across MD stages. The proportion of pattern II or pattern IV increased with the stage of unilateral MD. MD can manifest several patterns of horizontal VOR impairment, of which the impaired caloric response with normal vHIT is the most common pattern. With the progression of unilateral MD, the caloric-vHIT pattern tends to shift, which may reflect the deterioration of endolymphatic hydrops and vestibular hair cells impairments.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vestibulo-ocular reflex tests may reflect unilateral Ménière disease progression

Zhou¹,

Leng²,

Liu³

2020

Medicine

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“…There are significant correlations between age and the velocity of body oscillation with both eyes open and closed (p<0,001) as well as between Ménière's disease or vestibular neuritis and the velocity of body oscillation with eyes open (p=0,0194). The results of video head impulse test and caloric test demonstrate abnormal caloric tests in 39 patients with Ménière's disease (in 66,1%) and in 17 patients with vestibular migraine (in 34% of the cases) (39). There is abnormal video head impulse test gain of the lateral canal in 23 Ménière's disease patients (in 39%) and in nine vestibular migraine patients (in 18% of the cases).…”

Section: Comparative Diagnosis Of Common Vestibular Disordersmentioning

confidence: 92%

Recent advances in the epidemiology and diagnosis of some common vestibular disorders

Milkov

2021

International Bulletin of Otorhinolaryngology

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There is a rising interest in the diagnosis of the common vestibular disorders in childhood and adulthood. The results from numerous epidemiological investigations prove the socio-medical importance of this pathology. In the present survey, the applications of the main diagnostic methods in this interdisciplinary field are discussed.Here belong the caloric test, the video head impulse test, the cervical and ocular vestibular evoked myogenic potentials, the videonistagmography, the electrococheography, the magnetic resonance imaging, the computed tomography, etc. A special attention is paid to the comparative diagnosis of some socially significant common vestibular disorders.

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vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness

Kirazli,

Balayeva,

Kacan Yilmaz

et al. 2024

The Laryngoscope

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ObjectiveImpairment in the integration of different vestibular stimuli is the proposed mechanisms in vestibular migraine (VM). In this study, it was aimed to assess the vestibulo‐ocular reflex (VOR) and dynamic visual acuity (DVA) in patients with VM and to compare the results with migraine without vestibular symptoms (MwoV), and persistent postural‐perceptual dizziness (PPPD) to find out if there are discriminative differences and search for a correlation with the levels of anxiety.MethodsTwenty‐two patients with MwoV, 23 patients with VM, 22 patients with PPPD, and 23 healthy controls (HC) were studied. Video head impulse test (vHIT) and functional head impulse test (fHIT) without and with an optokinetic background (OB) were performed. Percentage of correctly identified optotypes (CA%) was considered for the fHIT test. Beck anxiety inventory (BAI) was used to assess anxiety.ResultsLateral canal vHIT gain of the patient groups were not different from the healthy controls (p > 0.05). fHIT and fHIT/OB CA% results of all patient groups were lower than the HC (p < 0.005), and VM patients had the lowest scores for both tests. BAI scores of the PPPD patients were the highest and a correlation between anxiety levels, and fHIT results could not be identified (p > 0.05).ConclusionProminent CA% drop by the use of an OB was the main finding in patients with VM. This discriminative feature was not correlated with anxiety scores. Difficulty in resolving the conflict between visual and vestibular inputs seem to be the underlying mechanism.Level of Evidence3 Laryngoscope, 2024

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Comparison of the results of caloric and video head impulse tests in patients with Meniere’s disease and vestibular migraine

Cited by 26 publications

References 18 publications

Vestibulo-ocular reflex tests may reflect unilateral Ménière disease progression

Vestibulo-ocular reflex tests may reflect unilateral Ménière disease progression

Recent advances in the epidemiology and diagnosis of some common vestibular disorders

vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness

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