Evaluation and assessment of roles of neurootological examinations, vestibular tests, and videonystagmography in patients with dizziness

Abstract

Background Vertigo and dizziness are frequent clinical symptoms. Peripheral vertigo and central vertigo are two different types of vertigo that result from a disrupted vestibular system. Imbalance and dizziness are frequent initial complaints. It is common for improper diagnosis and subpar treatment to result from a lack of a systematic approach to the examination and laboratory evaluation of the vestibular system. A correct diagnosis can be made with a fundamental knowledge of vestibular physiology and the right examination methods. Objectives The current study was done to evaluate and assess the roles of neuro-otological examinations, vestibular tests, and videonystagmography among patients with dizziness visiting a tertiary care centre. Methodology An analytical cross-sectional study was conducted among patients complaining of vertigo at a tertiary care centre for the duration of 18 months. A total of 64 patients were included according to inclusion and exclusion criteria. Various diagnostic tests were applied and correlated with the complaints of the patients. Result Forty-two percent of patients with dizziness had hearing loss, and 26.5% had tinnitus. 57.8% had the PTA test within the normal limit, and the head shake test (videonystagmography) was positive among 39.1%. Caloric test abnormality was seen in 53.1% of patients with dizziness. Neuro-otological examination of the head shake test was found positive in 29.7% of cases. 79.7% of cases show a positive Fukuda test. SP > AP is seen among 9.4% of cases in EchoG. 67.1% show a positive Romberg test. The Dix-Hallpike test was positive among 31.2% of dizziness patients. Conclusion In conclusion, history and neuro-otological testing can aid in the diagnosis of vertigo, but they cannot be relied on if the vertigo is complex. Only symptomatic history and neuro-otological tests are helpful in cases like a simple unilateral posterior canal BPPV, but in a complex case with tinnitus, aural fullness, Romberg positivity, or Fukuda positivity, we need the assistance of additional investigations such as vestibular tests such as ECochG and VNG.