Search-coil head-thrust and caloric tests in Ménière's disease

Abstract

Twenty subjects (52.6%) showed abnormal results on one or both tests. Pathologic UW was present in 16 subjects (42.1%). During HTTs, 11 subjects (28.9%) showed pathologic GA. Seven subjects (18.4%) showed abnormal results on both tests. A significant correlation was found between UW and GA. However, pathologic GA during HTTs in subjects with unilateral MD was less frequent and the values smaller than those published for vestibular neuritis patients. Two subjects with unilateral MD had 100% UW, but none had >30% asymmetry on HTTs.

The Caloric Test and the Video Head-Impulse Test in Patients with Vertigo

“…The correlation obtained between the amount of canal paresis and Gs in the vHIT is slightly higher than that reported in Ménière's disease [9] . It can be argued that it is because of the inclusion of patients with a permanent, stable, and more severe deficit, as is the case of those suffering from vestibular neuritis or labyrinthitis [10] ; however, there are also patients with less damaging disorders, such as those with BPPV or vestibular migraine, who are usually normal in the caloric test and in the head-impulse test evaluated at the bedside [11,12] .…”

“…In these 46 patients, we have to take into account that we are giving complementary information because of the different nature of the tests. In the former group of patients (abnormal caloric test, normal vHIT), it is important to rule out artifacts; however, this is the most frequent finding in Ménière's disease [9] . In the latter (normal caloric and abnormal vHIT), we recommend retesting the vHIT, and in case where the abnormality is reliable, we can conclude the existence of what has been defined as a new entity under the characteristic of high frequency/ acceleration vestibular loss [15] , in which the main clinical symptom is dizziness in quick head movements; this needs to be correlated to other findings in the clinical history and complementary exams.…”

“…New video-based equipment that enables registration of the eye response to sudden head impulses mimicking the performance of the scleral search coil (SSC) in a magnetic field installation has recently become available for clinical use [3,4] . With this video head-impulse test (vHIT) system, it is possible to measure the gain of the vestibulo-ocular reflex (VOR) and to register eventual refixation saccades with stimulations (head impulses) that acquire high velocity (>150º/s) and acceleration (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). This system is good not only for initial evaluation of the patient but also for follow-up, as has been demonstrated in patients with MD with rapid fluctuations in vestibular function [5] .…”

The Reliability and Validity of “Dokuz Eylül University Meniere’s Disease Disability Scale”

“…This feature is a "must-have feature" in this type of questionnaire [5,[33][34][35] . Demographic features, familial MD history, accompanying other systemic chronic disease history, and bilaterality of the disease findings were similar to those of other studies [36][37][38][39][40][41] . It has been reported that the emotional stress is the most powerful attack indicator [31,[41][42][43][44] .…”

“…Our finding was the same. Moreover, the audiological, eye movement, and bithermal caloric test findings of the patients were similar to the literature [19,35,[37][38][39][45][46][47][48][49][50][51][52] . Head-shaking nystagmus has been reported as 60% previously, though the value was 20.4% in this study [38] .…”