Res Vestib Sci.  2018 Jun;17(2):49-54. 10.21790/rvs.2018.17.2.49.

The Clinical Efficacy of Vestibular Function Tests in Patients with Acute Unilateral Vestibulopathy

Affiliations
  • 1Department of Neurology, Dankook University College of Medicine, Cheonan, Korea. neurokji@hanmail.net

Abstract


OBJECTIVES
Aim of this study is to investigate the clinical efficacy of the vestibular function tests (VFTs) and the predictability of lesion side of vestibular asymmetry parameters in acute unilateral peripheral vestibulopathy.
METHODS
Medical records and results of VFTs (caloric, rotatory chair, and head impulse tests) of 57 patients with acute unilateral vestibulopathy were reviewed retrospectively. The VFTs were examined within 7 days after the clinical onset.
RESULTS
For the caloric test, 74% showed significant canal paresis and the predictability of lesion side was 88%. For the sinusoidal harmonic acceleration test, 91% had low gain in at least 1 Hz, phase lead showed 70%, 89% showed phase asymmetry and the predictability of lesion side was 90%. For velocity step test, 67% had abnormal Tc asymmetry and the predictability of lesion side was 95%. In bedside head impulse test (HIT), abnormal catch up saccades were observed in 89% and the predictability of lesion side was 100%. For the video HIT, cover or overt catch-up saccades were observed in 95% and the predictability of lesion side was 100%. One hundred percent (100%) had low gain on the video HIT, but the lesion sides were uncertain because of bilateral involvements or artifacts.
CONCLUSIONS
The most important things in the diagnosis of acute unilateral vestibulopathy are typical clinical symptoms and spontaneous nystagmus. A combination of rotatory, caloric, and HITs will result in a more complete examination of the vestibular system. Among them, HIT is recommended as the best tool in acute unilateral vestibulopathy.

Keyword

Acute unilateral vestibulopathy; Vestibular function tests; Caloric test; Rotatory chair test; Head impulse test

MeSH Terms

Acceleration
Artifacts
Caloric Tests
Diagnosis
Exercise Test
Head
Head Impulse Test
Humans
Medical Records
Paresis
Retrospective Studies
Saccades
Treatment Outcome*
Vestibular Function Tests*
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