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Acta Otolaryngol. 2014 Dec;134(12):1239-44. doi: 10.3109/00016489.2014.939300.

Caloric stimulation and video-head impulse testing in Ménière's disease and vestibular migraine.

Author information

1
Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders , HELIOS-Klinikum Berlin-Buch , Germany.

Abstract

CONCLUSION:

Both the bithermal caloric test and the video-head impulse test (vHIT) were more often abnormal in Ménière's disease (MD) than in vestibular migraine (VM). Horizontal vestibulo-ocular reflex (hVOR) evaluation with caloric test (low-frequency test) was significantly more often abnormal than vHIT (high-frequency test). Therefore, both tests can be used in a complementary way for frequency-selective testing of peripheral vestibular function.

OBJECTIVES:

To compare the results of caloric testing and vHIT in MD and VM and to determine which test is more sensitive to uncover peripheral vestibular hypofunction.

METHODS:

Patients with MD (n=30) or VM (n=23) were examined with the caloric test and vHIT. The parameters analyzed were the canal paresis factor for the caloric test and the hVOR gain on both sides in vHIT.

RESULTS:

The caloric test was abnormal in 67% of patients with MD and in 22% with VM (p=0.002), while the vHIT showed an hVOR deficit in 37% in MD and 9% in VM (p=0.025). In all, 28% of patients with an abnormal caloric test had a normal vHIT, whereas 6% of those with an abnormal vHIT had a normal caloric test. The sensitivity of vHIT compared with caloric testing was 55% for MD and 40% for VM. Neither the caloric test nor vHIT could detect significant differences between early (<5 years) or advanced stages (>5 years) of MD or VM.

KEYWORDS:

Caloric test; Ménière; dizziness; vertigo; vestibular migraine; video-head impulse test

PMID:
25399882
DOI:
10.3109/00016489.2014.939300
[Indexed for MEDLINE]

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