PubMed · 6517132
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W Rubin. 1984. Rotation vestibular testing.. https://pubmed.ncbi.nlm.nih.gov/6517132/
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The usefulness of a monothermal warm caloric screening test (MWST) for predicting alternate binaural bithermal test abnormalities has been reexamined. Previously, researchers have reported false-negative rates for the MWST ranging from 0% to over 35%. Alternate binaural bithermal test data from 504 consecutive patients were evaluated with MWST failure criteria of 24.5% and 29%, with and without the addition of failure criteria from subtests of the electronystagmography examination. Sensitivity of the MWST alone was high, and improved with additional failure criteria. The specificity levels were correspondingly high. Results support the use of the MWST with adjunctive failure criteria when patients have otherwise normal electronystagmography findings.
It is known that loud tones can damage the cochlea, but vestibular involvement has been given less attention. However, patients with noise induced hearing loss (NIHL) sometimes have balance disorders as well as some have symptoms resembling those of Meniere's disease. In this study, we examined the relationship between loud sounds and vestibular problems. Thirty-six NIHL patients were divided into two groups according to the presence (vertigo group) or absence (non-vertigo group) of vestibular complaints. Electrocochleograms were recorded from all subjects after pure tone audiometry. A higher incidence of increased -summating potential (SP)/action potential (AP) ratio was observed in the vertigo group than in the non-vertigo group. Caloric tests were performed in the vertigo group, and a reduced response was observed in 47.1% of ears. It is generally considered that the -SP/AP ratio is a useful indicator of endolymphatic hydrops. Therefore, episodic vertigo in NIHL patients may result from a pathophysiological mechanism similar to that of Meniere's disease.
OBJECTIVE: Quantification of the stepping test in routine neurological examination. SETTING: University Hospital Groningen, the Netherlands. DESIGN: Prospective, controlled study. METHODS: The stepping test was assessed in 41 healthy subjects, in 7 subjects with artificially induced vertigo and in 83 patients with disturbances of gait or equilibrium resulting from different affections of the central nervous system. Displacement and rotation to the right or the left side were measured. The different groups were then compared with each other. RESULTS: We found a great inter- and intra-individual variation in direction and width of rotation and in displacement. The results of the test are not influenced by right(+)-or left(-)-handedness or by dominance of the right or the left leg. CONCLUSION: The current test does not appear to be useful for detection of abnormalities in the vestibular system or for distinguishing normal individuals from patients.