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At least 127 records · Page 7Linked to original sources
PubMed1986

[Differential diagnosis of benign paroxysmal positional vertigo in Menière's disease].

135 patients with BPPV and 56 patients with Meniere's disease were evaluated critically. The reliability of the diagnostic criteria (history and physical examination, audiograms and vestibular function tests) were compared. History, physical examination and patients' complaints were inconclusive. Moderate or severe medio- or pancochlear inner ear damage was more reliable, but not pathognomonic of Meniere's disease. Patients with BPPV had normal hearing or a high-frequency loss. Electronystagmographically recorded vestibular function tests were unreliable in establishing the diagnosis. The most valid test to distinguish BPPV and Meniere's disease was Hallpike's positional test, using Frenzel's spectacles for better observation of the provoked nystagmus.

Adult↗
PubMed1999

Current status of electronystagmography testing.

ENG testing, whether computerized or not, remains the most useful means of assessing the vestibular system. The caloric test provides invaluable site-of-lesion information that objectively documents a peripheral vestibular lesion. Double (bithermal) caloric irrigation of each ear provides a more thorough and wider range test of inner ear function than a single caloric irrigation because the vestibular system is both excited and inhibited, causing responses in opposite directions, which are important in evaluating patients with underlying spontaneous nystagmus. In an age in which economically efficient and clinically effective diagnostic methods are in high demand, ENG testing remains the gold standard of vestibular function tests.

Calorimetry↗
PubMed1992

[New indications for the rotating chair test for side localization and determination of central compensation in vestibular function disorder].

The horizontal vestibulo-ocular reflex was studied in normals and 35 patients with an acute or compensated unilateral peripheral vestibular deficit (PVD) in order to determine the efficacy of different response measures obtained from a rotating chair test in localizing the deficit side and defining its central compensation. The profiles of chair velocity and the visual fixation period were chosen in such a way that the slow phase velocity profiles were comparable to those obtained during caloric tests. Mean slow phase eye velocity measured during the culmination period elicited by constant chair acceleration of 5 degrees/s2 over 40 s was significantly reduced for rotations towards the side of an acute or compensated PVD. Per-rotatory gain asymmetry (after correcting for spontaneous nystagmus) was not always specific for the side of the deficit and often not significantly different from normal values in the compensated stage of the deficit. In combination both parameters (SPV and gain asymmetry) were reliable indicators (sensitivity 88%) of the underlying pathology and correctly localized the deficit side during the compensated state. The decay of post rotatory SPV followed a more rapid time course than normal during acute and compensated stages of the deficit. It may be concluded from those results that the rotating chair test is a valuable indicator of the presence and side of a peripheral vestibular deficit even when it has been centrally compensated.

Caloric Tests↗
PubMed2001

Perspectives for the comprehensive examination of semicircular canal and otolith function.

A review is presented on the three-dimensional aspects of the vestibulo-oculomotor system and the current functional tests for unilateral examination of the individual receptors in the vestibular labyrinth. In the presentation, attention is directed towards the recently developed vestibular tests, which promise a more comprehensive examination of labyrinth function. More explicitly, unilateral tests for the utricle, saccule and the individual semicircular canals are discussed. Caloric irrigation and rotatory testing are widely used as tests for the integrity of the (horizontal) semicircular canals. Little useful diagnosis is made however on the vertical canals, not to mention the otolith organs. A promising approach to the examination of individual semicircular canal function has been described. This involves the perception of self-rotation in each of the planes of the semicircular canals. The patient/subject is rotated by an arbitrary amount on a standard Barany chair and then required to return the chair to its original position, by joystick control of the chair velocity. In order to test the vertical canals, the head of the subject/patient is positioned so that the plane of each canal lies in the plane of rotation. A promising unilateral test of saccular function involves the use of vestibular evoked myogenic potentials. Here it has been demonstrated that the saccules can be activated using brief, high-intensity acoustic clicks. The myogenic potential is measured using surface electrodes over the sternocleidomastoid muscles. Initial data from patients has indicated that the test is specific for unilateral saccule disorders. The unilateral test of utricle function is based on the eccentric displacement profile. Thus, eccentric displacement of the head to 3.5 cm during constant velocity rotation about the earth-vertical axis generates an adequate unilateral stimulation of the otolith organ, without involving the semicircular canals. This paradigm has also proved efficient in localizing peripheral otolith dysfunction by means of SVV estimation. This represents a novel test of otolith function that can be easily integrated into routine clinical testing. In contrast to the otolith-ocular response, the subjective visual vertical also reflects the processing of otolithic information in the higher brain centres (thalamus, vestibular cortex). Exploitation of the two complementary approaches therefore provides useful information for both experimental and clinical scientists. Of direct interest is the finding that testing with the subject rotating on-centre is sufficient to localize peripheral otolith dysfunction by means of SVV estimation. This represents a novel test of otolith function that can be easily integrated into routine clinical testing. In addition to caloric testing, which has remained the classical unilateral test of vestibular function, the newly developed tests should improve the differential diagnosis of vestibular disorders.

Caloric Tests↗
PubMed1993

Vestibular ontogeny: measuring the influence of the dynamic environment.

In comparison to other special senses, we are only meagerly informed about the development of vestibular function and the mechanisms that may operate to control or influence the course of vestibular ontogeny. Perhaps one contributing factor to this disparity is the difficulty of evaluating vestibular sense organs directly and noninvasively. The present report describes a recently developed direct noninvasive vestibular function test that can be used to address many basic questions about the developing vestibular system. More particularly, the test can be used to examine the effects of the dynamic environment (e.g. gravitational field and vibration) on vestibular ontogeny.

Acceleration↗
PubMedDate not supplied

Relation between vestibular function and speech recognition in postlingually deafened adults with cochlear implantation.

Thirty-one postlingually deafened adults with 22-channel cochlear implants were evaluated preoperatively using vestibular function tests, the caloric test and stabilometry. The results of caloric response were classified into two diagnostic groups: normo- or hyporeflexia and areflexia. Stabilometric recordings were made using a computerized static posturographic platform. Between the two categories of caloric response, there was a significant difference in consonant recognition, but the recognition of vowels showed no significant difference. The results of the distance of body sway in stabilometry, but not of the area, correlated to the results of consonant recognition in speech perception tests. The degree of residual vestibular function seems to be one of the indicators influencing postoperative speech recognition by cochlear implant patients.

Adult↗
PubMed2003

[Nystagmographic findings in pontocerebellar angle tumors].

OBJECTIVE: To determine the diagnostic and prognostic value of vestibular function tests in cerebellopontine angle tumors METHODS: Analysis of preoperative nystagmographic findings in 29 patients affected of cerebellopontine angle tumors and its possible correlation with anatomical and progressive patterns RESULTS: Tumor size and growth pattern were statistically significantly related to auditory and vestibular functions and to central findings on nystagmography. Age, gender, tumor size and central findings on nystagmography did not show influence upon postoperative dysbalance. However, alterations related with adaptation of the vestibular system (positional nystagmus and asymmetry on rotational tests) correlated significantly with postsurgical dysbalance. CONCLUSIONS: The tests for vestibular function reflect a the characteristics of growth of the cerebellopontine angle tumors and can help to identify the patients susceptible of prolonged postoperative dysbalance.

Adult↗
PubMed1986

[Electronystagmography aspects of peripheral and central vestibular syndromes].

This report deals with what is to be known in applying ENG in the everyday office. From vestibular, visual and proprioceptive informations central neural processing evolve to stabilize images on the retina. ENG can perform an analysis of these systems, alone or interacting. Anatomical, neurophysiological backgrounds and experimental pathophysiology results are first described. The methodic rule of anamnesis is emphasized and the non instrumental examination is outlined. Concerning the technical aspects and the ENG achievement, some nonlinearities are stressed. Next, procedure of eye movements recording, oculomotor and vestibular testing are described. Alertness, stimulation order, gaze direction and drugs influence the response. The nystagmus responses are evaluated by quantitative parameters and morphological aspects. The variability of these implies the multiplication of the pathological arguments. Peripheral vestibular disturbances lead to labyrinthine paresis or paralysis and to nystagmus directional preponderance, sometimes alone, often combined. Thermic predominance may be associated and cause of some interpretation difficulty. Diagnosis of central neurological disturbances is submitted to four conditions: only specific criteria selection; complete oculomotor and vestibular testing; graduated conclusions in function of the criteria number; no etiological but only functional or topographical diagnosis. Central vestibular syndromes lead also to labyrinthine weakness or nystagmus directional preponderance but, first at all, to specific criteria who are: saccadic, pursuit and horizontal optokinetic abnormalities, central spontaneous or positional nystagmus, failure of fixation suppression, hyperreflexia, perverted nystagmus, slowing of the nystagmus fast phases, slowing-down of the nystagmus slow phases, anisonystagmus, vertical optokinetic deficits and retraction nystagmus. Finally, these dysfunctions incidence in personal observations with some multi or unifocal central pathologies is described and the correspondent more characteristic findings are outlined.

Animals↗
PubMed1994

Does intracochlear implantation jeopardize vestibular function?

We present the results of the vestibular function tests of 35 patients who were selected for cochlear implantation. Vestibular function was evaluated with a caloric test and a velocity step test. The preimplant data were compared to those in previously reported series. Intracochlear implantation was performed in 25 patients. The vestibular complications encountered in this group are presented and discussed. Six patients had normal or residual (but substantial) vestibular function in the ear eligible for implantation. Vestibular function was preserved in 3 patients and was lost in 3 patients, in 1 case through an iatrogenic cause. We estimate the risk of losing vestibular function as a result of intracochlear implantation as between 50% and 60% on the basis of the present and previously reported data.

Adult↗
PubMed2005

[Otolith function tests--a differentiated, quality-assured screening system].

INTRODUCTION: More than 30% of all otogenic vestibular disorders are related to isolated macular dysfunction. Videooculographic examination techniques for the otolith-ocular reflex, e. g. by means of eccentric rotation tests, are not widely used in clinical routine as these put a considerable strain on technical and staff resources. Thus, there is a considerable risk of "false negative" classification of vertigo disorders being labelled as "non-otogenic". By means of vestibular-evoked myogenic potentials (VEMPs) and caloric irrigation in prone and supine position, several examination techniques for a side-related investigation of macula-induced vestibulo-ocular reflexes are available. The objective of this study is to compare and evaluate these techniques as screening tests. METHODS: In 32 patients with vestibular disorders we performed investigations for VEMPs, eccentric rotation tests, as well as caloric irrigation for macular reaction in prone and supine position. In addition, we performed other audiologic and vestibular function tests which were complemented by the clinical course in order to differentiate each case between otogenic and non-otogenic vertigo with or without macular affection. RESULTS: The technical feasibility as well as patients' acceptance for VEMP testing is better than for eccentric rotation tests. The sensitivity index for VEMPs (89%) as well as for caloric irrigation in prone and supine position for macular examination (71%) is satisfactory. However, the specificity of VEMPs is inferior (53%) to eccentric rotation (100%). DISCUSSION: Both the examination for VEMPs as well as caloric macular testing in prone and supine position carry features which make them feasible for screening, even though these two procedures test for two different parts of the otolith system. However, to confirm a diagnosis and to set up a therapeutic concept for macular function disorders, eccentric rotation should be added.

Caloric Tests↗