OBJECTIVE: To show the value of rotating chair test (ROT) as an adjunct to the conventional electronystagmography (ENG) examination including caloric test for the diagnosis of vestibular lesions. BACKGROUND: Since caloric stimulatim is regarded as a very low frequency (0. 003Hz) test, it is desirable to test the function of horizontal semicircula canals by stimulating with faster frequencies. Baloh et al. (1984a) described that lesions ofdifferentiated by ROT. Leigh and Zee(1991) told that ROT can give more accurate and reproducible results than do caloric tests. METHOD: 30 patients who suffered from vertigo with either peripheral or central pathology were given computerized ENG and ROT. We discuss the representative examples of our initial experience with ROT. RESULTS: 1.In eight patients with known peripheral pathology, low-frequency phase deficits, asymmetry toward the lesim side and VOR suppression by gazefixation were seen during ROT. With bilateral peripheral vetibular disease, the ROT could identify remaining vestibular function at higher frequencies. 2. Seven patients with lesions of central vestibular structure showed abnormalities of saccades and pursuit during ENG and failure of VOR suppression by gaze fixation during ROT. 3. Out of 15 patients whose lesions could not be localized distinctly after caloric test, four patients were suggested to have central pathology. CONCLUSION: ROT can be a useful method to study the vestibular abnonnahties and an adjunct to the conventional ENG test.
Caloric Tests ; Diagnosis ; Electronystagmography ; Humans ; Pathology ; Saccades ; Vertigo* ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: Many authors(Simmons,1973, McGath et al.,1989) described that a small percentage(1-2 %) of patients initially complaining of vertigo was found to have bilateral vestibular failure (BLVF). This study evaluates the findings of vestibular function test (VFT) including rotating chair test (ROT) and computerized dynamic posturography test (CDP) in the patients with BLVF demonstrated by caloric test and others. Method : 400 vertigo patients were given VFT from June,1994 to October,1995. In the patients who had absent or reduced responses (total eye speed <10 degrees per second) in cold (17 C) water caloric testing or decreased responses in the range of lower fequencies during ROT, we evaluated their VFT results and clinical features. RESULTS: There were 38 cases out of total 400 patients(9.5%). Many patients with BLVF had rotational response magnitudes (at 0.04 Hz and above) that were within normal limits. CBP has shown vestibular dysfunction patterns in 32 patients. Hearing tests were normal in 9 cases and mixed hearing loss in 2 cases. Many patients experienced several episodes of acute vertigo with persistent imbalance; Only 4 patients complained of persistent oscillopsia. Viral infection (vestibuloneuronitis), immune reactions and toxic factors may play a role in the etiology of this rare BLVF. CONCLUSION: Our incidence of 9.5% is much higher than what was reported in the literature. Herb medications and frequent injections of aminoglycosides may be responsible for this higher incidence of BLVF. ROT is useful in detecting and predicting the remaining vestibular function in the BLVF patients.
Aminoglycosides ; Caloric Tests ; Electronystagmography ; Hearing Loss, Mixed Conductive-Sensorineural ; Hearing Tests ; Humans ; Incidence ; Vertigo ; Vestibular Function Tests* ; Water

Electronystagmography ; Humans ; Postural Balance ; Vestibular Function Tests

Recently with the introduction of video head impulse test (vHIT), it can be easily performed quantitative and objective measurement of vestibulo-ocular reflex (VOR). vHIT has been used as a clinical vestibular function test that can individually evaluate the function of each semicircular canal. Loss of VOR gain and corrective catch-up saccades that occur during the vHIT usually indicate peripheral vestibular hypofunction, whereas in acute vestibular syndrome, normal vHIT should prompt a search for a central lesion. In this study, we will examine the principle of vHIT and its interpretation, and explain its clinical application in peripheral and central vestibulopathy. In addition, we will compare the caloric test and the differences, and review the most recently introduced suppression head impulse paradigm test.
Caloric Tests ; Head Impulse Test ; Head ; Reflex, Vestibulo-Ocular ; Saccades ; Semicircular Canals ; Vestibular Function Tests

BACKGROUND AND OBJECTIVES: We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. SUBJECTS AND METHOD: The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. RESULTS: The mean age of 15 patients was 67.4±10.7 years and the mean duration of dizziness was 13.6±29.7 months. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. CONCLUSION: Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.
Caloric Tests ; Compensation and Redress ; Dizziness ; Head Impulse Test ; Humans ; Methods ; Paresis ; Retrospective Studies ; Vestibular Function Tests ; Vestibular Neuronitis ; Vibration*

BACKGROUND AND OBJECTIVES: To find out the causative factors and clinical features of bilateral vestibulopathy in the Korean population. SUBJECTS AND METHOD: The data of 42 patients (mean age: 55.04+/-18.87 years) with bilateral vestibulopathy were reviewed retrospectively between 1997 and 2009. We carried out a full neurotological examination, electronystagmography, a bithermal caloric test, a rotatory chair test, cranial imaging and laboratory studies. RESULTS: Nineteen patients (45.24%) were diagnosed as having secondary bilateral vestibulopathy with causative factors. The most common cause was ototoxic drug (14.29%). Other etiologic causes were labyrinthitis, temporal bone fracture, Meniere's disease, peripheral neuropathy and meningitis/encephalitis. Forty-five percent of all patients had symptoms that lasted less than 1 month, and about 43% of the patients presented with chronic progressive symptoms of over 1 year. CONCLUSION: In about 54% of all patients, we couldn't find any causative factors leading to bilateral vestibulopathy. Because a large subgroup of patients had a history of dizziness over one year, an adequate number of studies on vestibular and cerebellar function are recommended for patients of chronic dizziness to exclude bilateral vestibulopathy.
Caloric Tests ; Dizziness ; Ear, Inner ; Electronystagmography ; Humans ; Labyrinthitis ; Meniere Disease ; Peripheral Nervous System Diseases ; Retrospective Studies ; Temporal Bone ; Vestibular Function Tests ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: There are caloric test, SCEP, DP in Step velocity and VOR asymmetry in SHA test as parameters for evaluation in unilateral peripheral vestibulopathy in parameter of vestibular function test. The aim of this study is to assess the correlation between these parameters and intensity of spontaneous nystagmus in vestibular neuritis. MATERIALS AND METHOD: We evaluated 75 patients who were diagnosed as vestibular neuritis with 3 degree spontaneous nystagmus at vestibular function test lab from January 2000 to July 2005 in Dankook university hospital. The correlations between direction and intensity of spontaneous nystagmus and monothermal caloric test, SCEP and DP in step velocity, VOR asymmetry (0.01, 0.04, 0.16 Hz) in SHA test were analysed. And correlations according to sex, age were also analysed. RESULTS: The correlation coefficient between intensity of spontaneous nystagmus and monothermal caloric test was 0.60. The correlation coefficient between intensity of spontaneous nystagmus and SCEP was 0.35. The correlation coefficient between intensity of spontaneous nystagmus and Tc DP was 0.36 and it showed no significant correlation. The correlation coefficient between intensity of spontaneous nystagmus and VOR asymmetry (0.01, 0.04, 0.16) was 0.57, 0.46, 0.51, respectively and there was higher correlation in man, age under 60. CONCLUSION: Intensity of spontaneous nystagmus showed close relations to monothermal caloric test, VOR asymmetry of SHA, Tc DP, SCEP DP in sequence. In addition, young male patients tends to be closely related to intensity of spontaneous nystagmus.
Caloric Tests ; Humans ; Male ; Vestibular Function Tests* ; Vestibular Neuronitis*

OBJECTIVETo analyze the value of directional preponderance (DP) in vestibular dynamic compensation evaluation.

METHODSOne hundred fifty-five patients with sudden deafness accompanied vertigo were asked to accept routine vestibular tests including the spontaneous nystagmus (SN) and caloric test with video-nystagmography. DP, SN and unilateral weakness (UW) were selected as the observation parameters. Then the correlation analysis between DP, SN, UW and course of disease were investigated respectively. The change characteristic of the three parameters was also analyzed in the course of vestibular compensation.

RESULTSOf the 155 patients, there were negative correlations between SN, DP and course of disease (r(s) = -0.386, r(s) = -0.424, P < 0.05), positive correlation between SN and DP (r(s) = 0.543, P < 0.05), but no correlation between UW and course of disease (r(s) = 0.004, P > 0.05), and also positive correlation (r(s) = 0.274, P < 0.05) between DP and UW. According to three parameters were positive or negative, three main groups (DP+UW+SN+, DP+UW+SN- and DP-UW+SN-) in DP, UW, SN. The course of disease in three main groups was positively skewed distribution. Median was 6 days, 10 days and 20 days respectively. Through Kruskal-Wallis Test, chi(2) = 24.63, P < 0.05, there was statistical significance among the above three main groups.

CONCLUSIONSDP keeps on changing in the acute stage, static and dynamic compensation stage of peripheral vestibular disease. This indicates that DP can be considered as an objective evaluation index of vestibular dynamic compensation and as a guidance of the vestibular rehabilitation evaluation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caloric Tests ; Electronystagmography ; Female ; Hearing Loss, Sudden ; complications ; diagnosis ; physiopathology ; Humans ; Middle Aged ; Vertigo ; complications ; diagnosis ; physiopathology ; Vestibular Function Tests ; Young Adult

OBJECTIVE: To detect the significance of the electronystagmography (ENG) and the dynamic posturography (DPG) in the vestibular function examination in patients suffering BPPV. METHOD: Forty, 34 to 79 old vertigo patients were examined with DPG and ENG. DPG evaluation parameters includes sense organization test from vestibular sensory score, proprioception score, visual score, Romber's score and composite score. ENG examination include caloric test. RESULT: Twenty-six out of 40 BPPV patients got abnormal caloric test results; 33 patients got DPG abnormality which led to a low vestibular perception scores. Twenty-four out of these patients got abnormal results in both caloric test and DPG, while in 9 patients that got normal caloric results came up with low vestibular perception scores, except for which there was no significant abnormality in SOT. Besides, the BPPV patients, compared with normal, got abnormal scores in caloric test of ENG and vestibular perception test of DPG (P < 0.05), if course of BPPV was over 12 months, higher abnormal degrees appeared (P < 0.05). CONCLUSION ENG and DPG are important methods in vestibular function tests, a comprehensive analysis of both is applied to value the severity of vestibular function in patients with BPPV and the duration of BPPV directly affects the vestibular function.
Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Caloric Tests ; Electronystagmography ; Female ; Humans ; Male ; Middle Aged ; Postural Balance ; Vertigo ; physiopathology ; Vestibular Function Tests

BACKGROUND: In general, it is well known that dizzy patients show a remarkable ability to compensate for the loss of peripheral vestubular function. When the patient had decreased response to caloric stimulation and showed no symptoms of vestibular dysfunction, we thought that was a compensated state of unilateral peripheral vestibular loss. OBJECTIVES: The purpose of this study is to provide the basic data for analysis of findings of further rotatory chair test through analyzing the results of rotation test of unilateral peripheral vestibular loss patients. MATERIALS AND METHODS: We analysed the findings of rotatory chair test and clinical manifestations of 24 cases of unilateral vestublar loss which didn't show any symptoms of vestibular dysfunction and they were confirmed by bithermal caloric test and Kobrak's ice water test. RESULTS: We could find that phase lead, low gain and asymmetry could persist despite of chronic compensated state and these findings were relatively common in patients with nonspecific vestibular symptoms. CONCLUSION: Abnornal phase lead and decreased gain were observed in the compensated unilateral vestibular loss patients who showed nonspecific symptoms including oscillopsia, vague unsteadiness. We thought that their compensation was not completely perfect and SHA test was a good tool which detect the minor degree of vestibular dysfunction. We have to consider the past history and nonspecific symptoms of patients through precise history taking. Frequency of SHA test is slower than that of normal human movement and this status is not a real physiologic condition, so it would be advisable to consider the results of other vestibular function tests for precise evaluation the degree of compensation, and the serial check is also recommended.
Caloric Tests ; Compensation and Redress ; Humans ; Ice ; Vestibular Function Tests ; Water