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Comparison of three diagnostic tests in detecting vestibular deficit in patients with peripheral vestibulopathy

Published online by Cambridge University Press:  16 December 2015

P Eza-Nuñez ,
C Fariñas-Alvarez  and
N Perez Fernandez
P Eza-Nuñez
Affiliation:
Department of Otorhinolaryngology, Hospital Sierrallana, Cantabria, Spain
C Fariñas-Alvarez
Affiliation:
Health Care Quality Unit, Hospital Marques de Valdecilla, Santander, Spain
N Perez Fernandez*
Affiliation:
Department of Otorhinolaryngology, Clínica Universidad de Navarra, University Hospital and Medical School – University of Navarra, Pamplona, Spain
*
Address for correspondence: Dr N Pérez, ORL Department, Clínica Universidad de Navarra Pío XII 36 31008 Pamplona, Navarra, Spain E-mail: nperezfer@unav.es
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Abstract

Objectives:

This study aimed to evaluate the results of the video head impulse test and of the caloric and rotatory chair tests in patients with dizziness. Agreement between test results was assessed and the best protocol for detecting peripheral vestibulopathy was identified.

Methods:

Participants comprised 116 patients, 75 with a peripheral vestibulopathy and 41 with non-peripheral vestibulopathy. The main outcome measures were classified as normal or abnormal according to our laboratory data.

Results:

Agreement between tests was low. Vestibulopathy testing that required all three results to be abnormal had a sensitivity of 0.547, a specificity of 0.878, and positive and negative predictive values of 0.891 and 0.514, respectively. Vestibulopathy testing that required just one result to be abnormal had a sensitivity of 0.933, a specificity of 0.292, and positive and negative predictive values of 0.701 and 0.705, respectively.

Conclusion:

In peripheral vestibulopathy, there was weak concordance in the assessment of horizontal semicircular canal function among the different tests. However, the video head impulse test had sufficient statistical power to be recommended as the first-line test.

Keywords

VertigoHead Thrust TestDizzinessVestibulo-Ocular Reflex
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 2 , February 2016 , pp. 145 - 150
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Clarke, AH. Laboratory testing of the vestibular system. Curr Opin Otolaryngol Head Neck Surg 2010;18:425–30CrossRefGoogle ScholarPubMed
2Shepard, NT, Telian, SA, eds. Practical Management of the Balance Disorder Patient. San Diego: Singular Publishing Group, 1996.Google Scholar
3Ahmed, MF, Goebel, JA, Sinks, BC. Caloric test versus rotational sinusoidal harmonic acceleration and step-velocity tests in patients with and without suspected peripheral vestibulopathy. Otol Neurotol 2009;30:800–5CrossRefGoogle ScholarPubMed
4Proctor, LR. Results of serial vestibular testing in unilateral Meniere's disease. Am J Otol 2000;21:552–8Google ScholarPubMed
5Boleas-Aguirre, MS, Debellemanière, G, Pérez, N. Side effects and patients expectations after vestibular tests [in French]. Rev Laryngol Otol Rhinol (Bord) 2009;130:89–91Google ScholarPubMed
6Weber, KP, MacDougall, HG, Halmagyi, GM, Curthoys, IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci 2009;1164:486–91CrossRefGoogle ScholarPubMed
7Blödow, A, Pannasch, S, Walther, LE. Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders. Auris Nasus Larynx 2013;40:348–51CrossRefGoogle ScholarPubMed
8MacDougall, HG, Weber, KP, McGarvie, LA, Halmagyi, GM, Curthoys, IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 2009;73:1134–41CrossRefGoogle ScholarPubMed
9Arriaga, MA, Chen, DA, Cenci, KA. Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test. Otolaryngol Head Neck Surg 2005;133:329–33CrossRefGoogle ScholarPubMed
10Kaplan, DM, Marais, J, Ogawa, T, Kraus, M, Rutka, JA, Bance, ML. Does high-frequency pseudo-random rotational chair testing increase the diagnostic yield of the ENG caloric test in detecting bilateral vestibular loss in the dizzy patient? Laryngoscope 2001;111:959–63CrossRefGoogle ScholarPubMed
11Fitzgerald, G, Hallpike, CS. Studies in Human Vestibular function I. Observation on the direct preponderance of caloric nystagmus resulting from cerebral lesions. Brain 1942;65:115–37Google Scholar
12Jongkees, LB, Maas, J, Philipszoon, A. Clinical electronystagmography: a detailed study of electronystagmography in 341 patients with vertigo. Pract Otorhinolaryngol (Basel) 1962;24:65–93Google ScholarPubMed
13Palomar-Asenjo, V, Boleas-Aguirre, MS, Sánchez-Ferrándiz, N, Perez Fernandez, N. Caloric and rotatory chair test results in patients with Ménière's disease. Otol Neurotol 2006;27:945–50CrossRefGoogle ScholarPubMed
14Matiño-Soler, E, Esteller-More, E, Martin-Sanchez, JC, Martinez-Sanchez, JM, Perez-Fernandez, N. Normative data on angular vestibulo-ocular responses in the yaw axis measured using the video head impulse test. Otol Neurotol 2015;36:466–71CrossRefGoogle ScholarPubMed
15Perez, N, Garmendia, I, García-Granero, M, García-Tapia, R. Factor analysis and correlation between dizziness handicap inventory and dizziness characteristics and impact on quality of life scales. Acta Otolaryngol 2001;545:145–54Google ScholarPubMed
16Yardley, L, Masson, E, Verschuur, C, Luxon, L, Haacke, NP. Symptoms, anxiety and handicap in dizzy patients: development of the Vertigo Symptom Scale. J Psychosom Res 1992;36:731–41CrossRefGoogle ScholarPubMed
17Dal-Lago, AH, Ceballos-Lizarraga, R, Carmona, S. Immediate prediction of recovery, based on emotional impact of vertigo. Acta Otorrinolaringol Esp 2014;65:141–7CrossRefGoogle ScholarPubMed
18Hanley, K, O'Dowd, T. Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract 2002;52:809–12Google ScholarPubMed
19Neuhauser, HK, Lempert, T. Vertigo: epidemiologic aspects. Semin Neurol 2009;29:473–81CrossRefGoogle ScholarPubMed
20Byrt, T, Bishop, J, Carlin, JB. Bias, prevalence and kappa. J Clin Epidemiol 1993;46:423–9CrossRefGoogle ScholarPubMed
21Allum, JH, Honegger, F. Relation between head impulse tests, rotating chair tests, and stance and gait posturography after an acute unilateral peripheral vestibular deficit. Otol Neurotol 2013;34:980–9CrossRefGoogle ScholarPubMed
22Wilson, JMG, Jungner, G. Principles and Practice of Screening for Disease. World Health Organization Public Health Papers, No. 34, 1968Google Scholar
23Screening Programmes in the UK. In: http://medical.cdn.patient.co.uk/pdf/2757.pdf. [11 August 2015]Google Scholar