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Comparison Between the Video Head Impulse Test and Caloric Irrigation During Acute Vertigo
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0002-9205-0771
2022 (English)In: Indian Journal of Otolaryngology and Head and Neck Surgery, ISSN 2231-3796, Vol. 74, no Suppl. 3, p. S4475-S4482Article in journal (Refereed) Published
Abstract [en]

Caloric irrigation (CI) is the gold standard to investigate peripheral vestibular dysfunction. The video head impulse test (vHIT) is faster and more accessible and may be useful during acute vertigo stroke risk differentiation. Comparative studies between the two methods are needed. The objective of this study was to compare vestibular function data derived from caloric irrigation with that from vHIT. This study included 80 patients with acute onset vertigo who underwent caloric irrigation and vHIT. CI derived sum of slow phase velocities (SPVs) and unilateral weakness (UW) were compared with vHIT vestibulo-ocular reflex (VOR) gain and gain asymmetry (GA) using correlation analyses. Optimal cut offs for vHIT VOR gain and GA were calculated using Youden indexes. There was a strong positive correlation between the asymmetry measures UW and GA whereas the correlation between the sum of SPVs and VOR gain was weaker. The optimal cut offs to diagnose unilateral vestibular weakness were 0.80 for VOR gain and 28% for GA; with specificities for predicting normal caloric irrigation results of 55% and 93%, respectively. In one third of cases the results from caloric irrigation and vHIT dissociated. The results from vHIT correlated with those from CI, still neither test seem to have the accuracy to replace the other. GA appears as an attractive measure in acute vertigo as the high specificity can be used to identify those with a substantial probability of normal vestibular function in need of more comprehensive work-up for central causes. To diagnose vestibular dysfunction, CI remains gold standard.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 74, no Suppl. 3, p. S4475-S4482
Keywords [en]
Caloric irrigation, Dizziness, Vertigo, Video head impulse test
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:umu:diva-198569DOI: 10.1007/s12070-022-03123-zISI: 000834699500001Scopus ID: 2-s2.0-85135271689OAI: oai:DiVA.org:umu-198569DiVA, id: diva2:1687017
Funder
Umeå UniversityVästerbotten County CouncilSwedish Society of MedicineThe Swedish Stroke AssociationAvailable from: 2022-08-12 Created: 2022-08-12 Last updated: 2023-06-20Bibliographically approved

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Zborayova, KatarinaBarrenäs, Marie-LouiseSalzer, Jonatan

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CiteExportLink to record
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