Three-dimensional analysis of post-caloric nystagmus caused by postural change

In order to record caloric nystagmus (CN) using three-dimensional videonystagmography (3D VNG) 14 subjects were placed in the supine position with the head tilted up 30 degrees relative to the earth's horizontal plane. After the primary-phase CN had terminated, the subjects were repositioned from a supine to a sitting position, with the head anteflexed 30 degrees for recording the post-caloric nystagmus (PCN). In addition, 8 of the original subjects were placed in the supine position but with the head turned 40 degrees to the left so that the irrigated (right) ear was oriented upwards. After the primary-phase CN had terminated, the subjects were rotated by 180 degrees so that the irrigated ear was oriented downwards to record PCN. The results indicated that both methods successfully provoked horizontal and vertical CN. For torsional CN, the irrigated ear up/down method produced a higher provocation rate (75%) than the supine/sitting method (50%), but the difference was not significant. Comparing the provocation rate of the PCN for the horizontal component revealed that the two methods do not differ significantly. However, when comparing the provocation rates of PCN for the vertical component, the irrigated ear up/down method showed a higher rate (82%) than the supine/sitting method (18%). Thus using 3D VNG coupled with postural change during caloric testing, the horizontal or vertical components of PCN can be successfully provoked.