[Diagnostic value of head-shaking nystagmus in vestibular clinical evaluation]

To determine the sensitivity and specificity of the head-shaking nystagmus test (HSN), the nystagmus elicited in response to a vigorous rotation of the head in the horizontal plane, in the study of patients with peripheral unilateral vestibular disease.

Retrospectively, we analyze the relationships between the HSN and the rest of the videonystagmographic tests on eighty-three patients with peripheral unilateral vestibular disease.

Twenty-three patients showed a positive head-shaking nystagmus; twenty-one of them had unilateral caloric hypofunction and only two had a symmetric caloric test, but both of them showed some type of vestibular dysfunction on other videonystagmographic test. In our series, the HSN sensitivity for the existence of peripheral vestibular disease was 48.8%, while the specificity was 95% in relation to the caloric test, reaching 100% when the gold standard was the presence of any abnormal videonystagmographic test.

HSN is a simple test that can be useful to identify patients having unilateral vestibular hypofunction.