Vertical component of the caloric response, including a caloric second phase provoked by positional change: a...

We measured the horizontal and vertical components of caloric nystagmus in 120 ears of 60 vertiginous patients who had moderate to vigorous caloric first-phase response in both ears, no spontaneous nystagmus, and no severe disorders in the central nervous system. We provoked a caloric first phase in the supine position with 5 ml of water at 20 degrees C for 15 seconds. We provoked a caloric second phase by changing the position of a patient from supine to sitting after the end of the first phase. The horizontal component of the caloric second phase was recorded in 108 of 120 ears (90%). The vertical component was recorded in 57 of 120 ears (48%) during the caloric first phase and in 51 of 120 ears (43%) during the caloric second phase. We suspected that the vertical component of the caloric first phase was mainly due to the inhibition of the anterior semicircular canal.