Comparing caloric and self-experienced dizziness symptoms: diagnostic value and implications in functional dizziness

Area of Science:

• Vestibular science
• Neurology
• Audiology

Background:

• Dizziness symptom quality is difficult to diagnose due to variable patient self-reports.
• Caloric stimulation, a nonphysiological vestibular stimulus, may serve as a proxy for acute peripheral vestibular disorders.
• Comparing patient-reported dizziness to caloric stimulation could control for individual differences and aid diagnosis.

Purpose of the Study:

• To test the hypothesis that dizziness of peripheral origin is perceived as more similar to caloric stimulation than nonperipheral dizziness.
• To explore the diagnostic potential of comparing subjective dizziness experiences with objective vestibular testing.

Main Methods:

• Patients with peripheral (n=49) and nonperipheral dizziness (n=34) rated 30 symptoms during dizziness and caloric stimulation.
• Participants compared symptom intensity and rated overall similarity between dizziness and caloric stimulation.
• Exploratory analyses examined symptom-specific group differences and compared results to controls (n=20).

Main Results:

• Peripheral and nonperipheral dizziness groups did not differ in overall perceived similarity to caloric stimulation.
• Exploratory analyses revealed symptom-specific differences; nonperipheral dizziness patients reported stronger spinning during caloric stimulation.
• These symptom-specific differences, particularly motion perception overestimation in functional dizziness, showed diagnostic potential.

Conclusions:

• Comparing subjective dizziness symptoms to caloric stimulation shows potential diagnostic value, especially for functional dizziness.
• Findings support the concept of motion perception overestimation in functional dizziness.
• Further research into symptom-specific comparisons may refine diagnostic approaches for vestibular disorders.