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Vestibular decruitment, hyperactivity, and rebound caloric nystagmus
1Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, USA.
Objective:
This study examined the collective sensitivities of decruitment, hyperactivity, and rebound caloric nystagmus (RCN) for lesions of the brain stem/cerebellum against the current gold standard of imaging, the contrast enhanced magnetic resonance imaging (MRI).
Study Design:
This is a retrospective study of patients who underwent a vestibular evaluation and a contrast-enhanced MRI scan.
Setting:
The study was performed at a tertiary referral center.
Patients:
The patients included in this study were evaluated for investigation of a variety of reported problems, including vertigo/dysequilibrium, headache, hearing loss, and tinnitus. Their age range was 13 to 79 years.
Intervention:
Every patient underwent a vestibular evaluation, which included the Torok monothermal caloric test and an MRI scan.
Main Outcome Measures:
The results of this caloric test include vestibular decruitment, hyperactivity, and rebound caloric nystagmus. The sensitivity and specificity of these results for MRI confirmed brain stem/cerebellar lesions were determined.
Results:
The overall sensitivity of the measures of this caloric test was 90%. The overall specificity was 25%.
Conclusions:
As a screening test for brain stem cerebellar lesions, the Torok monothermal caloric test performs well in terms of its sensitivity. The specificity is low, and this probably because MRI looks at morphology rather than function.