Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T06:04:03.741Z Has data issue: false hasContentIssue false
  • English
  • Français

Nonspecific vertigo with normal otoneurological examination. The role of vestibular laboratory tests

Published online by Cambridge University Press:  29 June 2007

Carlos R. Gordon ,
Avi Shupak ,
Orna Spitzer ,
Ilana Doweck  and
Yehuda Melamed
Carlos R. Gordon*
Affiliation:
Motion Sickness and Human Performance Laboratory, Israel Naval Medicine Institute, Haifa. The Department of Neurology, Meir General Hospital Kfar Saba, and Sackler School of Medicine, Tel Aviv University, Tel Aviv
Avi Shupak
Affiliation:
Motion Sickness and Human Performance Laboratory, Israel Naval Medicine Institute, Haifa. The Department of OtolaryngolgoyCarmel Lady Davis Hospital, Haifa, Israel
Orna Spitzer
Affiliation:
Motion Sickness and Human Performance Laboratory, Israel Naval Medicine Institute, Haifa.
Ilana Doweck
Affiliation:
Motion Sickness and Human Performance Laboratory, Israel Naval Medicine Institute, Haifa. The Department of OtolaryngolgoyCarmel Lady Davis Hospital, Haifa, Israel
Yehuda Melamed
Affiliation:
Motion Sickness and Human Performance Laboratory, Israel Naval Medicine Institute, Haifa.
*
Address for correspondence: Carlos R. Gordon, M.D., Motion Sickness and Human Performance Laboratory, Israel Naval Medical Institute, P.O. Box 8040, 31 080 Haifa, Israel. Fax: 972-4-8693240, 8693258
Get access Rights & Permissions [Opens in a new window]

Abstract

Vestibular larobatory tests are not general necessary in the diagnosis of patients with a clear description of vertigo accompanied by positive otoneurological examination findings. The purpose of the study was to inverstigate the role of conventional vestibular laboratory tests in the diagnosis of patients compaining of hnonspecific vertigo, despite their having a documented normal otoneurological examination. The results patients referred for ambulatory vestibular laroratory testes due to a nonspecific illusion of movement, but with nornal otoneurological examination, were reviewed. Abnormalities were found in the vestibular tests of 35 patients (67 per cent), 22 of whom (63 per cent) were finally diagnosed as having a unilateral perpheral vestibular lesion, and 13(37 per cent) benign positional vertigo. These results suggests that a high percentage of patients with nonspecific vertigo and a normal otoneurologica examination probably suffer from peripheral vestibular dusfunction, which can be objectively documented by the ENG and SHA tests.

Keywords

VertigoVestibular function testsVestibular disease
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 12 , December 1996 , pp. 1133 - 1137
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Attias, J., Gordon, C. R., Rolnick, A., Sade, J. (1987) Nystagmus episodes related to sea sickness. Archives of Otorhinolaryngology 244: 84–87.Google Scholar
Baloh, R. W., Honrubia, V. (1990) Clinical Neurophysiology of the Vestibular System. 2nd Edition, F.A. Davis Company, Philadelphia, PA. pp 91–111.Google Scholar
Baloh, R. W., Honrubia, V., Jacobson, K. (1987) Benign positional vertigo: clinical and oculographic features in 240 cases. Neurology 37: 371–378.CrossRefGoogle ScholarPubMed
Baloh, R. W., Honrubia, V., Yee, R. D., Hess, K. (1984) Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity. Annals of Neurology 16: 222–228.Google Scholar
Barber, H. O., Stockwell, C. W. (1980) Manual of Electronystagmography. 2nd Edition, the C. V. Mosby Company, St Louis.Google Scholar
Brandt, T. (1991) Vertigo: its multisensory syndromes, Springer-Verlag, London, pp 1–24.CrossRefGoogle Scholar
Brandt, T., Daroff, R. B. (1980) The multisensory physiological and pathological vertigo syndromes. Annals of Neurology 7: 195–203.CrossRefGoogle ScholarPubMed
Dix, M. R., Hallpike, C. S. (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Proceedings of the Royal Society of Medicine 45: 341–354.CrossRefGoogle ScholarPubMed
Drachman, D. A., Hart, C. W. (1972) An approach to the dizzy patient. Neurology 22: 323–334.Google Scholar
Epley, J. M. (1992) The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngology-Head Neck Surgery 107: 399–404.CrossRefGoogle ScholarPubMed
Gordon, C. R., Kuritzky, A., Doweck, I., Spitzer, O., Shupak, A., Hering, R. (1993) Vestibulo-ocular reflex in migraine patients: the effect of sodium valproate. Headache 33: 129–132.CrossRefGoogle Scholar
Hamid, M. A., Hughes, G. B., Kinney, S. E., Hanson, M. R. (1986) Results of sinusoidal harmonic acceleration test in 1,000 patients: preliminary report. Otolaryngology-Head and Neck Surgery 94: 1–5.CrossRefGoogle Scholar
Herdman, S. J. (1994) Assessment and management of benign paroxysmal positional vertigo. In Vestibular Rehabilitation. (Herdman, S. J., ed.), F. A. Davis Company, Philadelphia, PA, pp 331–346.Google Scholar
Herdman, S. J., Tusa, R. J., Zee, D. S., Proctor, L. R., Mattox, D. E. (1993) Single treatment approaches to benign paroxysmal positional vertigo. Archives of Otolaryngology, Head and Neck Surgery 119: 450–454.CrossRefGoogle ScholarPubMed
Honrubia, V., Jenkins, H. A., Minser, K., Baloh, R. W., Yee, R. D. (1984) Vestibulo-ocular reflexes in peripheral labyrinthine lesions: II. Caloric testing. American Journal of Otolaryngology 5: 93–98.CrossRefGoogle ScholarPubMed
Jongkees, L. B. W. (1948) Value of the caloric test of the labyrinth. Archives of Otolaryngology 48: 402–417.CrossRefGoogle Scholar
Katsarkas, A., Kirkham, T. H. (1978) Paroxysmal positional vertigo – a study of 255 cases. Journal of Otolaryngology 7: 320–330.Google ScholarPubMed
Leigh, R. J., Brandt, T. (1993) A reevaluation of the vestibuloocular reflex: new ideas of its purpose, properties, neural substrate, and disorders. Neurology 43: 1288–1295.CrossRefGoogle ScholarPubMed
Moretz, W. H. Jr., Orchik, D. J., Shea, J. J. Jr., Emmett, J. R. (1986) Low-frequency harmonic acceleration in the evaluation of patients with intracanalicular and cerebellopontine angle tumors. Otolaryngology-Head and Neck Surgery 95: 324–332.CrossRefGoogle ScholarPubMed
Nedzelski, J. M., Barber, H. O., Mcllmoyl, L. (1986) Diagnoses in a dizziness unit. Journal of Otolaryngology 15: 101–104.Google Scholar
Olson, J. E., Wolfe, J. W., Engelken, E. J. (1981) Symposium on low frequency harmonic acceleration, the rotatory chair. Responses to low-frequency harmonic acceleration in patients with acoustic neuromas. Laryngoscope 91: 1270–1277.Google Scholar
Olsson, J. E. (1988) Rotational testing of the horizontal vestibulo–ocular reflex. In Vestibular Disorders. (Barber, H. O., Sharpe, J. A., eds.), Year Book Medical Publishers Inc., Chicago, IL, pp 97–116.Google Scholar
Oosterveld, W. J. (1983) The vertiginous syndrome. Advances in Otorhinolaryngology 29: 39–49.Google ScholarPubMed
Parnes, L. S., Price-Jones, R. G. (1993) Particle repositioning maneuvre for benign paroxysmal positional vertigo. Annals of Otology, Rhinology and Laryngology 102: 325–331.CrossRefGoogle Scholar
Rubin, W., Brookler, K. H. (1991) Dizziness: etiologic approach to management, Thieme Medical Publishers Inc., New York.Google Scholar
Shepard, N. T., Telian, S. A. (1995) Programmatic vestibular rehabilitation. Otolaryngology-Head and Neck Surgery 112: 173–182.Google ScholarPubMed
Wolfe, J. W., Engelken, E. J., Kos, C. M. (1978) Lowfrequency harmonic acceleration as a test of labyrinthine function: basic methods and illustrative cases. Otolaryngology 86: 130–142.Google Scholar
Wolfe, J. W., Engelken, E. J., Olson, J. E. (1982) Lowfrequency harmonic acceleration in the evaluation of patients with peripheral labyrinthine disorders. In Nystagmus and Vertigo. Clinical Approaches to the Patient with Dizziness. (Honrubia, V., Brazier, M. A. B., eds.), Academic Press Inc., Orlando, pp 95–105.Google Scholar
Zee, D. S. (1988) In Vestibular disorders. (Barber, H. O., Sharpe, J. A., eds.), Year Book Medical Publishers Inc., Chicago, pp 254–274.Google Scholar