Scientific publications

Clinical and video-assisted examination of the vestibulo-ocular reflex: a comparative study

Pérez-Fernández N, Gallegos-Constantino V, Barona-Lleo L, Manrique-Huarte R [SP].
Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, Navarra, España

Magazine: Acta Otorrinolaringológica Española

Date: Jul 10, 2012

Otorhinolaryngology

INTRODUCTION
The assessment of the vestibulo-ocular reflex (VOR) is one of the main steps in clinically evaluating patients with dizziness. It can be performed at the bedside with common head-impulse test in which eye position is analysed at the end of the head-thrust. It is an important test due to its high specificity but low sensitivity.

MATERIAL AND METHODS
We studied 179 patients with different types of balance- affecting disorders. The results were analysed in contingency tables. The clinical test was classified as normal or abnormal according to the absence or existence, respectively, of fixation saccades once the head-thrust was ended. The video head-impulse test (vHIT) was classified according to vestibulo-ocular reflex (VOR) gain and presence of fixation saccades. The speed of the slow phase of spontaneous nystagmus was also quantified, as well as the caloric test results.

RESULTS
There were significant differences (Chi-square test, P=0.00) for the findings in the clinical evaluation and with the vHIT: 32.1% of the tests performed yielded different findings in both tests. In the vHIT, the differences were due to the finding of normal gain with saccades; in these patients, the mean canal paresis was significantly abnormal: 39%±10%.

CONCLUSIONS
The distribution of findings for the VOR bedside examination and for that with the help of a video system are significantly different; as such, the video head-impulse examination is not simply an added VOR detection and registration system. The difference relies mainly on a vHIT response characterised as of normal gain but with fixation saccades. These have been considered as the cause for the low sensitivity of the bedside VOR examination and sometimes regarded as normal responses; we have demonstrated that these findings are abnormal according to the findings of higher canal paresis in the caloric test.

CITATION   2012 Jul 10

you mayBE INTERESTED

WHAT TECHNOLOGY
DO WE USE?

The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

OUR
PROFESSIONALS

The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.

Imagen profesionales de la Clínica Universidad de Navarra

WHY CHOOSE
THE CLINICA?

Learn why we are different from other healthcare centers. Quality, speed, comfort and results.

Imagen del edificio de la Clínica Universidad de Navarra