Triple Test as Predictive Screen for Unilateral Weakness on Caloric Testing in Routine Practice

Rohrmeier, Christian; Richter, O.; Schneider, Michael; Wirsching, Kornelia; Fiedler, Isabella; Haubner, Frank; Strutz, Jürgen; Kühnel, Thomas

doi:10.1097/mao.0b013e31827d0901

Cited by 18 publications

(21 citation statements)

References 30 publications

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“…This coupled with the fact that many patients experience excellent compensation in a matter of days to weeks means that a significant vestibular dysfunction may only be apparent with vestibular testing. These need not be with advanced equipment in specialized centres as simple bedside tests are reliable indicators of vestibular dysfunction [19]. Most reports in the literature only use caloric testing to evaluate vestibular function whereas today it is possible to examine all 5 components of the vestibular system, namely, the three semicircular canals, utriculus, and sacculus.…”

Section: Discussionmentioning

confidence: 99%

Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage

Pézier¹,

Baráth²,

Hegemann³

2013

Case Reports in Otolaryngology

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The diagnosis, work-up, and treatment of sudden sensorineural hearing loss and sudden vestibular loss vary widely between units. With the increasing access to both magnetic resonance imaging and objective vestibular testing, our understanding of the various aetiologies at hand is increasing. Despite this, the therapeutic options are limited and without a particularly strong evidence base. We present a rare, yet increasingly diagnosed, case of intralabyrinthine haemorrhage (ILH) together with radiological, audiological, and vestibular test results. Of note, this occurred spontaneously and has shown partial recovery in all the mentioned modalities.

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Section: Discussionmentioning

confidence: 99%

Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage

Pézier¹,

Baráth²,

Hegemann³

2013

Case Reports in Otolaryngology

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“…In clinical practice the bedside examination is directed to separate central and vestibular vertigo and to find the test or test set strongly suggestive of canal paresis. In this context triple bedside test described by Rohmeier et al [19] seems to present the high predictive value. The test battery including spontaneous nystagmus, head-shaking nystagmus, and the Head Impulse Test could predict a results on caloric testing with sensitivity of 63.6% and specificity of 85.4%.…”

Section: Discussionmentioning

confidence: 99%

Bedside examination for vestibular screening in occupational medicine

Zamysłowska-Szmytke

Szostek-Rogula²,

Śliwińska-Kowalska

2015

Int J Occup Med Environ Health

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Objectives: The aim of the study was to assess the usefulness of bedside examination for screening of vestibular and balance system for occupational medicine purposes. Study group comprised 165 patients referred to Audiology and Phoniatric Clinic due to vestibular and/or balance problems. Caloric canal paresis of 19% was the cut off value to divide patients into 43 caloric-positive vestibular subjects and 122 caloric-negative patients. The latter group comprised 79 subjects revealing abnormalities of videonystagmographic (VNG) oculomotor tests (central group) and 43 subjects with normal VNG. Material and Methods: Vestibular and balance symptoms were collected. Five tests were included to bedside examination: Romberg and Unterberger tests, Head Impulse Test (HIT), Dynamic Visual Acuity (DVA) and gaze nystagmus assessment. Results: Vestibular and balance symptoms were reported by 82% of vestibular, 73% of central and 40% of VNG-normal patients. Thirteen out of 18 VNG-normal but symptomatic subjects (73%) had abnormal tests in clinical assessment. The sensitivity of bedside test set for vestibular pathology was 88% as compared to caloric test and 68% for central pathology as compared to VNG oculomotor tests. Conclusions: The combination of 5 bedside tests reveal satisfactory sensitivity to detect vestibular abnormalities. Bedside examination abnormalities are highly correlated with vestibular/balance symptoms, regardless the normal results of VNG. Thus, this method should be recommended for occupational medicine purposes.

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“…For the measurement of SPN, the patient sat in the upright position with his/her gaze located in the center, and infrared goggles were used to assess SPN. The presence of SPN was considered to be positive regardless of intensity or direction [ 12 ]. For HSN, the patient's head was tilted forward at 30 degrees, and then shaken 20 times over 10 seconds at a speed of 2 Hz.…”

Section: Methodsmentioning

confidence: 99%

“…For HSN, the patient's head was tilted forward at 30 degrees, and then shaken 20 times over 10 seconds at a speed of 2 Hz. An increased frequency of preexisting SPN was considered to be positive [ 12 ]. For HIT, the patient was asked to fixate his/her focus on the examiner's nose while rotating the patient's head 20 degrees to the right and left.…”

Section: Methodsmentioning

confidence: 99%

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Unidentified Bright Objects on Brain Magnetic Resonance Imaging Affect Vestibular Neuritis

Lee

Kim

Chang

et al. 2015

Clin Exp Otorhinolaryngol

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ObjectivesThe aim of this study was to investigate the differences in clinical manifestations of in two groups of vestibular neuritis (VN) patients with or without unidentified bright objects (UBOs).MethodsA prospective, observational study with 46 patients diagnosed with VN between May 2013 and November 2013 was executed. A caloric test, a cervical vestibular-evoked myogenic potentials (cVEMPs) test, brain magnetic resonance imaging (MRI), spontaneous nystagmus test, head impulse test, and head-shaking nystagmus test were performed.ResultsOf the patients, 56.5% (n=26) were classified as UBO-positive by MRI. These showed lower caloric weakness and more prominent cVEMP asymmetry compared with the UBO-negative group (P<0.05). Total VN (TVN) was the most common in the UBO-positive group (45.0%), followed by superior VN (SVN, 30.0%), and inferior VN (IVN, 25.0%). However, in the UBO-negative group, SVN (75.0%) was the most common, followed by TVN and IVN (P<0.05). The recovery rate was not influenced by UBOs (P>0.05).ConclusionUBOs on T2-weighted or fluid attenuated inversion recovery MRI may affect the patterns of the vestibular nerve in patients with VN.

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Triple Test as Predictive Screen for Unilateral Weakness on Caloric Testing in Routine Practice

Abstract: The triple test represents a good screening tool that quickly and reliably excludes unilateral weakness and in particular pronounced canal paresis on caloric testing.

Cited by 18 publications

References 30 publications

Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage

Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage

Bedside examination for vestibular screening in occupational medicine

Unidentified Bright Objects on Brain Magnetic Resonance Imaging Affect Vestibular Neuritis

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