[Serum catecholamines and blood pressure in caloric test].
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In a group of patients with unilateral labyrinthine dysfunction, the maximal velocity of the slow component response to caloric stimulation was compared with that to horizontal vestibular rotatory stimulation by a low-frequency stimulus. It was found that the larger the magnitude of the caloric response, the larger were the gain and sensitivity of the vestibulo-ocular reflex induced by physiologic stimuli. Rotary stimulation of patients with only one functioning inner ear provides information equivalent to that obtained from caloric stimulation and allows more rigorous quantification of the state of the vestibulo-ocular reflex.
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In order to evaluate the screening capacity and the reliability of monothermal caloric stimulation, the caloric results obtained in 272 patients have been reviewed. The results of a complete bithermal 4-test-set are compared with the results of the hot and cold stimulation considered separately. The supposition that a complete 4-test set is necessary only if the monothermal reaction shows significant asymmetry, is tested by determining how far this would lead to a correct evaluation compared with the final results obtained by the bithermal testing. The study shows that hot as well as cold monothermal screening would result in too many false positive as well as false negative findings. A test procedure consisting of an alternating bithermal stimulation is proposed as a technique for shortening the examination time. This technique has proven to be reliable and it is also more comfortable for the patient.
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Patients with dizziness were evaluated with caloric stimulation and with dynamic platform posturography (Neurocom Equitest). The ability of these tests to detect abnormalities in patients with and without vertigo was assessed. In 159 patients, roughly a third had abnormal calorics while half experienced one or more "falls" during posturography. Calorics revealed proportionately more abnormalities in patients with vertigo, whereas posturography alone did not distinguish between patients with or without vertigo. Posturography did, however, identify abnormalities in a third of patients with normal calorics, regardless of their history of vertigo. Overall, more patients with vertigo had at least one abnormal test result (70%) compared with patients without vertigo (47%). We conclude that caloric abnormalities correlate with a history of vertigo, whereas posturographic deficits can be identified regardless of the presence of vertigo.