Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Caloric Tests”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2001

[Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology].

From February 1998 to July 1999, 569 patients affected by vestibular disorders--following a whiplash injury and/or a cranial trauma--were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

Adolescent↗
PubMed2000

Vestibular function in auditory neuropathy.

Auditory neuropathy is characterized by mild-to-moderate pure-tone hearing loss, poor speech discrimination out of proportion with this loss, absent or abnormal auditory brainstem responses and normal outer hair cell function as measured by otoacoustic emissions and cochlear microphonics. We followed three patients in our clinic whom we classified as auditory neuropathy patients. These patients also complained of balance disorders and we report our auditory and vestibular system analyses of these patients. The data presented herein include results of audiometric tests (serial pure-tone audiometry and speech discrimination tests), otoacoustic emissions, auditory-evoked brainstem responses and vestibular function tests (clinical tests of balance, electronystagmography, damped rotation tests and vestibular-evoked myogenic potentials). In all patients, pure-tone audiometry revealed mild-to-moderate sensorineural hearing loss, markedly poor speech discrimination scores and absent auditory-evoked brainstem responses, all in the presence of normal otoacoustic emissions. Balance tests (caloric tests and damped rotation test) were abnormal. Saccades, smooth pursuit eye movements and optokinetic nystagmus were normal in all patients. Neurological and motor system evaluations were normal in all patients. These three auditory neuropathy patients manifest a disorder of cochlear nerve function in the presence of normal outer hair cell activity. They additionally manifest a disorder of the vestibular nerve and its end organs. We conclude that, in patients with isolated auditory neuropathy, the vestibular branch of the VIIIth cranial nerve and its innervated structures may also be affected. We suggest the use of the term "cochlear neuropathy" to characterize those patients with involvement of only the auditory branch of the VIIIth cranial nerve and its innervation.

Aged↗
PubMed2002

A comparison of electronystagmography results with posturography findings from the BalanceTrak 500.

OBJECTIVE: To determine a correlation between conventional electronystagmography findings with results obtained from BalanceTrak 500 posturography assessment. STUDY DESIGN: Individuals with a variety of dizziness and balance disorder symptoms were tested with both electronystagmography (ocular motor studies, positional/positioning testing, caloric testing) and computer posturography using the BalanceTrak 500. SETTING: Tertiary referral center. PATIENTS: Urban/rural midwesterners referred for dizziness and balance dysfunction symptoms. INTERVENTION: Results of both testing modalities were sent to referring physicians. OUTCOME MEASURES: Electronystagmography and posturography results. RESULTS: When electronystagmography results were compared with BalanceTrak findings, a majority of patients whose electronystagmography findings indicated central and mixed causes, or peripheral lesions other than benign paroxysmal positional vertigo, had abnormal findings on posturography. Specifically, tests similar to the Balance Master Sensory Organization Tests 4 and 5 and a new test, Limits of Stability, presented the most difficulty for these individuals. Patients with normal electronystagmography findings and those with benign paroxysmal positional vertigo had mixed results on posturography. The results for specific individual electronystagmography tests were compared with those of posturography tests. No correlation was noted among any of the electronystagmography results and posturography findings. Furthermore, no correlation was observed between posturography and the causes of dizziness. CONCLUSION: For many patients with dizziness and/or balance dysfunctions, posturography can provide additional information to that obtained with electronystagmography. This is especially apparent in individuals who have these symptoms but have normal or borderline normal electronystagmography findings.

Dizziness↗
PubMed2007

Vestibular function testing.

PURPOSE OF REVIEW: This review provides an overview of vestibular function testing and highlights the new techniques that have emerged during the past 5 years. RECENT FINDINGS: Since the introduction of video-oculography as an alternative to electro-oculography for the assessment of vestibular-induced eye movements, the investigation of the utricle has become a part of vestibular function testing, using unilateral centrifugation. Vestibular evoked myogenic potentials have become an important test for assessing saccular function, although further standardization and methodological issues remain to be clarified. Galvanic stimulation of the labyrinth also is an evolving test that may become useful diagnostically. SUMMARY: A basic vestibular function testing battery that includes ocular motor tests, caloric testing, positional testing, and earth-vertical axis rotational testing focuses on the horizontal semicircular canal. Newer methods to investigate the otolith organs are being developed. These new tests, when combined with standard testing, will provide a more comprehensive assessment of the complex vestibular organ.

Electrodiagnosis↗
PubMed1996

Auditory and vestibular system findings in patients with vertebrobasilar dolichoectasia.

Impairment of the auditory-vestibular system has been reported in patients with vertebrobasilar dolichoectasia (VBD), but little is known about the underlying cause of the symptoms. Auditory testing (pure tone audiometry, auditory brain stem response and stapedius reflex) and vestibular tests (assessment of nystagmus, eye tracking tests, caloric test and rotational test) were performed in 23 patients with auditory-vestibular symptoms and/or cranial nerve impairment associated with VBD. Specific evidence of auditory and/or vestibular system impairment was observed in 19 cases (83%). Among patients with abnormal test findings, 47% had evidence suggesting peripheral impairment, 16% evidence suggesting central dysfunction, and 37% evidence suggesting both peripheral and central dysfunction. Although compression of the vestibulocochlear nerve plays an important role in the genesis of the auditory-vestibular dysfunction in patients with VBD, mechanism such as brain stem-cerebellar ischemia and impaired blood supply to the vestibular labyrinth may be just as important.

Aged↗
PubMed2002

[Results of combined treatment for vestibular receptor impairment with physical therapy and Ginkgo biloba extract (Egb 761)].

UNLABELLED: Vestibular receptor impairment causes symptoms called vestibular organ peripheral lesion syndrome. Subjective and objective symptoms of vestibular lesion diminish gradually in the process of vestibular compensation. Stimulating a patient to action is a basic factor that influences on the compensation process. The aim of our studies was an evaluation of treatment results in patients with vertigo of peripheral origin with the use of gingko biloba extract together with kinezytherapy. Ginkgo biloba extract shows vasoactive, rheologic, metabolic and neural effects. We have examined 45 persons aged between 35 and 48 years (38 on average, 35 female, 13 male) with clinical symptoms of peripheral vestibular lesion. In each case we performed as follows: ORL physical examination, pure tone audiometry, suprathreshold audiometry, electronystagmography (eyes open and closed nystagmus, cervical tests, caloric tests according to Hallpike), static and dynamic posturography. In all of the cases vestibular rehabilitation originally programmed in our Clinic was applied. N 23 cases (17 female and 6 male) chosen at random, kinezytherapy together with gingko biloba in tablet was applied: 2 tablets twice a day for 3 months. Control examination were performed on 30, 60 and 90 days of treatment. Treatment results evaluation was based on anamnesis, electronystagmography, static and dynamic posturography. CONCLUSIONS: 1. In almost all of the cases with peripheral lesion of vestibular organ, after 30 days of application of gingko biloba extract together with kinezytherapy and without gingko biloba there was vestibular compensation confirmed in electronystagmography but there were disturbances in static and dynamic posturography. 2. Control examination in the course of treatment revealed gradual improvement in vestibular tests in both group (with and without biloba extract). But in patients treated with gingko biloba extract the improvement was more clear and faster an dynamic posturography. It implies central effect of gingko biloba extract that allows to gain full vestibular compensation sooner.

Adult↗
PubMed2006

[Hearing evaluation in patients with vertigo].

INTRODUCTION: Vertigo is one of the most frequent and disturbing sensations that the practicing otolaryngologist is called upon to treat. Vertigo is the illusory sensation of motion. True vertigo is caused by pathology in the peripheral end organ, the vestibular nerve, and the pathways that connect them in the brainstem and rarely, in the cortex. AIM: The aim of this study was to evaluate hearing in people with vertigo according to the etiology of balance disorders. The study comprised 127 patients treated in our clinic between 1999 and 2004, 88 women and 39 men (254 ears) aged 24-90 years. The average age was 56. METHODS: Hearing tests (pure tone audiometry, speech audiometry, impedance audiometry, auditory brainstem responses, OAE) as well as vestibular function tests (electronystagmography, rotational chair tests, caloric tests) were performed. In order to evaluate the nature of vertigo radiological diagnostics (head and cervical computer tomography, vascular diagnostics using Doppler sonography) was performed. RESULTS: Audiometric testing showed impaired hearing in 71 of 127 subjects. Among 73 patients with vertigo of vascular origin caused by vertebrae-basilar insufficiency, bilateral cochlear lesion was noticed in 33 cases and unilateral in 9. In 8 patients with cervical ankylosing spondylitis 3 had cochlear hearing loss (1--unilateral, 2--bilateral). CONCLUSIONS: In our group of patients with vertigo in the most of cases the hearing loss was on cochlear origin.

Adult↗
PubMed1993

A case of Bickerstaff's encephalitis. With special reference to neurotological findings.

The case of a 60-year old male with prodromal common cold symptoms and progression of brain stem involvement with no cardiac or respiratory complications is described. This conformed to the criteria of Bickerstaff's encephalitis. Neurotological examinations, including the OKN test, the caloric test, and the GBST were performed from onset to recovery of the disease. The results of these tests closely reflected the central nervous system disorders each time, but there was a discrepancy in the results of the two test batteries of equilibrium function, the caloric test and the GBST. The caloric test showed bilateral canal paresis while the GBST showed normal responses. These results suggested that the involved area of the vestibular nucleus was localized to the superior portions. Form our clinical observations, we can conclude that neurotological examinations provide more vital information for localized diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.

Brain Stem↗
PubMed1980

Caloric screening tests.

The electronystagmograms on 400 sequential patients who completed bithermal caloric tests were examined. It was found that taking +/- 25 per cent as the limit for bithermal caloric testing and +/- 15 per cent for monothermal hot caloric testing, the hot caloric screen detected almost all patients who gave abnormal bithermal caloric test results without producing an excess of false positive results. Cold caloric screening tests were shown to be inaccurate enough to be unsatisfactory. When the speed of the slow phase was less than 11 degree per sec on either hot caloric test, cold calories were done even if the monothermal hot tests were the same, as a bilateral caloric reduction was sometimes detected.

Caloric Tests↗
PubMed1998

[The effect of Lasix on nystagmus in the caloric and optokinetic tests in Menière's disease].

The study was made of labyrinthine changes induced by lasix dehydration. Changes indicative of Meniere's disease were identified at comparison of the findings obtained by audiological lasix test, caloric optokinetic reactions. Four types of the nystagmic response in the bithermal lasix-test were determined. These reactions are helpful for more precise staging of the disease.

Adolescent↗
PubMed2000

Isolated directional preponderance of caloric nystagmus: I. Clinical significance.

OBJECTIVES: To determine the clinical significance of an isolated directional preponderance (DP) on bithermal caloric testing. An isolated caloric DP was defined as a DP, calculated according to the standard Jongkees formula, of > or = 40%, with a spontaneous nystagmus (SN) in darkness of < or = 2 degrees/s and a canal paresis (unilateral weakness) of < or = 25%. STUDY DESIGN: A retrospective analysis of all 15,542 bithermal caloric tests performed in the authors' department in the previous 10 years to identify all tests with an isolated DP of > or = 40%. This was followed by a review of the clinical data on the 144 patients identified with such a result and then by a telephone or postal follow-up study of these patients. The study group eventually comprised 114 patients; these were patients in whom a clinical diagnosis could be made at the time the caloric test was done, or who responded to requests for follow-up information. The 34 patients in whom a clinical diagnosis could not be made at the time of the caloric test, and who did not respond to requests for follow-up information, were excluded. STUDY SETTING: A balance disorders clinic in a tertiary referral hospital. INTERVENTION: All patients underwent standard bithermal caloric testing. Some of the patients also underwent rotational testing. OUTCOME MEASURES: A clinical diagnosis for the cause of the isolated DP, made either at the time of the caloric test or on the basis of information supplied at follow-up by the patient or by the referring physician. RESULTS: Of 114 patients, 39 had benign paroxysmal positioning vertigo, 14 had Ménière's disease, and 5 had migrainous vertigo. Five patients had central nervous system (CNS) disorders, and this was clinically apparent at the time of the caloric test in 4, so that only 1 patient with an isolated DP developed evidence of a CNS disorder after the caloric test was done. In the other 54 patients, no definite diagnosis could be made, but 41 of these 54 were either completely well or much better at follow-up. CONCLUSIONS: An isolated DP on caloric testing is usually a transient, benign disorder. About half the patients with an isolated DP have either Ménière's disease or benign paroxysmal positioning vertigo; in most of the other half, no definite diagnosis is made but most of these patients will do well. Only approximately 5% have a CNS lesion and in almost all this is apparent at the time the caloric test is done. In a relapsing-remitting peripheral vestibular disorder such as benign paroxysmal positioning vertigo or Ménière's disease, the mechanism of an isolated DP could be enhanced dynamic gain of ipsilesional medial vestibular nucleus neurons, perhaps as a result of intermittent hyperfunction of primary semicircular canal vestibular afferents. The authors postulate that an isolated DP reflects a gain asymmetry between neurons in the medial vestibular nucleus on either side, caused either by increased sensitivity on one side or by reduced sensitivity on the other, perhaps as an adaptive change in response to abnormal input. In an accompanying article, the authors implement a realistic neural network model in which it is possible to simulate an isolated DP by adjusting the dynamic sensitivity of type 1 medial vestibular nucleus neurons on one side or of type 2 medial vestibular nucleus neurons on the other.

Caloric Tests↗
PubMed2006

[Clinical significance of vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders].

OBJECTIVE: To clarify the clinical significance of vibration-induced nystagmus (VIN) and to calculate the sensitivity and the specificity of the vibration test. METHODS: One hundred and twelve patients with unilateral peripheral vestibular disorders and 30 normal subjects were enrolled into this study. However, patients with spontaneous nystagmus were excluded. Vibratory stimuli (approximately 92Hz) were presented to the mastoids and the forehead. Patients and normal subjects also underwent head shaking testing and caloric testing. RESULTS: Of the 112 patients, 91 (81%) showed VIN which were mainly horizontal. VIN was more frequently evoked on the mastoids than on the forehead. In the majority of patients (76 cases), the direction of VIN was toward the healthy side, whereas patients with Meniere's disease (15 cases), showed nystagmus toward the affected side. None of 30 normal subjects showed VIN. Whereas, HSN was found in 70 (63%) patients and 9 (30%) in normal subjects. Of 112 patients, 10 showed a canal paresis (CP) value of caloric test less than 25% ,while 32 with a CP value between 25% and 40%, 48 with a CP value between 40% and 70%, and 22 with a CP value more than 70%. It is notable that with increasing canal paresis value on caloric testing, VIN was more likely to be evoked. CONCLUSIONS: VIN testing is a simple, non-invasive and well-tolerated clinical test that indicates unilateral peripheral vestibular dysfunction. VIN testing had greater sensitivity and the specificity than HSN testing in the diagnosis of unilateral peripheral vestibular disorders.

Adolescent↗
PubMedDate not supplied

Caloric vestibular test with the use of air.

In a group of 28 test subjects the vestibular caloric test was performed with the aid of two different methods. In the first method the ears were irrigated for 30 sec with water with a temperature of 30 C and 44 C and later on with airstream with a temperature of 20 C and 50 C. The wet method proved to be a significant stronger stimulus than the dry method. The authors conclude that the water irrigation is the method of choice for the caloric test. The dry method is only useful when the wet method is undesirable.

Adolescent↗
PubMedDate not supplied

Efficacy of a monothermal warm water caloric screening test.

The validity of using monothermal caloric screening tests to shorten bithermal caloric test time has been disputed by several investigators. The purpose of this study was to reexamine the efficacy of a monothermal warm caloric screening test. Two retrospective investigations (n = 130) served to generate normative data and provide an estimate of the false-negative rate of the warm monothermal caloric screening test. A prospective investigation (n = 30) was also conducted. Predictions were made regarding bithermal caloric test normality from warm monothermal data, and the bithermal test was completed. The results of this prospective investigation suggested that a warm monothermal screening test can predict normal bithermal caloric responses with greater than 97% accuracy. Criteria for normality include less than 29.54% warm caloric maximum slow phase eye velocity (SPEV) interaural difference, maximum SPEVs that are greater than 11 degrees/s for each ear, absence of significant positional or spontaneous nystagmus, and normal ocular motility.

Caloric Tests↗
PubMed1993

Neuro-otologic abnormalities in myelopathy associated with human T-cell lymphotropic virus type 1.

Auditory testing (pure tone audiometry, auditory brain stem response), and vestibular tests (eye tracking test, optokinetic pattern test, and caloric test) were performed to define neuro-otologic abnormalities in myelopathy associated with human T-cell lymphotropic virus type 1. Of the eight patients tested, seven showed sensorineural hearing loss and one showed mixed hearing loss on pure tone audiometry. The auditory brain stem responses of five patients showed increases of the I-III and I-V interpeak latencies. Two patients showed fast superimposed saccadic movements on the smooth pursuit test, and one other patient showed canal paresis on the caloric test. These findings suggest both the presence of neuro-otologic abnormality and involvement of the brain stem in myelopathy associated with human T-cell lymphotropic virus type 1.

Adult↗
PubMed1995

Patient comfort in audiological testing.

A questionnaire survey was conducted to investigate the relative comfort of a comprehensive range of diagnostic procedures. The mean comfort ranking and variability in comfort were examined. Pure tone audiometry and speech audiometry are the most comfortable tests, while caloric testing and transtympanic electrocochleography are the least comfortable. However, caloric testing and glycerol dehydration are not significantly different in comfort to magnetic resonance imaging (MRI), and brainstem evoked response testing is more comfortable than other diagnostic tests, including MRI. The reasons for these differences and the implications for diagnostic management are discussed.

Adult↗
PubMed1991

[Heat radiation--an essential factor of heat transport in caloric vestibular tests? Current experimental findings].

According to the accepted theory, in vestibular testing the caloric stimulus is transported from the auditory canal to the lateral semicircular canal by heat conduction via the bone. Some findings, however, are not consistent with this concept, e.g. the short latency of the vestibular response, and the fact that removing of the osseous bridge does not stop the transport of heat to the semicircular canal. Physically there are three modes of heat transport: conduction, convection, and radiation. So far, only the first two have been discussed with regard to vestibular calorization, however, they fail to explain the findings mentioned above. We carried out experiments on 10 cadaveric temporal bone specimens in order to evaluate the possible effect of heat radiation. With experimental conditions strictly regulated (specimens kept in climate box, 37 degrees C, saturated humidity, standardized irrigation of the auditory canal with 50 ml of water of 50 degrees C in 15 sec., temperature measured by thermistors at selected points of the specimen), the deviation in repeated experiments was within 0.1 degree C. In normal temporal bones a spreading of heat along the osseous structures was found in accordance with heat conduction via the bone. Then the bony bridge between posterior frame of the tympanic membrane and the lateral canal was removed along with the tegmen tympani, leaving the auditory canal and labyrinth connected only by a small anterior-inferior strut. The rise of temperature in the lateral canal, however, was not delayed and reduced, as expected, but faster and greater than in the original situation. If, now, a reflecting shield was inserted in the cleft between tympanic membrane and labyrinth the heat transfer was dramatically reduced. A similar effect could be achieved in the intact middle ear by a shield or by filling the cavity with gel. Convection as means of heat transport could be excluded. The experiments show that heat transport in the vestibular calorization is a complex process, which besides heat conduction involves radiation as an essential factor. This explains a number of experimental and clinical findings that, so far, had been unclear.

Bone Conduction↗
PubMed1998

Vestibular evoked myogenic potentials in patients with acoustic neuromas.

BACKGROUND: To diagnose acoustic neuromas (ANs), the auditory brainstem response test and the caloric test have been used in addition to magnetic resonance imaging. The auditory brainstem response and the caloric tests mainly reflect functions of the auditory pathway, ie, the cochlear nerve and the superior vestibular nerve, respectively. Because the vestibular evoked myogenic potential (VEMP) has been thought to originate in the inferior vestibular nerve, we hypothesized that the VEMP could provide different information from the auditory brainstem response and the caloric test and that it could be helpful in diagnosing ANs. In other words, we hypothesized that the VEMP could provide information concerning inferior vestibular nerve involvement in patients with ANs. OBJECTIVE: To find out if the VEMP could be useful in classifying ANs according to the involved nerves. DESIGN: We reviewed preoperative clinical tests, including VEMPs, in 21 patients (8 men, 13 women) with ANs confirmed surgically and histopathologically, comparing them with VEMPs in 8 normal subjects (5 men, 3 women). RESULTS: Whereas the first positive-negative peak of the VEMP, P13-N23, was ipsilaterally present on stimulation of the unaffected side in all patients with ANs and both sides in all normal subjects, it was absent on the affected side in 15 patients (71%) and significantly decreased in amplitude in 2 patients (9%). Thus, 17 (80%) of the 21 patients showed abnormal VEMPs. Three patients had abnormal VEMPs although they had normal caloric responses. Three patients had abnormal caloric responses although they had normal VEMPs. CONCLUSION: These results suggest that the VEMP could be useful for the diagnosis of AN, especially for classifying ANs according to the involved nerves.

Adult↗