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.

SourceResearch connectionFrom yearThrough year

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

At least 73 records · Page 4Linked to original sources

PubMed2005

Prediction of vestibulo-autonomic symptoms during the caloric test: evaluation of autonomic activity by spectral analysis of the electrocardiographic R-R interval.

CONCLUSION: If the high-frequency (HF) component of the R-R interval spectrum of the electrocardiogram (ECG) increases after the first stimulation during a bithermal caloric test, subsequent repeated stimulations may be likely to induce autonomic symptoms such as nausea. OBJECTIVE: Nausea often occurs as a vestibulo-autonomic symptom during the caloric test. However, there have been only a few clinical studies of autonomic activity during this test. To determine whether certain factors can predict the development of nausea, we performed an autonomic function test by means of R-R interval spectral analysis of the ECG during caloric testing. MATERIAL AND METHODS: The study subjects were 53 healthy volunteers aged 22-39 years (41 males, 12 females; mean age 25.3 years) and a 35-year-old male patient with a labyrinthine defect. The caloric test was performed in 43 subjects using an air caloric apparatus with bithermal stimulation of alternate ears. After each stimulation, the subjects were asked about autonomic symptoms. Serial ECG records were obtained and R-R interval spectral analysis was performed. RESULTS: Severe nausea was observed in 12 subjects (28%). In the group with severe nausea, the HF component of the R-R interval spectrum increased after the first caloric stimulation when autonomic symptoms had not yet become marked.

Adult↗

PubMedDate not supplied

Caloric testing. 1. Effect of different conditions of ocular fixation.

Twelve normal subjects received standard caloric testing under the following conditions: 1) fixation, 2) Frenzel glasses in a dimly lit room, 3) eyes open in total darkness, and 4) eyes closed. Multiple nystagmus response parameters were evaluated and statistically compared for each condition. Fixation markedly diminished induced nystagmus and produced the largest coefficient of variation for each response parameter. Caloric testing with eyes closed resulted in periodic nystagmus suppression and a less distinct saw-toothed pattern. As with fixation, the coefficient of variation was consistently higher with eyes closed compared to eyes open in darkness or Frenzel glasses. It is concluded that caloric testing of the vestibulo-ocular reflex arc should be performed with eyes open in darkness or with Frenzel glasses.

Central Nervous System Diseases↗

PubMed1989

Evaluation of the monothermal caloric test.

In 1970, Torok reported that patients with labyrinthine disease showed vestibular recruitment and that patients with retrolabyrinthine disease showed vestibular decruitment on the monothermal caloric test. Other investigators have failed to confirm these findings; however, their studies did not precisely replicate Torok's test procedure. Following Torok's procedure exactly, the monothermal caloric test was administered to normal individuals and to patients with well-documented vestibular lesions. Nine of ten normal persons showed normal responses and one person showed borderline decruitment. Six of eight patients who had lesions of the vestibular nerve or central vestibular pathways showed decruitment. Two patients with active Meniere's disease showed recruitment and one showed asymmetry. Two patients with Meniere's disease who had undergone endolymphatic sac operations showed normal responses. These findings support Torok's claim that the monothermal caloric test discriminates between labyrinthine and retrolabyrinthine vestibular pathology.

Adult↗

PubMed1981

Diagnostic advantages of the Torok monothermal differential caloric test.

In the Torok monothermal differential caloric test, each ear is irrigated with 10 ml and 100 ml of water at 20 degrees C in 5 and 20 sec., respectively. The intensity of the induced nystagmus is expressed in terms of frequency at culmination. The ratio between the weak and strong caloric responses may be normal of disproportionately large or small. When large, the ratio exceeds 3.5 and is called vestibular decruitment, a sign of labyrinthine disease. A ratio of 1.1 or less is called vestibular decruitment, a sign indicative of posterior fossa abnormality. Of 54 patients showing decruitment, a central lesion was confirmed in 51, an identification rate of 94%. The test is thus valuable in differentiating labyrinthine from retrolabyrinthine lesions.

Adult↗

PubMedDate not supplied

[Micrographic recordings in the caloric test].

We report 97 cases of micrographic nystagmus recordings elicited by the caloric test. This response was found in 27% of patients examined for dizziness. The main feature of these tracings was low amplitude. Patients had a mean age of 55 years, frequent episodes of instability related with head movements, and perception of imbalance during walking which was described as being like drunkenness. No noteworthy audiological findings were observed, but there were signs of cervical bone lesions on radiography, scanning, vertebral Doppler, and MRI. The special organization of the arterial system of the inner ear as a terminal system make it sensitive to hemodynamic effects of ischemic and hypoxic episodes, which explains the frequency and nature of the dizziness described. Although not pathognomonic, micrographic recordings or a low-amplitude nystagmus response to the caloric test suggest the existence of the hemodynamic phenomenon of vertebrobasilar insufficiency.

Adult↗

PubMed1997

ABR findings, electrocochleograms and caloric tests in vertebrobasilar ischemic rats.

In rats with ischemia induced by occlusion of the anterior inferior cerebellar artery (AICA) or vertebral artery (VA), we investigated the auditory brainstem response (ABR), electrocochleogram and caloric test result. Upon occlusion of the VA, there was no change of the ABR, whereas in the caloric test the duration of nystagmus upon stimulation of both ears shortened. Upon occlusion of the AICA, the cochlear blood flow (CoBF) showed one of three patterns of change no change: n = 5; decrease: n = 10; and transient decrease with recovery: n = 5. The cochlear potentials were dependent on the residual CoBF. In the caloric test, when the left AICA was occluded, the duration of nystagmus induced by stimulation of the left (ipsilateral) ear was shorter than that induced by the right (contralateral) ear. Based on the functional test results, we conclude that in this model of ischemia the function of the vestibular structures including the semicircular canals is more severely affected than is the hearing function.

Action Potentials↗

PubMedDate not supplied

Caloric testing. 3. Patients with peripheral and central vestibular lesions.

Results of bithermal caloric testing in 83 patients with unilateral peripheral vestibular disease, cerebellopontine angle tumors and vertebrobasilar insufficiency were compared in order to find which response measurements identified the most abnormal responses in each disease category. A laboratory digital computer was used to quantitatively assess each caloric response and a large digital computer was used to statistically compare 110 measurements generated from each caloric test. Of the commonly used response parameters maximum slow component velocity (SVMx) and sum of slow amplitudes (SSA) were most sensitive in each category and duration of response (TDUR) was least sensitive. This order was maintained for the vestibular paresis (VP), directional preponderance (DP) and temperature effect (TE) formulas. The magnitude of DP was significantly correlated with the magnitude of spontaneous vestibular nystagmus and both occurred with approximately the same frequency in peripheral and central disorders. There was no reliable way of separating end-organ from VIII nerve or peripheral from central disorders on the basis of the caloric responses.

Adolescent↗

PubMed1999

The air caloric test in children: subdivision and statistical analysis of the response.

Among a population of 200 children, suffering by dizziness that we examined in the ENT department of the G. Gaslini Institute of Genoa, we acquired and checked, through the statistical analysis, the data of an air caloric test (according to the standard stimulation method) performed in 20 children (resulted normal to neurological, ophtalmological and audiovestibuler examinations which included audiometry, tympanometry, spontaneous, positional and positioning nystagmus research, OKN and caloric tests) and subdivided into 10 s sequences. The statistical analysis of the results obtained showed the following: (1) in both cold and warm air caloric test, the response can be obtained already in the stimulation phase, requiring ENG recording to start at the beginning of stimulation; (2) even in children, response culmination occurs in a period ranging from 60 to 90 s from stimulation onset; therefore the Visual Suppression Test should be performed in this period to obtain more significant data; (3) in cold and warm test, considering SSCs, the response is constant and intense up to 130 and 110 s, respectively, from beginning of ENG recording. After these time ranges, the response is less intense and homogeneous, becoming poor and variable. In our opinion, this allows suspension of recording immediately after these periods without the risk of the excluding significant aspects of the response.

Adolescent↗

PubMed2000

Evaluation of the caloric test by combining 3 response parameters.

The slow-phase velocity of nystagmus is one of the most sensitive parameters of vestibular function and is currently the standard for evaluating the caloric test. However, the assessment of this parameter requires recording the response by using nystagmography. The aim of this study was to evaluate whether frequency and duration of the caloric nystagmus, as measured by using a clinical test with Frenzel glasses, could predict the result of the recorded test. The retrospective analysis of 222 caloric test results recorded by means of electronystagmography has shown a good association between the 3 parameters for unilateral weakness. The asymmetry observed in the velocity can be predicted by a combination of frequency and duration. On the other hand, no relationship was observed between the parameters for directional preponderance. These results indicate that a clinical caloric test with frequency and duration as parameters can be used to predict the unilateral weakness, which would be obtained by use of nystagmography. We propose an evaluation of the caloric test on the basis of diagrams combining the 3 response parameters.

Adolescent↗

PubMed1990

Relationship between results of electrocochleography and caloric test in Menière's disease.

The relationship between an increase in the negative summating potential (-SP) and the results of caloric tests was examined in 35 patients with unilateral Menière's disease. The -SP was recorded by extratympanic electrocochleography. The quantitative bithermal caloric test was performed by irrigating with cool (30 degrees C) and hot (44 degrees C) water. An increased -SP was recorded in 20 of 35 patients (57%). Abnormal unilateral weakness (UW) on the involved side and abnormal directional preponderance (DP) to the involved side were observed in 16 of 35 (46%) and in 4 of 35 patients (11%), respectively. No significant correlation was found between an increased -SP and an abnormal UW and DP in Menière's disease.

Audiometry, Evoked Response↗

PubMed1987

Auditory brainstem response artefact caused by caloric testing.

In the external ear canal, residual water from caloric testing or any other irrigation may act to simulate a conductive hearing loss and interfere with subsequent auditory brainstem response recording leading to increased latencies and reduced amplitudes. This artefact in the ABR may be mistaken for a retrocochlear lesion.

Auditory Threshold↗

PubMed2006

[Reference values for the vestibulo-ocular reflex response to the head shaking and the bithermal caloric tests].

OBJECTIVE: To obtain reference values for the vestibulo-ocular reflex response to the head-shaking nystagmus and the bithermal caloric test in the spanish population. PATIENTS AND METHODS DESIGN: A descriptive study. SET UP: General hospital. INDIVIDUALS: One hundred and seven healthy sex and age stratified voluntiers were included. The final sample included 97 individuals over 18 years of age. INTERVENTION: Spontaneous nystagmus (SN), head-shaking nystagmus (HSN) and caloric induced nystagmus were explored. The eyes movement was recorded by a video-oculographic system. The SN or HSN was considered significant when at least 6 consecutive beats with a slow phase velocity of 2 degrees/sec were detected. The caloric test was performed with water flow at 250mL/20 s at 30 degrees C and 44 degrees C with an interval of 10 minutes between irrigations. The percentage of canal paresis (CP) and directional preponderance (DP) was calculated using maximum slow phase velocity and the Jongkees index formula. MAIN OUTCOME MEASUREMENTS: Presence of SN, horizontal and vertical SHN, percentage of CP and DP. RESULTS: SN was found in 10,3% individuals (6 women and 4 men). Horizontal HSN was also observed in 9 women and 10 men (19,5%), and vertical HSN in 8 women and 10 men (18,6%). The mean and 95 percentil for CP were 13,10 and 28,60 in women and 11,02 and 27,30 in men. For DP, the mean and 95 percentil were 11,76 and 35,80 in women and 11,58 and 28,65 in men. The 5 percentils for slow phase velocity of nystagmus after each irrigation were 6,30; 5,14; 5,96; 4,02 degrees/s (left ear 44 degrees, right ear 44 degrees, left ear 30 degrees, right ear 30 degrees, respectively) in the group of women; and 5,82; 6,99; 5,67; 4,55 degrees/s in men (with the same irrigation sequence). CONCLUSION: Results presented should be considered as a population-based norms and may be useful as references for water bithermal test for VOG studies. The SN or HSN could be observed in subjects without vestibular pathology.

Adolescent↗

PubMed2006

Caloric test and simultaneous recording of sympathetic skin response.

CONCLUSIONS: It was found that there was a close correlation between sympathetic skin response (SSR) parameters and nystagmus parameters obtained in caloric tests. Further studies are needed to investigate the clinical correlation of these findings. OBJECTIVES: To investigate whether the caloric response creates a measurable SSR and, if so, to compare the SSR parameters with the nystagmus parameters and the feelings of the patient. MATERIAL AND METHODS: Patients completed an autonomic symptom questionnaire (ASQ) regarding their past history of autonomic symptoms. They used a visual analog scale (VAS) to assess the severity of symptoms during simultaneous SSR and caloric tests. Symptoms were also noted separately by the investigator. RESULTS: Eighteen patients were included in the study (13 females, 5 males). Eight of the patients had central and 10 had peripheral vertigo. The mean VAS score was 6.6+/-1.9 and the mean ASQ score was 7.2+/-3.6. In terms of the recorded parameters, there were no significant differences between patients with central and peripheral vertigo, males and females or warm and cold irrigation. The number of SSR waves increased significantly when the slow-phase velocity was > 26 degrees/s (p<0.01) and the nystagmus latency was < or = 27 s (p<0.05). The VAS score was also correlated with the number of SSR waves (p<0.01).

Adult↗

PubMed1983

Vestibular caloric test and local anaesthesia: a nystagmographical study on pigeons.

The caloric test was conducted on pigeons before and after the application of infiltration anaesthesia around the investigated ear. After irrigation with the same amount of water at the same temperature, it was observed that following local anaesthesia the caloric response was intensified. This result suggests that the nerve supply and blood supply of the external ear may be one of the factors responsible for the large variability of caloric responses found in routine caloric investigations.

Anesthesia, Local↗

PubMed1979

The stimulus controlled caloric tests: a reliability study.

Preliminary studies have shown that a new caloric testing method described by Proctor and Dix offers several advantages over conventional methods. However, it had not been established that the Proctor-Dix method would prove reliable and practical when routinely applied in a clinical setting. Therefore, we administered the test to 60 patients referred for evaluation of vestibular function and compared the test scores with results from the conventional Fitzgerald-Hallpike test applied during the same test session. The analysis was based on the average slow phase eye speed of nystagmus during the most intense 20 seconds of individual responses. A close agreement was found between "right-left difference" and "directional preponderance" scores when results of the Proctor-Dix and Fitzgerald-Hallpike tests were compared in the 54 patients who completed all steps in the experiment. Larger differences between the results of the two tests were confined to subjects who were "normal" or only slightly abnormal. Order effects and additional analysis of correlations are discussed. The present study demonstrates that reliable results, comparable to those obtained from conventional methods, can be obtained when the new Proctor-Dix test is applied in a clinical setting.

Caloric Tests↗

PubMed1979

Air caloric testing in otitis media. (preliminary studies).

On certain occasions it becomes important to evaluate vestibular function in a patient with otitis media. The potential application of the air caloric test in evaluating such patients was examined. Patients with unilateral otitis media before and after surgery were studied to answer certain clinical questions. More questions were raised than answers provided. The preliminary conclusions from this study are: 1. Patients with tympanostomy tubes or small perforation of one ear may show a caloric response in the perforated ear equal to that of the intact ear. 2. Patients with a large tympanic membrane perforation on one side may show hyperactive caloric responses on the perforated side. 3. Patients with a moist ear may show inverted horizontal nystagmus to warm air caloric testing. This applies to patients with a large perforation or mastoidectomy cavity. 4. Patients with a dry open mastoid or fenestration cavity are likely to show a hyperactive caloric response on the side of previous surgery, accompanied by vegetative symptoms. This size of the cavity appears to be less important than the presence of the cavity per se. 5. Patients may be safely tested in the early postoperative period.

Air↗

PubMed1999

[On "Position of Brünings++" during caloric tests].

In common opinion one of the sitting position used during caloric tests is "position V of Brünings". The name of this position is incorrectly applied by a lot of authors (without knowledge of original paper of Brünings [1]. This designation could concern a modification of position V, presented by Barre in 1927 [2].

Caloric Tests↗

PubMedDate not supplied

[Comparative evaluation of the Fitzgerald-Hallpike caloric test and the monothermal Torok test in lesions of the cerebellar hemispheres].

The Fitzgerald-Hallpike caloric test and the monothermal Torok test were done in 58 patients with damage to the cerebellar hemispheres. In the Fitzgerald-Hallpike test symmetric vestibular reactions were obtained in 79.3% of cases. In the monothermal test vestibular decruitment of only type I and II according to Torok was demonstrated in 68.9% of all cases. This suggests that Torok test may be of great value in the diagnosis of damage to the cerebellar hemispheres. In the light of these results the author concludes that cerebellar hemispheres are responsible for stabilization of vestibulo-ocular reflexes and regulate the adequacy of the vestibulo-ocular responses in relation to the stimulus.

Adolescent↗