Importance of simultaneous binaural bithermal caloric testing.
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A large number of variables were examined simultaneously for 43 normal subjects over the four irrigations of a caloric test. Care was used for every step of the testing procedure and data analysis to eliminate as much of the variance in the caloric responses as possible. The normality of each variable's distribution was examined using the Wilk-Shapiro W test and corrected if necessary by the best of several transformations. The means, standard deviation, and 95% confidence intervals of the resultant data were derived. Statistical tests of temperature, sidedness, and directionality were done on the variables and several important sources of variance were found and explained.
OBJECTIVE: To evaluate the vestibular's sensitivity to the stimulus of the cold and hot water. METHOD: Forty volunteers are randomly divided into four groups, group one for maths calculation, group two for answering the questions (they are active alerting groups) and group three and four for listening to music and to stories respectively (they are passive alerting groups). Each group has ten volunteers, their left ears are separately stimulated with the cold and hot water, recording the nystagmus slow phase velocity for 20 s at the highest level with the nystagmography instrument of HB-3 ENG computer treatment system. RESULT: There are significant differences between the two active alerting groups and the two passive ones (P < 0.01). CONCLUSION: In performing the vestibular's caloric test, it's more reasonable for clinic to use active alerting tasks.
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The selective vulnerability of distinct neuronal structures is a major feature of Machado-Joseph disease (MJD), also known as spinocerebellar ataxia 3 (SCA3). Vestibular dysfunction is known to be a symptom of MJD, but little is known about precisely when the vestibular system becomes impaired. Using a caloric test, we evaluated vestibular function in 2 MJD patients. One developed the initial symptom 1 year before evaluation, and the other 3 years before evaluation. Neither demonstrated a bilateral response in electronystagmography using ice-cold water irrigation, indicating severe vestibular disturbance. These results suggest that vestibular dysfunction is a symptom that develops very early in MJD and may contribute to unsteady gait as the initial symptom. The vestibular system thus appears to be one of the structures most vulnerable to MJD.
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The investigations were carried out in 50 normals by means of Fitzgerald-Hallpike bithermal and Torok monothermal tests. The detailed description of examinations technique and interpretations of results were presented. The more irregularities were found in Fitzgerald-Hallpike test.
The test-retest repeatability of the hot caloric response alone and of the hot and cold caloric responses combined, was evaluated in 29 subjects, over a 6-month period. The subjects were from two different age groups, 20-30 years (15 subjects) and 65-75 years (14 subjects). Intersubject variability was statistically significant in both age groups, though of greater magnitude in the older subjects. Once a vestibular caloric response baseline was established, for any given subject, there was reasonably reliable test-retest repeatability over time, in both age groups, with coefficients of reliability greater than 0.90.