comparison between video-head-impulse test and caloric testing of vestibular function

Introduction:

Caloric testing is still considered to be the gold standard for examination of vestibular function. In addition, the video-head impulse test has become an established diagnostic tool.

The aim of this study was to compare the validity of these two test methods for the development of a new diagnostic staging.

Methods:

30 patients with the symptom “dizziness” were included retrospectively. Including criteria were a completed caloric testing and the VHIT. The VHIT was defined as pathological, if the gain was 0,6 or less in at least one of the semicircular canals or if correction saccades were detectable. In the caloric testing an asymmetry between both sides of 22% or more was defined as abnormal.

Results:

30 patients were included in the study. 6 patients had abnormal VHIT and these 6 and 5 more had a pathological result in the caloric testing. This resulted in a sensitivity of 26%, a specificity and positive predictive value of 100% and a negative predictive value of 44% of the VHIT.

Conclusion:

In case of a normal result of VHIT, an additional caloric testing is indicated. However, it can be discussed if in the case of a pathological VHIT the caloric testing can be omitted, due to the high positive predictive value of the VHIT. Based on these results the VHIT should be used as the first diagnostic test in the clinical routine in analysing the vestibular function of patients with dizziness.

Publication History

Publication Date:
18 April 2018 (online)