Abstract
Objectives:
(1) Compare the lateralization value of video head impulse test (vHIT) with that of bithermal caloric test. (2) Analyze the influence of covert saccade on VOR gain and unilateral weakness (UW) of caloric test.
Methods:
Retrospective study from May 2012 through December 2013 in a tertiary referral center. There were 99 dizzy patients with peripheral vestibulopathy and 16 healthy volunteers. Caloric test parameters (UW and sum of warm and cold slow phase velocity [SPV] of each ear) were compared with VOR gain on vHIT. Cutoff point of vHIT was calculated using the receiver operating characteristic curve.
Results:
(1) Correlation between UW/Sum of SPV and the gain of vHIT was statistically significant and correlation coefficient was 0.655 (P < .0001) and 0.584 (P < .0001), respectively. (2) Cutoff point of vHIT was 0.84 with the sensitivity of 0.91 and the specificity of 0.66 (abnormal value of UW >25%). (3) False negative rate was 34% and (4) UW scores of overt saccade only, overt+covert saccade, covert saccade only, and normal VOR were 69%, 66%, 53%, and 16%.
Conclusions:
Gain on vHIT was well correlated with UW on caloric test. However, both tests seem to be necessary since substantial proportion of patients showed conflicting results, which resulted from testing VOR of 2 extreme frequencies.
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