BACKGROUND. Vestibular disorders are a group of widely spread diseases that have as a common denominator the disturbance of the equilibrium system. The assessment of vestibular disorders consists in a complex examination of the patient including a thorough anamnesis, a rigorous clinical examination and multiple functional explorations.
OBJECTIVE. To asses weather there is a correlation between the data obtained in posturography and those obtained in the videonystagmography in patients with peripheral vestibular disorders.
MATERIAL AND METHODS. Collecting data from the observation sheets of patients diagnosed with peripheral vestibular syndrome and examined in the Department of Otorhinolaryngology of the “Sfanta Maria” Hospital in Bucharest over a period of 18 months.
RESULTS. We analyzed a number of 97 cases of patients diagnosed with peripheral vestibular disorder. A large number of patients (49) had correlated changes in the caloric tests and also in the posturography. A second group of patients (43) had changes in caloric tests but with no changes in posturography. The third group of 5, paradoxically, had a vestibular deficiency in posturography associated with normal caloric reactivity.
CONCLUSION. The results obtained with the videonystagmography are correlated with those of the caloric and rotational videonystagmographic tests in the case of acute vestibular diseases. In chronic vestibular diseases, it is possible to find caloric vestibular paresis in the presence of a normal posturography. The “vestibular omission” is a phenomenon in which the patient does not use the vestibular input of a normal labyrinth with caloric and rotary tests within normal limits. As no vestibular examination can be considered as selfstaging diagnosis, we always have to establish the final diagnosis correlating the results of all the tests available.
1. Bisdorff A, Bosser G, Gueguen R, Perrin P. The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Front Neurol. 2013;4:29. DOI: 10.3389/fneur.2013.00029. eCollection 2013.
2. Muncie HL, Sirmans SM, James E. Dizziness: Approach to Evaluation and Management. Am Fam Physician. 2017;95(3):154-62.
3. Newman-Toker DE, Edlow JA. TiTrATE: a novel, evidence-based approach to diagnosing acute dizziness and vertigo. Neurol Clin. 2015;33(3):577–99, viii. DOI: 10.1016/j.ncl.2015.04.011.
4. Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82(4):361-8, 369.
5. Shepard NT, Schubert MC. Interpretation and usefulness of ocular motility testing. In: Jacobson GP, Shepard NT, eds. Balance Function Assessment and Management. San Diego, CA: Plural Publishing; 2008, p.147–67.
6. Hain TC. Interpretation and usefulness of ocular motility testing. In: Jacobson GP, Newman CW, Kartush JM, eds. Handbook of Balance Function Testing. St. Louis, MO: Mosby Year Book; 1993, p.101–21.
7. Nashner LM. Computerized dynamic posturography. In: Goebel JA, ed. Practical Management of the Dizzy Patient. Philadelphia, PA: Lippincott Williams & Wilkins; 2001, p.143–69.
8. Shepard NT, Janky K. Background and technique of computerized dynamic posturography. In: Jacobson GP, Shepard NT, eds. Balance Function Assessment and Management. San Diego, CA: Plural Publishing; 2008, p.339–54.
9. Leigh RJ, Zee DS. The Neurology of Eye Movements. 3rd ed. New York, NY: Oxford University Press; 1999.
10. Shepard NT. Rotational chair testing. In: Goebel JA, ed. Practical Management of the Dizzy Patient. Philadelphia, PA: Lippincott Williams & Wilkins; 2001, p.129–41.
11. Blin EA. Le concept d’omission vestibulaire résiste à l’augmentation de la fréquence de stimulation du système vestibulo-oculaire. Kinésithérapie la Revue. 2013;13(134):28–9. DOI: 10.1016/j.kine.2012.12.018.