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Monothermal differential caloric testing in patients with Meniere's disease

1991; Wiley; Volume: 101; Issue: 1 Linguagem: Inglês

10.1288/00005537-199101000-00009

1531-4995

David Wexler, Lee A. Harker, Richard J. Voots, Brian F. McCabe,

Infrared Thermography in Medicine

Abstract The monothermal differential caloric test allows determination of vestibular recruitment and de‐cruitment, variables which may help discriminate peripheral from central vestibular lesions. Previous reports indicated a strong association between vestibular recruitment and Meniere's disease. This study examined patients having unilateral Meniere's disease. Nystagmus beat frequency (NBF) and slow‐component velocity (SCV) responses were recorded by electronystagmography (ENG). Electronystagmo‐graphic findings showing unilateral dysfunction were present in 54% of patients by slow‐component velocity and in 31% by nystagmus beat frequency. Unilateral hypofunction was the most frequent lat‐eralizing ENG finding. Absolute vestibular recruitment occurred in less than 10% of patients but relative recruitment was found in nearly 20% of patients. Slow‐component velocity had higher sensitivity than nystagmus beat frequency, with excellent clinical concordance. Monothermal caloric testing as described in this study best detects peripheral vestibular disease in Meniere's patients using slow‐component velocity to determine unilateral hypofunction and relative vestibular recruitment.