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The Journal of Laryngology & Otology The Journal of Laryngology & Otology

Article contents

Dissociation between caloric and head impulse testing in patients with congenital abnormalities of the semicircular canals

Published online by Cambridge University Press:  08 August 2018

B Shaw  and
R S Raghavan
B Shaw
Affiliation:
Audiovestibular Medicine, Royal Surrey County Hospital, Guildford, UK
R S Raghavan
Affiliation:
Audiovestibular Medicine, Royal Surrey County Hospital, Guildford, UK
Corresponding
E-mail address:
rsr@doctors.org.uk
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Abstract

Background

Dissociation between caloric and head impulse test results in patients with vestibular disorders has been well documented since the introduction of video head impulse testing. Prior to the introduction of video head impulse testing, vestibular diagnostic services relied mainly on caloric testing, and it is now known that the caloric testing shows more positive results than video head impulse testing. A dissipation model was proposed to explain this dissociation.

Case reports

This paper presents two cases in which caloric testing indicated an absent or significantly reduced response on the horizontal semicircular canal plane but video head impulse testing showed near-normal or normal vestibulo-ocular reflex gain on the same plane.

Conclusion

This report supports the dissipation theory and questions the functional relevance of canal paresis values calculated from caloric test results.

Keywords

Vestibulo-Ocular Reflex; Caloric Tests; Head Impulse Test
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 10 , October 2018 , pp. 932 - 935
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr R S Raghavan takes responsibility for the integrity of the content of the paper

A report of case one was presented at the British Association of Audiovestibular Physicians Annual Conference, 16–17 March 2017, Chesham, UK.

References

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7Valli, P, Buizza, A, Botta, L, Zucca, G, Ghezzi, L, Valli, S. Convection, buoyancy or endolymph expansion: what is the actual mechanism responsible for the caloric response of semicircular canals? J Vestib Res 2002;12:155–65Google ScholarPubMed
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