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Do central vestibular findings predict abnormal findings on magnetic resonance imaging?

Published online by Cambridge University Press:  14 June 2019

G Mankekar Open the ORCID record for G Mankekar [Opens in a new window] ,
G Jeha ,
I Erbele ,
M Klumpp ,
A Sevy ,
R Mehta ,
L Son  and
M A Arriaga
G Mankekar*
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA Louisiana State University Health Sciences Center, New Orleans, USA
G Jeha
Affiliation:
Louisiana State University Health Sciences Center, New Orleans, USA
I Erbele
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA Louisiana State University Health Sciences Center, New Orleans, USA
M Klumpp
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA
A Sevy
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA Louisiana State University Health Sciences Center, New Orleans, USA
R Mehta
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA Louisiana State University Health Sciences Center, New Orleans, USA
L Son
Affiliation:
Louisiana State University Health Sciences Center, New Orleans, USA
M A Arriaga
Affiliation:
Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA Louisiana State University Health Sciences Center, New Orleans, USA
*
Author for correspondence: Dr G Mankekar, Hearing and Balance Center, Suite# 709, 7777, Hennessy Blvd, Baton Rouge, Louisiana 70810, USA E-mail: gaurimankekar@gmail.com
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Abstract

Objective

To determine whether central findings from vestibular tests predict abnormal findings on magnetic resonance imaging.

Method

This study was a retrospective case series at a tertiary referral centre. The main outcome measure of this diagnostic intervention study was the positive predictive value of central vestibular findings in relation to magnetic resonance imaging abnormalities.

Results

Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups although they varied according to age group. Optokinetic nystagmus (p < 0.05) and abnormal findings on videonystagmography tests (p < 0.05) were the main predictors of magnetic resonance imaging abnormalities. White matter lesions constituted the bulk of the central lesions on magnetic resonance imaging followed by cortical and cerebellar atrophy.

Conclusion

Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups. Magnetic resonance imaging is medically justified to further evaluate patients with central findings on vestibular studies. Therefore, it is reasonable to request magnetic resonance imaging in these patients.

Keywords

Vestibular TestsMagnetic Resonance Imaging Findings
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 7 , July 2019 , pp. 554 - 559
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr G Mankekar takes responsibility for the integrity of the content of the paper

References

1Karatas, M. Central vertigo and dizziness: epidemiology, differential diagnosis and common causes. Neurologist 2008;14:355–64Google Scholar
2Newman-Toker, DE. Missed stroke in acute vertigo and dizziness: it is time for action, not debate. Ann Neurol 2016;79:27–31Google Scholar
3Cherchi, M, Hain, TC. Migraine-associated vertigo. Otolaryngol Clin North Am 2011;44:367–75Google Scholar
4Strupp, M, Brandt, T. Central vertigo. Otorhinolaryngol Clin An Int J 2012;4:71–6Google Scholar
5Rosenberg, ML, Gizzi, M. Neuro-otologic history. Otolaryngol Clin North Am 2000;33:471–82Google Scholar
6Mohamed, ES. Predictors of central vestibular disorders from videonystagmography tests. Egyptian J Otolaryngol 2016;32:202–9Google Scholar
7Lopes, AR, Moreira, MD, Trelha, CS, De Moraes Marchiori, LL. Association between complaints of dizziness and hypertension in non-institutionalized elders. Int Arch Otorhinolaryngol 2013;17:157–62Google Scholar
8Arriaga, MA, Chen, DA, Cenci, KA. Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test. Otolaryngol Head Neck Surg 2005;133:329–33Google Scholar
9Hain, TC, Cherchi, M. Approach to the patient with dizziness and vertigo. In: Biller, J, ed. Practical Neurology, 5th edn. Philadelphia: Wolters Kluwer Health Pharma Solutions (Europe) Ltd, 2017;207–26Google Scholar
10Swartz, RH, Kern, RZ. Migraine is associated with magnetic resonance imaging white matter abnormalities: a meta-analysis. Arch Neurol 2004;61:1366–8Google Scholar
11Williamson, W, Lewandowski, AJ, Forkert, ND, Griffanti, L, Okell, TW, Betts, J et al. Association of cardiovascular risk factors with MRI indices of cerebrovascular structures and function and white matter hyperintensities in young adults. JAMA 2018;320:665–73Google Scholar
12Ahmad, H, Cerchiai, N, Mancuso, M, Casani, AP, Bronstein, AM. Are white matter abnormalities associated with “unexplained dizziness”? J Neurol Sci 2015;358:428–31Google Scholar
13Gong, L, Liu, XY, Fang, M. Recent progress on small vessel disease with cognitive impairment. Int J Clin Exp Med 2015;8:7701–9Google Scholar
14Colledge, N, Lewis, S, Mead, G, Sellar, R, Wardlaw, J, Wilson, J. Magnetic resonance brain imaging in people with dizziness: a comparison with non-dizzy people. J Neurol Neurosurg Psychiatry 2002;72:587–9Google Scholar
15Gamba, P, Pavia, M. White matter lesions and vascular vertigo: clinical correlation and findings on cranial magnetic resonance imaging. Eur Rev Med Pharmacol Sci 2016;20:2786–91Google Scholar
16Kim, KW, MacFall, JR, Payne, ME. Classification of white matter lesions on magnetic resonance imaging in elderly persons. Biol Psychiatry 2008;64:273–80Google Scholar
17Baloh, RW, Honrubia, V, Kerber, KA. Clinical Neurophysiology of the Vestibular System, 4th edn. New York: Oxford University Press, 2011Google Scholar
18Luxon, LM, Bamiou, D-E. Vestibular system disorders. In: Neurology and Clinical Neuroscience, ed Schapira, AHV. Philadelphia: Mosby Elsevier, 2007;337–52Google Scholar
19Kinney, WC, Wallace, RC, Ross, JS, Kinney, SE, Hamid, MA. Retrospective blinded review of magnetic resonance imaging in patients with central electronystagmography findings. Am J Otol 1998;19:341–4Google Scholar
20Stoddart, RL, Baguley, DM, Beynon, GJ, Chang, P, Moffat, DA. Magnetic resonance imaging results in patients with central electronystagmography findings. Clin Otolaryngol Allied Sci 2000;25:293–7Google Scholar
21Fazekas, F, Barkhof, F, Wahlund, LO, Pantoni, L, Erkinjuntti, T, Scheltens, P et al. CT and MRI rating of white matter lesions. Cerebrovasc Dis 2002;13(suppl 2):31–6Google Scholar
22Akoglu, EU, Akoglu, H, Cimilli Ozturk, T, Onur, B, Eroglu, SE, Onur, O et al. Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo. Am J Emerg Med 2018;36:615–9Google Scholar