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Variability and habituation of nystagmic responses to hot caloric stimulation of normal subjects

Evidence that this test may be inapplicable to monitoring drug-induced vestibular toxicity

Published online by Cambridge University Press:  29 June 2007

P. G. Davey
Affiliation:
Birmingham
E. S. Harpur*
Affiliation:
Birmingham
F. Jabeen
Affiliation:
Birmingham
D. Shannon
Affiliation:
Birmingham
P. M. Shenoi
Affiliation:
Birmingham
*
Pharmacology Laboratories, Department of Pharmacy, University of Aston in Birmingham, Gosta Green, Birmingham B47ET.

Abstract

Experiments were performed on 25 otoneurologically ‘normal’ subjects to evaluate the hot caloric test as a screening test for aminoglycoside vestibular toxicity.

Using portable equipment under non-ideal conditions, it was found that there was a large inter-subject variability in nystagmic response and that, instead of a random test-retest variability, a systagmic variation in response occurred on repeated caloric stimulation with water at 44°C.

A response deline (habituation) evident in both the maximum slow phase velocity and the maximum frequency occurred at second test, although the inter-test interval ranged from 24 to 72 hours.

After a 3-month interval with no intervening tests, the mean value of the maximum frequency reverted back to the original level. However, there was still a significant reduction in maximum slow phase velocity at this time. Some individuals had a sustanined reduction in both parameters.

Hence it is concluded that the hot caloric test, used under the conditions described in this study, is not a suitable serial screening method for aminoglycoside vestibular toxicity. The reproducibility of this test under other conditions, or any other caloric test, should be established in normal subjects befre employing, it as a serial screen for aminoglycoside vestibular toxicity.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 1982

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References

REFERENCES

Baloh, R. W., Sills, A. W. and Honrubia, V. (1977). Caloric testing. 3. Patients with peripheral and central vestibular lesions. Annals of Otology, Rhinology and Laryngology, Supplement, 43: 2430.CrossRefGoogle Scholar
Baloh, R. W., Solingen, L., Sills, A. W. and Honrubia, V. (1977) Caloric testing. 1. Effect of different conditions of ocular fixation. Annals of Otology, Rhinology and Laryngology, Supplement, 43: 16.CrossRefGoogle Scholar
Barber, H. O., Wright, G. and Demanuele, F. (1971) The hot caloric test as a clinical screening device. Archives of Otolaryngology, 94: 335337.CrossRefGoogle ScholarPubMed
Bernstein, L. (1965) Simplification of clinical caloric test. Archives of Otolaryngology, 81: 347349.CrossRefGoogle ScholarPubMed
Collins, W. E. (1962) Effects of mental set upon vestibular nystagmus. Journal of Experimental Psychology, 63: 191197.CrossRefGoogle ScholarPubMed
Collins, W. E. (1965). Subjective responses and nystagmus following repeated unilateral caloric stimulation. Annals of Otology, Rhinology and Laryngology, 74, 10341054.CrossRefGoogle ScholarPubMed
Dayal, V. S., Farkashidy, J. and Kuzin, B. (1973) Clinical evaluation of the hot caloric test as a screening procedure. Laryngoscope, 83, 14331438.CrossRefGoogle ScholarPubMed
Dayal, V. S., Smith, E. L. and Mccain, W. G. (1974) Cochlear and vestibular gentamicin toxicity. Archives of Otolaryngology, 100: 338340.CrossRefGoogle ScholarPubMed
Fee, W. E. Jr., Vierra, V. and Lathrop, G. R. (1978) Clinical evaluation of aminoglycoside toxicity: tobramycin versus gentamicin, a preliminary report. Journal of Antimicrobial Chemotherapy, 48: Supplement A, 3136.CrossRefGoogle Scholar
Fitzgerald, G. and Hallpike, C. S. (1948) Studies in human vestibular function: 1. Observations on the directional preponderance of caloric nystagmus resulting from cerebral lesions. Brain, 65: 115137.CrossRefGoogle Scholar
Fluur, E. and Mendel, L. (1962). Habituation, efference and vestibular interplay. 1. Monaural caloric habituation. Acta Otolaryngologica, 55: 6580.CrossRefGoogle Scholar
Hart, C. W. J. (1965) The value of the hot caloric test. Laryngoscope, 75: 302315.CrossRefGoogle ScholarPubMed
Henriksson, N. G. (1956) Speed of slow component and duration in caloric nystagmus. Acta Otolaryngologica, Supplement, 125: 129.Google ScholarPubMed
Hinchcliffe, R. (1967 a) Validity of measures of caloric test response. Acta Otolaryngologica, 63: 6973.CrossRefGoogle ScholarPubMed
Hinchcliffe, R. (1967 b) Normal values for caloric tests using electro-oculography. Journal of Laryngology and Otology, 81: 221228.CrossRefGoogle ScholarPubMed
Jackson, G. G. and Arcieri, G. (1971) Ototoxicity of gentamicin in man. A survey and controlled analysis of clinical experience in the United States. Journal of Infectious Diseases 124: SupplementSI30137.CrossRefGoogle Scholar
Jongkees, L. B. W. (1973) The caloric test and its value in evaluation of the patient with vertigo. Otolaryngologic Clinics of North America, 6: 7393.CrossRefGoogle ScholarPubMed
Lidvall, H. F. (1961) Vertigo and nystagmus responses to caloric stimuli repeated at short and long intervals. Acta Otolaryngologica. 55: 315325.CrossRefGoogle Scholar
Lidvall, H. F. (1962) Specific and non-specific traits of habituation in nystagmus responses to caloric stimuli. Acta Otolaryngologica, 53: 507518.CrossRefGoogle Scholar
Nordström, L., Banck, G., Belfrage, S., Juhlin, I., Tjernström, Ö. and Toremalm, N. G. (1973) Prospective study of the ototoxicity of gentamicin. Acta Pathologica Microbiologica Scandinavica, Section B. 81, Supplement 241: 5457.Google Scholar
Sills, A. W., Baloh, R. W. and Honrubia, V. (1977) Caloric testing. 2. Results in normal subjects. Annals of Otology, Rhinology and Laryngology, Supplement, 43: 723.CrossRefGoogle Scholar
Torok, N. (1969) Nystagmus frequency versus slow phase velocity in rotatory and caloric nystagmus. Annals of Otology, Rhinology and Laryngology, 78: 625639.CrossRefGoogle ScholarPubMed
Winkel, O., Hansen, M. M., Kaaber, K. and Royarth, K. (1978) A prospective study of gentamicin otoxicity. Acta Otolaryngologica, 86: 212216.CrossRefGoogle Scholar