Classification of peripheral and central (pontine infarction) vestibular deficits. Selection of a neuro-otological test battery using discriminant analysis.
The results obtained from a complete neuro-otological test battery were examined statistically in order to select measurement variables which would optimally indicate significant differences between four groups: normal patients, patients with partially compensated unilateral peripheral vestibular deficit, patients with an acoustic neurinoma and patients with central (brainstem) vestibular deficit. A stepwise-discriminant analysis was performed on measurements of slow-phase velocity obtained from each test. The primary measurements selected to assign a subject optimally to one population were the canal paresis (CP) of the caloric test, the eye-tracking gain contralateral to the deficit for a 15 deg/s stimulus, the gain asymmetry for optokinetic nystagmus with a 30 deg/s stimulus, and the level of spontaneous nystagmus. The resulting classifications were 100% correct for normal and central deficit patients. However, the division between peripheral deficit and acoustic neurinoma patients overlapped causing about 30% false classifications of neurinoma patients: some 20% of the peripheral deficit patients were classified as normal. If the CP was not available the discriminant analysis substituted the rotating chair response for 5 deg/s2, in place of CP. This substitution caused a 10 to 20% decrease in classification accuracy.
Allum
J H
JH
Department of Otorhinolaryngology, University Hospital, Basel, Switzerland.
Ura
M
M
Honegger
F
F
Pfaltz
C R
CR
D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D004584:Electronystagmography / Q000706:statistics & numerical data; D004585:Electrooculography / Q000706:statistics & numerical data; D006801:Humans; D007238:Infarction / Q000453:epidemiology*; D009464:Neuroma, Acoustic / Q000453:epidemiology*; D009760:Nystagmus, Physiologic / Q000502:physiology; D011149:Pons / Q000098:blood supply*; D015837:Vestibular Diseases / Q000453:epidemiology*; D014724:Vestibular Function Tests / Q000706:statistics & numerical data*