title: Normal Caloric Responses during Acute Phase of Vestibular Neuritis.
abstract: OBJECTIVE
  We report a novel finding of caloric conversion from normal responses into unilateral paresis during the acute phase of vestibular neuritis (VN).
  
  
  METHODS
  We recruited 893 patients with a diagnosis of VN at Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2014 after excluding 28 patients with isolated inferior divisional VN (n=14) and those without follow-up tests despite normal caloric responses initially (n=14). We retrospectively analyzed the neurotological findings in four (0.5%) of the patients who showed a conversion from initially normal caloric responses into unilateral paresis during the acute phase.
  
  
  RESULTS
  In those four patients, the initial caloric tests were performed within 2 days of symptom onset, and conversion into unilateral caloric paresis was documented 1-4 days later. The clinical and laboratory findings during the initial evaluation were consistent with VN in all four patients except for normal findings in bedside head impulse tests in one of them.
  
  
  CONCLUSIONS
  Normal findings in caloric tests should be interpreted with caution during the acute phase of suspected VN. Follow-up evaluation should be considered when the findings of the initial caloric test are normal, but VN remains the most plausible diagnosis.
authors.affiliation: Department of Neurology, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Sun Uk
authors.initials: SU
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Biomedical Laboratory Science, Kyungdong University, Goseong, Korea.
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ja Won
authors.initials: JW
authors.lastname: Koo
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. jisookim@snu.ac.kr.
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Kim
keywords: caloric test; head-impulse test; vestibular neuritis; vestibulo-ocular reflex