Comparison of caloric and head-impulse tests during the attacks of Meniere's disease.
To aid in diagnosis of Meniere's disease (MD) during the attacks using caloric and head-impulse tests (HITs).



Retrospective case series review.



We analyzed the results of bithermal caloric and HITs during the attacks in 16 patients with MD. Quantitative analyses of HITs were conducted using a magnetic search coil technique.



In unilateral MD (14 patients, 42 semicircular canals), the head impulse gain of the vestibulo-ocular reflex (VOR) was either normal (28 of 42, 67%), decreased (8 of 42, 19%), or increased (6 of 42, 14%) for each semicircular canal in the affected ear. Likewise, the head impulse VOR gain was either normal (29 of 42, 69%), increased (11 of 42, 26%), or decreased (2 of 42, 5%) in the intact ear. The VOR gain for the horizontal canal was significantly lower on the affected side (P = 0.013). However, the VOR gains for the anterior and posterior canals did not differ between the sides (P = 0.270, P = 0.282). In bilateral MD (two patients, 12 semicircular canals), the VOR gain was either decreased (6 of 12, 50%) or normal (6 of 12, 50%) in either ear. In contrast, the caloric responses were usually decreased in the affected ear (7 of 11, 64%, including one with bilateral MD).



During the attacks of MD, HITs showed varied results between the ears and among the canals, although the caloric responses were usually decreased in the involved ear. These dissociations suggest a frequency-dependent impairment of canal function or mechanical property of the endolymphatic hydrops during the attacks of MD.



4. Laryngoscope, 127:702-708, 2017.
Department of Neurology, Ajou University College of Medicine, Ajou University Hospital, Suwon, Republic of Korea.
Sun-Uk
SU
Lee
Department of Biomedical Laboratory Science, Kyungdong University, Goseong, Republic of Korea.
Hyo-Jung
HJ
Kim
Department of Otolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Ja-Won
JW
Koo
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Ji-Soo
JS
Kim
D000328:Adult; D000368:Aged; D002150:Caloric Tests / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D064087:Head Impulse Test / Q000379:methods*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis*; D008875:Middle Aged; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
Meniere's disease; Nystagmus; Vertigo