Affiliations: [a] Department of Otolaryngology, Head and Neck Surgery, McGill University, Royal Victoria Hospital, Montreal, QC, Canada
| [b] Division of Otolaryngology Head and Neck Surgery, Royal Inland Hospital, Kamloops, BC, Canada
| [c] Department of Audiology, St. Paul’s Hospital, Vancouver, BC, Canada
| [d] Division of Otolaryngology – Head and Neck Surgery, B.C. Rotary Hearing and Balance Centre, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
Correspondence:
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Corresponding author: Dr. Jane Lea, St. Paul’s Hospital - B.C. Rotary Hearing and Balance Centre, 2600 –1081 Burrard St., Vancouver, V6Z 1Y6 BC, Canada. Tel.: +1 604 806 8540; Fax: +1 604 806 8777; E-mail: jlea@providencehealth.bc.ca.
Abstract: BACKGROUND:There is a prevailing opinion that spinning sensations signify a peripheral vestibular pathology while non-spinning sensations are not of vestibular origin. OBJECTIVES:1) Characterize the subjective sensations reported by patients during caloric testing. 2) Assess if the sensation was correlated with the peak slow phase velocity (SPV). METHODS:Retrospective chart review at a Canadian adult tertiary-quaternary care balance centre for patients undergoing diagnostic caloric testing between December 2014 and September 2015. RESULTS:Of 163 patients included, 122 had normal calorics and 41 demonstrated unilateral weakness. Spinning/rotatory movements were the most commonly reported sensations (55–70%). No sensation was reported among 10–20% of patients. Other non-rotatory sensations were reported 20–25% of the time. Both lack of sensation and other sensations were more likely to be correlated with SPVs that were significantly lower than those associated with spinning/rotating sensations. However, 18% of patients with normal calorics and robust SPVs with warm irrigation still reported non-spinning sensations. CONCLUSIONS:During caloric irrigation, subjective sensations other than spinning and rotating are reported 20–25% of the time and these tend to be associated with lower peak SPV. Non-spinning vertigo is not uncommon as a subjective description of vestibular sensation even in normal patients with strong SPVs.
Keywords: Caloric tests, dizziness, vertigo, vestibular diseases, vestibular function tests
