Affiliations: [a] Harvard University – Massachusetts Institute of Technology Division of Health Sciences and Technology, Boston, USA | [b] Harvard Medical School, Department of Otology and Laryngology, Boston, USA | [c] Jenks Vestibular Diagnostic Laboratory of the Massachusetts Eye and Ear Infirmary, Boston, USA
Correspondence:
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Corresponding author: Conrad Wall III, Ph.D., Jenks Vestibular Diagnostic Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA. Tel.: +1 617 573 4154; Fax: +1 617 573 4154; E-mail: cwall@mit.edu
Abstract: This paper discusses the use of vestibular testing to discriminate between right (n = 29) and left (n = 27) Ménière's disease. We examined reduced vestibular response (RVR), directional preponderance, and spontaneous and positional nystagmus measurements from electronystagmography, as well as the asymmetry measurements from the sinusoidal harmonic acceleration test, to determine whether multivariate logistic regression could improve upon the discrimination performance of RVR alone. We found that patients with a spontaneous or positional nystagmus often had a “recovery nystagmus”, beating in the opposite direction of that predicted for an acute lesion. When present, the direction and magnitude of such nystagmus could be used in the classification algorithm to increase the discriminatory power over RVR alone, but in these patients the rotation test asymmetry measurements were rendered useless. In the absence of spontaneous or positional nystagmus, asymmetry measurements significantly enhanced right/left discrimination. Directional preponderance was insignificant in determining the side of lesion.
