Comparison between caloric and video-head impulse tests in Ménière’s disease and vestibular neuritis

Abstract

Objective To compare the diagnostic accuracies of air caloric testing with electronystagmography and the vHIT (video-head impulse test). Design Prospective, controlled study. Study sample MD (Ménière’s disease), 26; vestibular neuritis, 27; control, 56. Results In MD, CP (canal paresis) was pathological in 88.5%, the GA (gain asymmetry) on vHIT was pathological in 65.3%, and the gain was abnormal in only one patient. The GA and CP, were significantly higher in the MD group than in the control group, indicating hypofunction of the horizontal canals in MD, whereas a hyperfunction may also occur. No correlation was observed between the results of the two tests for evaluating MD, suggesting that pathological outcomes of one test do not guarantee abnormalities on the other test. For vestibular neuritis, significantly higher CP (96.3%), GA (81.5%), and gain (51.9%) values were detected. A correlation was identified between the two tests for vestibular neuritis, indicating a similar diagnostic efficiency. The higher percentage of pathological GA versus pathological gain values indicates that the asymmetry may be more informative. Conclusions The vHIT showed a higher specificity, whereas the caloric test a higher sensitivity. No correlation between the two methods was observed; therefore, the tests appear to provide complementary information.