Abstract
Delayed endolymphatic hydrops (DEH) represents a rare clinical entity characterized by intermittent vertigo attacks mimicking those of Ménière's disease (MD) in a patient with a prior sensorineural hearing loss. Some vestibular tests have been employed in patients with DEH. These tests provide useful diagnostic information and facilitate clinical decision-making. Here, we retrospectively studied the features of video head impulse test (vHIT) and examined its relationship with caloric test used in DEH patients. Included in this study were 17 patients with ipsilateral DEH and 2 with contralateral DEH. Among them, 73.7% (14/19) showed abnormal caloric test response (76.5% in ipsilateral DEH and 50% in contralateral DEH). Meanwhile, only 15.8% (3/19) of patients yielded abnormal horizontal vHIT results (11.8% in ipsilateral DEH and 50% in contralateral DEH). Abnormal caloric response in the presence of a preserved vHIT was common in DEH patients, especially those with ipsilateral DEH. This dissociation might be a distinctive pattern of vestibular deficit in DEH.
Highlights
Vestibular test is designed to assess the status of the vestibular system objectively and quantitatively
According to the diagnostic criteria, 17 patients were diagnosed with ipsilateral Delayed endolymphatic hydrops (DEH) and two as having contralateral DEH
In one case of ipsilateral DEH, concurrent horizontal semicircular canals (SCC) type benign paroxysmal positioning vertigo (BPPV) was diagnosed in the opposite ear, and the patient suffered from both the Ménière -like episodic vertigo lasting for over 1 h during the past several months and recurrent transient positional vertigo while lying down or getting up before presentation
Summary
Vestibular test is designed to assess the status of the vestibular system objectively and quantitatively. The caloric test has been used for the assessment of the vestibulo-ocular reflex (VOR) function of horizontal SCC by using a non-physiological stimulus in a frequency ranging 0.002–0.004 Hz [2]. Video head impulse test (vHIT) extends the testing range to physiological high frequency (5–7 Hz) [3]. The relationship between these two VOR tests has been investigated in multiple vestibular disorders, such as Ménière’s disease (MD), vestibular neuritis, vestibular migraine, benign paroxysmal positioning vertigo (BPPV), enlarged vestibular aqueduct (EVA), among others [2, 4, 5]. A dissociation between caloric test and vHIT was found to be common in patients with MD [6, 7], and has been suggested as an instrumental hallmark of MD [5]
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