The Value of Rotatory Tests in Vestibular Testing

Abstract

The aim of this paper is to evaluate the usefulness of rotatory tests in the diagnosis of otoneurological disorders. Material and Method: The charts of 203 consecutive outpatients investigated at the Vestibular Pathology Unit of the University Hospital of Strasbourg were reviewed, to analyze the clinical history, the results of the physical examination, the pure tone audiogram, the spontaneous nystagmus evaluated with nystagmography, the caloric test, the Conraux damped pendular swing rotatory test and the index of nystagmus inhibition by visual fixation. Results: 28 patients were suffering from benign positional paroxysmal vertigo, 84 had a normal caloric test, 17 a bilateral vestibular weakness, 73 a unilateral vestibular weakness (UVW) with directional preponderance (DP) of the nystagmus in 9, 22 a DP of the nystagmus without any UVW, 49 an horizontal unisense nystagmus, 15 had a vertical nystagmus and 9 a multisense nystagmus. The rotatory test was normal in 92 patients and asymmetric in 111. The index of nystagmus inhibition by visual fixation was abnormal in 18 patients. Discussion: The rotatory test is the best test to establish vestibular compensation: 31 patients were compensated, 33 uncompensated while only 17 patients had a unilateral horizontal spontaneous nystagmus. DP of the nystagmus at the rotatory test directed toward the UVW was present in the case of vestibular hydrops (11 patients). 40 patients had an asymmetric rotatory test although the caloric test was normal. These patients will improve with vestibular rehabilitation.