Vestibulo-spinal reflex tests to determine unilateral vestibular loss

Abstract

Objective The purpose of this study was to investigate subjective vestibulo-spinal reflex test sensitivity in subjects with unilateral vestibular loss. Method Forty subjects diagnosed with UVL within 7 days of onset and 30 subjects without dizziness/balance disorder complaints were included in the study as the unilateral vestibular loss and control groups (70 subjects aged 18–60 years [mean: 42.95 ± 10.82]). Bithermal caloric test, Fukuda, Babinski Weil, tandem walking, and past pointing tests were performed. The subjective VSR tests’ sensitivities were compared among the various methods. Results The Fukuda test was determined to have the highest sensitivity value (65%; kappa coefficient: 0.352). The sensitivity values of the other tests, in descending order, are: Babinski Weil (55%, Kappa coefficient: 0.274), tandem walking (10%, Kappa coefficient: 0.022), and past pointing (2.5%, Kappa coefficient: −0.014). A positive moderate correlation was obtained between canal paresis asymmetry and Fukuda deviation degree (p = 0.009, r = 0.407). There was no correlation between Babinski Weil (p = 0.619), tandem walking (p = 0.538), and past pointing test results and canal paresis asymmetry (p > 0.05). Conclusions Fukuda and Babinski Weil tests can be used under conditions where all subjective tests are not performed because of limited time. However, these tests must be used alongside objective vestibular test batteries owing to their limited specificity and sensitivity.