Peripheral Vestibular Disorders Research Articles

A role of vascular risk factors in the development of peripheral vestibulopathy

The development of peripheral vestibular disorders are often thought to be associated with vascular mechanisms, taking into account terminal type of inner ear blood supply and other predisposing factors. A number of studies indicates a high frequency of vascular risk factors in the patients with vestibular neuronitis and benign paroxysmal positional vertigo (BPPV). According to other results, migraine is widely spread among patients with Meniere's disease and BPPV. However currently there is no evidence for casual relationship between vascular factors and development of peripheral vestibulopathy. The only exclusion is labyrinthine infarction, which develops as a result of posterior circulation disorder. More research is needed in this area.

Variants of treatment of the head direction at the festulars of the labi-rint of inflammatory genesis

To analyze the effectiveness of various methods of treating dizziness with fistulas of the labyrinth (FL) of inflammatory genesis. An analysis of the surgical treatment of 216 patients with chronic suppurative otitis media (CSOM) with cholesteatoma complicated by FL using a variety of FL treatment methods is presented. All patients underwent a debridement operation on the middle ear or revision of the postoperative cavity: in 48 patients with a matrix of cholesteatoma in situ on the fistula, in 109 patients with matrix removal followed by plastic repair or FL filling with various autotissues, in 59 patients with matrix conservation, plastic removal or filling FL and SLD labyrinth. In the last two groups, filling of a semicircular canal (SC) defect was performed in 33 patients, and mastoidoplasty - in 47. All used FL treatment techniques are effective in the treatment of peripheral vestibular disorders. Careful treatment of SC fistula after removal of all pathological conditions in the absence of active inflammation and the appointment of hormone therapy in the postoperative period are the main factors in preserving the functions of the labyrinth in any surgical technique. Filling of the lumen of the SC and mastoidoplasty in patients with CSOM with FL can eliminate peripheral dizziness.

The risk of stroke in patients with dizziness

Primary prevention of cerebrovascular diseases is not realized, developed aspect of the program, such as dietary habits, blood pressure control, lipid concentrations, assessment of metabolic disorders - are not used as a single unit. The first step in the solving of this problem, the main recommendation of the Guide to the primary prevention of CVD which based on the fact that the risk of disease should be evaluated for all patients on the basis of a careful study of medical history, physical examination, and the results of certain lab tests. The determina-tion monitoring purposes of different risk factors with the obligatory account of individual risk factors - it is one of the advantages in identifying those who have a higher risk of developing cerebral accidents.Proved that to the high-risk group of stroke include the patients with vertigo (other neurologic symptoms), especially men of middle and old age. Furthermore, during the imaging of the brain in most patients with dizziness have been identified unexpressed signs of a lesion of the barrel or the cerebellum, which resemble the clinical manifestations of peripheral vestibular disorders. Recent studies have shown that the dizziness is often a basic of vestibular dysfunctions that lead to the development of acute cerebral ischemia. The importance of the influence of vestibular physiology, affective neuroscience and so-cial neuroscience require a correction of manifestations of dizziness, as a factor in the risk of stroke by Citoflavin drug has a pronounced antiischemic and antioxidant effect, significantly preventing the build-up of ischemic damage to brain tissue. Drug, including in biochemical power shunt, helps to prevent unwanted effects that are typical of ischemic tissue to stabilize the work of their own antioxidant systems.

Clinical significance of bedside dynamic visual acuity test

Objective: Dynamic visual acuity (DVA) is defined as the visual acuity when there are relative movements between subjects and visual targets. The purpose of this study was to discuss the correlation between bedside DVA test and other examinations of vestibular function, and to assess the value of DVA test for clinical diagnosis. Methods: Retrospective analysis of 323 cases with peripheral vestibular disorder, and analyzing the correlation between bedside DVA results and caloric test were performed. Results: Out of these 323 cases, 113 cases showed positive results of DVA.Among these 113 cases with positive DVA test, 109 cases were bilateral or unilateral vestibular function loss according to the results of caloric test or VEMP. The disease with the highest positive rate of DVA was bilateral vestibulopathy(BVP), followed by vestibular neuritis (VN) and profound sudden sensorineural hearing loss (pSSNHL). Conclusions: Bedside DVA is effective to determine the cases with BVP and severe unilateral vestibular function loss.

Direction-Changing and Direction-Fixed Positional Nystagmus in Patients With Vestibular Neuritis and Meniere Disease.

ObjectivesDirection-changing positional nystagmus (PN) was considered to indicate the presence of benign paroxysmal positional vertigo involving lateral semicircular canal in most cases. We investigated the incidence of PN on the supine head-roll test and compared the characteristics of nystagmus in patients with vestibular neuritis (VN) and Meniere disease (MD).MethodsA retrospective review of patients, who were diagnosed with unilateral VN or unilateral definite MD between September 2005 and November 2011, was conducted. Sixty-five VN patients and 65 MD patients were enrolled. Eye movements were recorded for 30–60 seconds at the positions of sitting, head roll to the right, and head roll to the left, and maximum slow-phase eye velocity was calculated. PN was classified as direction-fixed (paretic or recovery) and direction-changing (geotropic or apogeotropic).ResultsSpontaneous nystagmus was observed in 57 patients (87%, the slow-phase eye velocity of 7°/sec±5°/sec) with acute VN, 39 (60%, 2°/sec±1°/sec) with follow-up VN, and 32 (49%, 2°/sec±2°/sec) with MD. Direction-fixed PN was the most common type. Direction-fixed paretic type was most common in acute VN (80%) and follow-up VN (42%), and direction-fixed recovery type was most common in MD (31%). Paretic type was significantly more common in acute VN (80%) than in follow-up VN (42%) and MD (26%), and the recovery type was significantly more common in MD (31%) than in acute VN (3%) and follow-up VN (14%). Direction-changing PN was more common in MD (22%), followed by follow-up VN (14%) and acute VN (9%).ConclusionThough direction-fixed paretic PN was most common in VN and MD patients, direction-changing PN could be observed in a few patients (9%–20%) with peripheral vestibular disorders regardless of the duration from the onset of dizziness, suggesting the presence of otolith-related dizziness.

Implementation of evidence-based practice for benign paroxysmal positional vertigo: DIZZTINCT\u2013 A study protocol for an exploratory stepped-wedge randomized trial

BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, and accounts for 8% of individuals with moderate or severe dizziness. BPPV patients experience substantial inconveniences and disabilities during symptomatic periods. BPPV therapeutic processes – the Dix-Hallpike Test (DHT) and the Canalith Repositioning Maneuver (CRM) – have an evidence base that is at the clinical practice guideline level. The most commonly used CRM is the modified Epley maneuver. The DHT is the gold standard test for BPPV and the CRM is supported by numerous randomized controlled trials and systematic reviews. Despite this, BPPV care processes are underutilized.Methods/designThis is a stepped-wedge, randomized clinical trial of a multi-faceted educational and care-process-based intervention designed to improve the guideline-concordant care of patients with BPPV presenting to the emergency department (ED) with dizziness. The unit of randomization and target of intervention is the hospital. After an initial observation period, the six hospitals will undergo the intervention in five waves (two closely integrated hospitals will be paired). The order will be randomized. The primary endpoint is measured at the individual patient level, and is the presence of documentation of either the Dix-Hallpike Test or CRM. The secondary endpoints are referral to a health care provider qualified to treat dizziness for CRM and 90-day stroke rates following an ED dizziness visit. Formative evaluations are also performed to monitor and identify potential and actual influences on the progress and effectiveness of the implementation efforts.DiscussionIf this study safely increases documentation of the DHT/CRM, this will be an important step in implementing the use of these evidenced-based processes of care. Positive results will support conducting larger-scale follow-up studies that assess patient outcomes. The data collection also enables evaluation of potential and actual influences on the progress and effectiveness of the implementation efforts.Trial registrationClinicalTrials.gov, ID: NCT02809599. The record was first available to the public on 22 June 2016 prior to the enrollment of the first patients in October 2016.

Prevalence of Benign Paroxysmal Positional Vertigo: Our experiences at a tertiary care hospital of India

Introduction: Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo.BPPV is often overlooked by general physician and treated with anti-vertigo drugs. Objective: To evaluate the prevalence, incidence, clinical presentation of benign paroxysmal positional vertigo (BPPV). Also assessing the age, gender and site of the lesion, association with other vestibular disorders, progression, and recurrence in these patients. Materials and methods: A retrospective study of total of 172patients those attended in vertigo clinic for giddiness diagnosed as BPPV. Data analyzed from medical records since last 3 years. Out of total 685 vertigo patients in our Vertigo Clinic, 172were found to suffer from BPPV.The age of the patients ranged from 23 years to 76 years with mean of 41.4 year. Results: Out of 685 patients with vertigo,172 were diagnosed as BPPV. Among them, 102 female and 70 male patients. The posterior canal was affected in 81.97 %, the lateral in 10.46 %, the anterior in 5.23 % and multiple canals in 2.32 %.The treatment maneuver used most was Epley’smaneuver. Recurrence was observed in 10.37 % of the cases. It was idiopathic in 73.83% of cases. Conclusion: BPPV is a common peripheral vestibular disorder causing significant morbidity, psychosocial impact and medical costs. Epley’s maneuver provides rapid relief of symptoms of BPPV. In addition daily Brandt–Daroff exercises decrease the chances of recurrence rate.

Comparative analysis of the data obtained in computerized posturography and videonystagmography for patients with peripheral vestibular deficit

Abstract BACKGROUND. Vestibular disorders are a group of widely spread diseases that have as a common denominator the disturbance of the equilibrium system. The assessment of vestibular disorders consists in a complex examination of the patient including a thorough anamnesis, a rigorous clinical examination and multiple functional explorations. OBJECTIVE. To asses weather there is a correlation between the data obtained in posturography and those obtained in the videonystagmography in patients with peripheral vestibular disorders. MATERIAL AND METHODS. Collecting data from the observation sheets of patients diagnosed with peripheral vestibular syndrome and examined in the Department of Otorhinolaryngology of the “Sfanta Maria” Hospital in Bucharest over a period of 18 months. RESULTS. We analyzed a number of 97 cases of patients diagnosed with peripheral vestibular disorder. A large number of patients (49) had correlated changes in the caloric tests and also in the posturography. A second group of patients (43) had changes in caloric tests but with no changes in posturography. The third group of 5, paradoxically, had a vestibular deficiency in posturography associated with normal caloric reactivity. CONCLUSION. The results obtained with the videonystagmography are correlated with those of the caloric and rotational videonystagmographic tests in the case of acute vestibular diseases. In chronic vestibular diseases, it is possible to find caloric vestibular paresis in the presence of a normal posturography. The “vestibular omission” is a phenomenon in which the patient does not use the vestibular input of a normal labyrinth with caloric and rotary tests within normal limits. As no vestibular examination can be considered as selfstaging diagnosis, we always have to establish the final diagnosis correlating the results of all the tests available.

The Video Head Impulse Test: Our Experience in 45 Cases.

To evaluate the role of video head impulse test in the diagnosis of peripheral vestibular disorders, we performed an observational study in the outpatient department in a tertiary setup in which the clinical head impulse test and the video head impulse test were performed on 45 patients with clinically suspected peripheral vestibular disorders, and their results were correlated. To analyse our results, each ear was counted individually and hence, among 45 patients, 12 out of 90 ears showed abnormal clinical head impulse test for lateral semicircular canals and 27 out of 90 ears showed abnormal video head impulse test for lateral semicircular canals. This gave us an additional diagnostic accuracy of 21.1% on using video head impulse test for the lateral semicircular canals as compared to the clinical head impulse test. Video head impulse test is a physiological, quick and well tolerated test for assessing the vestibular function, and the only practical test for assessing the vertical semicircular canal function. Video head impulse test provides valuable information in localising the site of lesion as it assesses the semicircular canals individually. Video head impulse is merely not an objectification and registration system for the clinical head impulse test as it provides additional information such as vestibulo-ocular reflex gain, and occurrence of covert refixation saccades which cannot be picked up by naked eyes.

Oxidative Status in Patients with Benign Paroxysmal Positional Vertigo.

Benign paroxysmal positional vertigo (BPPV) is the most frequent peripheral vestibular disorder and is particularly seen among older patients suffering from vertigo. The brief vertigo attacks in and imbalance symptoms of BPPV are caused by freely floating otoconia within the semicircular canals. The aim of this prospective study was to evaluate the role of oxidative stress, using native thiol/disulfide (SH/SS) homeostasis as a novel indicator, in the etiology of BPPV. The 62 participants in the study included 31 patients with BPPV and, as the control group, 31 healthy individuals without any cochleovestibular disorders. Patients with BPPV initially had significantly lower native SH levels and significantly lower SH/total thiol (TT) ratios, as well as significantly higher SS/SH and SS/TT ratios, than the healthy controls. After successful treatment of their vertigo, which was confirmed based on the results obtained from the second blood sample, patients with BPPV still had lower SH levels and SH/TT ratios and significantly higher SS/SH and SS/TT ratios than the healthy controls. Our results suggest a role of oxidative stress in the development of BPPV, through both calcium metabolism and the direct toxic effects of free oxygen radicals, including the triggering of apoptosis.

Clinical significance of spontaneous nystagmus in pediatric patients

ObjectiveTo analyze spontaneous nystagmus recorded in pediatric patients and determine its diagnostic value. Materials and methodsRetrospective review of 86 patients (mean age = 13.9 ± 4.7 years) with definitive spontaneous nystagmus recorded by videonystagmography (VNG). Spontaneous nystagmus was categorized and analyzed based on its characteristics. Correlations between spontaneous nystagmus and established clinical diagnoses were explored. ResultsAmong the patients seen in a period of three years at our pediatric vestibular clinic, 15.4% (86 out of 560) were found to have spontaneous nystagmus and half of them had horizontal nystagmus with a fixed-direction. The majority of cases with spontaneous nystagmus (77%, 66/86) were present without fixation only, while the presence of spontaneous nystagmus with and without fixation was found in 16 patients (19%). Most patients with spontaneous nystagmus without fixation only (68%) were diagnosed with a peripheral vestibular disorder (e.g., vestibular neuritis) or vestibular migraine. In contrast, vertical nystagmus was found in 15 patients, most of whom had central vestibular disorders. Other rare forms of nystagmus or abnormal eye movements, such as pendular nystagmus, ocular oscillation or flutter were recorded in only four patients. ConclusionsSpontaneous nystagmus in children and young adults with possible vestibular impairments may vary in clinical presentation. Identification of its characteristics may help to make an accurate clinical diagnosis. While spontaneous nystagmus associated with peripheral vestibular disorders can be readily recognized, spontaneous nystagmus in pediatric patients with vestibular migraine appears to be more complex and variable in form.

Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic

Background: Dizziness and vertigo are frequent complaints of outpatients in the neurological department. Our objective was to explore the epidemiological category and clinical features of patients with dizziness or vertigo in the neurological outpatient department of a tertiary hospital. Methods: We consecutively recruited all patients with dizziness and/or vertigo visiting the neurological outpatient clinic of the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2017. All patients were interviewed by 4 neurologists and they completed self-administered questionnaires. General physical and standardized neuro-otology bedside examinations were performed in all participants. Instrumental examinations and other related examinations were prescribed as needed. Results: A total of 392 patients, 272 female and 120 male, were enrolled and the ratio of males to females was 1: 2.27. The mean age was 52.39 ± 13.87 years (range 11–90). Elderly patients (≥60 years) accounted for about one-third of the patients. Peripheral vestibular disorders accounted for 54.6% of patients, central vestibular disorders (including vestibular migraine [VM]) accounted for 22.4% of patients, psychogenic vertigo in 64 (16.3%), other reasons in 9 (2.3%) and unknown in 17 (4.3%). Benign paroxysmal positional vertigo (BPPV; 30.8%), psychiatric dizziness (20.5%), and VM (14.4%) were the 3 major vestibular diseases in patients under 60 years of age; however, BPPV (27.9%), central vertigo (21.7%), and Meniere’s disease (11.7%) were more common in patients over 60 years of age. Conclusions: This study provided a classification and clinical features of vestibular disorders in a neurological outpatient department of a tertiary hospital in China. The spectrum of vertigo or dizziness is different between different age groups and clinicians should pay attention to this difference in clinical reasoning.

Short- and long-latency auditory evoked potentials in individuals with vestibular dysfunction.

Purpose Evaluate the auditory pathway at the brainstem and cortical levels in individuals with peripheral vestibular dysfunction. Methods The study sample was composed 19 individuals aged 20-80 years that presented exam results suggestive of Peripheral Vestibular Disorder (PVD) or Vestibular Dysfunction (VD). Participants underwent evaluation of the auditory pathway through Brainstem Auditory Evoked Potentials (BAEP) (short latency) and P1, N1, P2, N2, and P300 cortical potentials (long latency). Results Nine individuals presented diagnosis of VD and 10 participants were diagnosed with PVD. The overall average of the long latency potentials of the participants was within the normal range, whereas an increased mean was observed in the short latency of waves III and V of the left ear, as well as in the I - III interpeak interval of both ears. Association of the auditory potentials with VD and PVD showed statistically significant correlation only in the III - V interpeak interval of the right ear for short latency. Comparison between the long and short latencies in the groups showed differences between VD and PVD, but without statistical significance. Conclusion No statistically significant correlation was observed between VD/PVD and the auditory evoked potentials; however, for the long latency potentials, individuals with VD presented higher latency in P1, N1, P2, and N2, where as participants with PVD showed higher latency in P300. In the short latency potentials, there was an increase in the absolute latencies in the VD group and in the interpeak intervals in the PVD group.

OVEMP as an objective indicator of successful repositioning maneuver

Background and objectiveBenign paroxysmal positioning vertigo (BPPV) is the most common peripheral vestibular disorder. Canalolithiasis in the posterior semi-circular canal is the most common underlying pathology that can be treated effectively by repositioning maneuvers. Our hypothesis suggested that successful maneuvers can lead to repositioning of dislodged otoconia to the utricle. Materials and methodsAir conducted oVEMP, which is thought to originate from the contra-lateral utricular organ was measured in twenty patients with unilateral BPPV and we compared n1•p1 peak to peak amplitude of the affected ears in 3 separate intervals: on pre-treatment when typical nystagmus was confirmed, immediately after, and 1 week after repositioning maneuvers to assess change, if any, in amplitude. ResultsThis study showed significant increase of oVEMP amplitude in the affected ears after successful repositioning maneuver that was more significant after 1 week. ConclusionsoVEMP can be used as a reliable objective test for ensuring a successful maneuver rather than subjective dependence on the patient's symptoms, which may be misleading due to a remission.

Peripheral Vestibular Disorders in Children and Adolescents with Concussion.

Objective To review peripheral vestibular disorders in pediatric patients with dizziness following concussion. Study Design Case series with chart review. Setting Pediatric vestibular clinic and pediatric multidisciplinary concussion clinic at a tertiary level pediatric hospital. Subjects and Methods We retrospectively reviewed 109 patients seen for dizziness following a concussion between September 2012 and July 2015. Patients were ≤20 years of age at the time of concussion. Incidences of specific peripheral vestibular disorders were assessed along with timing of diagnosis relative to the date of injury, diagnostic test findings, and treatment interventions associated with those diagnoses. Results Twenty-eight patients (25.7%) were diagnosed with peripheral vestibular disorders. None of these disorders were diagnosed prior to evaluation in our pediatric vestibular clinic or our multidisciplinary concussion clinic, which occurred a mean of 133 days (95% confidence interval, 89.2-177.3) after injury. Benign paroxysmal positioning vertigo was diagnosed in 19 patients, all of whom underwent successful canalith repositioning maneuvers. Other diagnoses included temporal bone fracture (n = 3), labyrinthine concussion (n = 2), perilymphatic fistula (n = 2), and superior semicircular canal dehiscence (n = 2). Both patients with perilymphatic fistula and 1 patient with superior semicircular canal dehiscence underwent successful surgical management, while 1 patient with superior semicircular canal dehiscence was managed nonsurgically. Conclusion Peripheral vestibular disorders may occur in pediatric patients with dizziness following concussion, but these disorders may not be recognized until symptoms have persisted for several weeks. An algorithm is proposed to guide the diagnosis and management of peripheral vestibular disorders in pediatric patients with concussion.

Vestibular vertigo treatment in a polymorbid patient

Many physicians have difficulty managing patients with vertigo. Incorrect routine diagnoses are frequently made in patients with peripheral vestibulopathy, which makes therapy fail. Most cases of vestibular vertigo are caused by peripheral vestibular disorders (otolithiasis, hydrops, neuronitis). Rehabilitation maneuvers are effective in the treatment of benign paroxysmal positional dizziness; salt-free diet, diuretics, and betahistine dihydrochloride are for MОniПre’s disease (syndrome); vestibular rehabilitation is for vestibular neuronitis. Betahistine dihydrochloride is most effective among all the medicines used in different causes of vestibular vertigo, including that of unclear origin. The paper gives the positive experience with betahistine made in Russia for vestibular vertigo.

Randomized trial of betahistine mesilate tablets as augmentation for oxcarbazepine and carbamazepine in treating vestibular paroxysmia.

BackgroundVestibular paroxysmia (VP) is a rare episodic peripheral vestibular disorder. This study was conducted to compare the efficacy and acceptability of carbamazepine (CBZ) plus betahistine mesilate tablets (BMT) (CBZ+BMT) and oxcarbazepine (OXC) plus BMT (OXC+BMT) in treating VP, and investigated whether the synergistic effect could be increased along with the increased dose of BMT.MethodsVP patients were recruited and randomly assigned to receive CBZ+BMT or OXC+BMT. The doses of CBZ and OXC were set to 200 and 300 mg/time, twice daily, respectively. The doses of BMT were set to 12 and 18 mg/time, twice daily. Half of the patients in each group received BMT 12 mg/time and the other half received BMT 18 mg/time. The treatment was continued for 12 weeks. The vertigo frequency, vertigo score, vertigo duration, response rate, and drug-related side effects were analyzed.ResultsIn total, 92 patients in the CBZ+BMT group and 93 patients in the OXC+BMT group completed this trial. After 12 weeks of treatment, the two groups had similar average vertigo frequency, average vertigo score, average vertigo duration, and response rate. But the incidence of side effects was significantly higher in the CBZ+BMT group than in the OXC+BMT group (p=0.04). Subgroup analysis found that patients receiving BMT (18 mg) had greater reductions in average vertigo frequency, average vertigo duration, and average vertigo score, and higher response rates than patients receiving BMT (12 mg).ConclusionThese results demonstrated that OXC+BMT may be suitable as an alternative method in VP patients with CBZ hypersensitivity, and the synergistic effect could be increased along with the increased dose of BMT.

THE USE OF VESTIBULAR REABILITATION IN PATIENTS WITH VIOLATIONS OF THE VESTIBULAR ANALYZER

Aim - to present the results of the observational program, the purpose of which was to reduce visual disorders associated with vestibular dysfunction, and restore balance, thereby reducing the risk of falls. Materials and methods. 46 patients took part in the observational study. Determination of the optimal duration of vestibular rehabilitation in patients with unilateral non-progressive peripheral vestibular disorder. Results. It was found that the optimal duration of treatment is no less than 2 months.

Comparative Study of Management of BPPV (Benign Paroxysmal Positional Vertigo) with only Drugs Versus Drugs Plus Epley Manoeuvre.

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, accounting for 20% of all vertigo cases. Idiopathic BPPV is most common between the ages of 50 and 70, although the condition is found in all age groups. The importance of early diagnosis and treatment can lead to a much improved quality of life for patients afflicted by this ailment. It is presently common for physicians to treat these patients mainly with benzodiazepines, antihistamines, and anticholinergic medications, especially if the history and physical is consistent with BPPV. This method of treatment has had questionable success. Several reviews of the management of vertigo have shown that no medication in current use has well established curative or prophylactic value or is suitable for long-term treatment. Epleys manoeuvre is also used in the treatment of BPPV. This manoeuvre relocates free floating particles from the affected semi-circular canals back into utricle, thus relieving the symptoms of vertigo. The purpose of this study is to compare the efficacy of Epleys manoeuvre with conventional drug therapy versus conventional therapy alone in patients who present with vertigo. The purpose of this study to evaluate and examine two methods of treatment.

Subjective visual vertical in different peripheral vestibular disorders

Context: The subjective visual vertical (SVV) is considered to be a functional measure of otolith-mediated verticality perception. Aims: This study aims to detect the normative data of SVV and to analyze SVV changes in peripheral vestibular disorders. Settings and Design: This was a observational, cross-sectional study. Subjects and Methods: Forty-five adult patients with chronic peripheral vestibular disorders endolymphatic hydrops, vestibular neuritis, and benign paroxysmal positional vertigo and 20 normal individuals were included in this study. After full history taken, SVV deviations and caloric tests were completed. Statistical Analysis Used: Independent Student's t-test for independent sample when comparing 2 groups. ANOVAs test compared three or more means for statistical significance. Tukey's test compared the means of every treatment to the means of every other treatment. Chi-square test was performed. Normal cutoff value was calculated by mean +2 standard deviation (SD) as high limit and mean −2 SD as low limit. Results: The normative data of SVV ranged from −0.2° to 1.26° in clockwise direction and from −0.04° to 0.95° in the counterclockwise direction. SVV in counterclockwise direction were significantly deviated among the three groups of Peripheral vestibular disorder (PVD) patients when compared with controls. It revealed a significant deviation in counterclockwise tilt between left diseased ears in relation to controls. Conclusions: Normal adults displayed a narrow range of one-degree SVV deviation (1.06° and 0.91°) in clockwise and counterclockwise direction, respectively. The three vestibular disorders significantly deviate the SVV in counterclockwise direction compared to control with no gender difference. SVV test alone cannot differentiate between different PVD.