Instruction Course. Vestibular Test Battery

Instruction Course. Vestibular Test Battery
Procedures, Interpretation, Case reports
Dr. Nima Rezazadeh (PhD in Audiology)
Dr. Moslem Shaabani (PhD in Audiology)
Dr. Mohsen Ahadi (PhD in Audiology)

The course consists of three sections. In the first section, we explain the videonystagmography (VNG) test. It includes oculomotor subtests (i.e. saccade, smooth Pursuit, optokinetic, and gaze tests) and peripheral vestibular subtests (i.e. spontaneous nystagmus, head-shaking nystagmus, Dix-Hallpike maneuver, and Caloric tests). The overall goal of VNG test is to identify peripheral vestibular disorders (such as BPPV and vestibular neuritis) and differentiate them from central lesions (such as brainstem or cerebellar disorders). In the end, we will mention some case reports.

In the second section, we describe two different examinations to evaluate the otolith system. We will initially talk about the subjective visual vertical/horizontal test (SVV/SVH) to evaluate utricular/ saccular systems. These tests are most valuable in acute and unilateral vestibular disorders. We then describe the cervical/ocular vestibular evoked myogenic potentials (cVEMP/oVEMP) which are in the group of electrophysiological tests. The cVEMP test evaluates sacculocolic pathway (i.e. saccule, inferior vestibular nerve, ipsi. SCM). The oVEMP test evaluates utriculo-ocular pathway (i.e. utricle, superior vestibular nerve, contra. Inferior oblique muscle). VEMP tests are valuable in both acute/chronic and unilateral/bilateral vestibular disorders. To conclude, we will discuss some case reports.

In the third section, we have focus on video head-impulse test (vHIT) and electrocochleography test (ECochG). In vHIT, using some physiological and high frequency head impulses, we can overcome the caloric test limitations. vHIT known as a peripheral vestibular test but it is under a wide-ranging research to determine its specific results in peripheral and also central vestibular disorders. ECochG is another electrophysiological test that has been used for many years for diagnosis of Meniere’s disease. We will highlight its clinical applications and limitations. Finally, we will argue about some case reports.