Diagnostic value of vestibulo-ocular reflex parameters in the detection and characterization of labyrinthine lesions.

Détails

ID Serval
serval:BIB_8AD27FF6B5DA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Diagnostic value of vestibulo-ocular reflex parameters in the detection and characterization of labyrinthine lesions.
Périodique
Otology & Neurotology
Auteur(s)
Maire R., van Melle G.
ISSN
1531-7129
Statut éditorial
Publié
Date de publication
2006
Peer-reviewed
Oui
Volume
27
Numéro
4
Pages
535-541
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article
Résumé
OBJECTIVE: To evaluate the power of various parameters of the vestibulo-ocular reflex (VOR) in detecting unilateral peripheral vestibular dysfunction and in characterizing certain inner ear pathologies. STUDY DESIGN: Prospective study of consecutive ambulatory patients presenting with acute onset of peripheral vertigo and spontaneous nystagmus. SETTING: Tertiary referral center. PATIENTS: Seventy-four patients (40 females, 34 males) and 22 normal subjects (11 females, 11 males) were included in the study. Patients were classified in three main diagnoses: vestibular neuritis: 40; viral labyrinthitis: 22; Meniere's disease: 12. METHODS: The VOR function was evaluated by standard caloric and impulse rotary tests (velocity step). A mathematical model of vestibular function was used to characterize the VOR response to rotational stimulation. The diagnostic value of the different VOR parameters was assessed by uni- and multivariable logistic regression. RESULTS: In univariable analysis, caloric asymmetry emerged as the most powerful VOR parameter in identifying unilateral vestibular deficit, with a boundary limit set at 20%. In multivariable analysis, the combination of caloric asymmetry and rotational time constant asymmetry significantly improved the discriminatory power over caloric alone (p<0.0001) and produced a detection score with a correct classification of 92.4%. In discriminating labyrinthine diseases, different combinations of the VOR parameters were obtained for each diagnosis (p<0.003) supporting that the VOR characteristics differ between the three inner ear disorders. However, the clinical usefulness of these characteristics in separating the pathologies was limited. CONCLUSION: We propose a powerful logistic model combining the indices of caloric and time constant asymmetries to detect a peripheral vestibular loss, with an accuracy of 92.4%. Based on vestibular data only, the discrimination between the different inner ear diseases is statistically possible, which supports different pathophysiologic changes in labyrinthine pathologies.
Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Case-Control Studies, Female, Humans, Labyrinth Diseases/diagnosis, Labyrinth Diseases/physiopathology, Labyrinthitis/diagnosis, Labyrinthitis/physiopathology, Logistic Models, Male, Meniere Disease/diagnosis, Meniere Disease/physiopathology, Middle Aged, Multivariate Analysis, Nystagmus, Pathologic, Prospective Studies, Reflex, Vestibulo-Ocular/physiology, Vertigo, Vestibular Function Tests
Pubmed
Web of science
Création de la notice
25/01/2008 12:00
Dernière modification de la notice
03/03/2018 19:10
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