Affiliations: Department of Otolaryngology, Clinique Notre-Dame de Grâce, Charleroi, Belgium
Correspondence:
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Corresponding author: Claudio Krstulovic Roa, Department of Otolaryngology, Clinique Notre-Dame de Grâce, Chaussée de Nivelles 212, 6041 Charleroi, Belgium. E-mail: [email protected], ORCID: 0000-0002-0573-4869.
Abstract: BACKGROUND:Galvanic Vestibular Stimulation (GVS) has long been used as a vestibular stimulus. A major issue observed in GVS research was the high variability of the responses, which has led some researchers to question its diagnostic utility. OBJECTIVES:Determine the diagnostic accuracy of galvanically induced nystagmus for the diagnosis of subjects with unilateral peripheral vestibular hypofunction. METHODS:A total of 195 dizzy patients were prospectively enrolled, forming a consecutive series as they were received. Individuals with spontaneous nystagmus or using vestibular sedatives were excluded. Nystagmus induced by a 4 mA galvanic stimulus was compared with the caloric test as a reference standard. RESULTS:Of the 195 subjects tested with GVS, 115 were subjects with a unilateral peripheral vestibular hypofunction. The presence of nystagmus showed an AUC of only 0.529 (0.478 to 0.580, p = 0.125), and the maximum slow phase velocity of nystagmus showed an AUC of only 0.523 (0.472 to 0.573, p = 0.439). CONCLUSIONS:Since neither AUC is better than random discrimination, this study concludes that GVS-induced nystagmus is not useful as a diagnostic tool for unilateral peripheral vestibular hypofunction. These findings discourage the use of GVS-induced nystagmus in the clinical setting.
