Association between vestibular dysfunction and findings of horizontal head-shaking and vibration-induced nystagmus

Article type: Research Article

Authors: Fujimoto, Chisato^{a; b; *} | Kawahara, Takuya^c | Yagi, Masato^a | Murofushi, Toshihisa^{a; d}

Affiliations: [a] Department of Otolaryngology, Tokyo Teishin Hospital, Tokyo, Japan | [b] Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan | [c] Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan | [d] Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki, Japan

Correspondence: [*] Corresponding author: Chisato Fujimoto, MD PhD, Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Tel.: +81 3 5800 8665, Fax: +81 3 3814 9486, E-mail: [email protected]. Co-authors: Takuya Kawahara MPH PhD ([email protected]), Masato Yagi MD PhD ([email protected]), Toshihisa Murofushi MD PhD ([email protected]).

Abstract: BACKGROUND:The association between vestibular function and findings of horizontal head-shaking nystagmus (HHSN) and vibration-induced nystagmus (VIN) tests is not well understood. OBJECTIVE:To investigate the association between function in the five distinct vestibular end organs and findings of these nystagmus tests. METHODS:We retrospectively reviewed the medical records of 50 patients with vestibular diseases who underwent HHSN testing, VIN testing, video head impulse testing (vHIT), cervical vestibular evoked myogenic potential testing to air-conducted sound (ACS cVEMP) and ocular VEMP testing to ACS (ACS oVEMP). We performed mixed-effects logistic regression analyses to see whether age, sex or the presence of nystagmus in HHSN or VIN have an association with the presence of peripheral vestibular dysfunction on the opposite side to the direction of nystagmus. RESULTS:The presence of HHSN had a significant association with abnormal vHIT in the lateral semicircular canal (LSCC) on the opposite side to the direction of nystagmus. The presence of VIN had a significant association with abnormal vHIT in all the SCCs and abnormal ACS oVEMP on the opposite side to the direction of nystagmus. CONCLUSIONS:HHSN had an association with LSCC dysfunction alone. VIN had an association with dysfunction in all the SCCs and the utricle.

Keywords: Nystagmus, vestibular diseases, vestibular function tests, vestibule

DOI: 10.3233/VES-200721

Journal: Journal of Vestibular Research, vol. 30, no. 5, pp. 319-327, 2020