Caloric tests in clinical practice in benign paroxysmal positional vertigo

Abstract

Background: The value of caloric tests in benign paroxysmal positional vertigo (BPPV) patients is unclear.

Objectives: To analyze the features and clinical significance of caloric tests in BPPV patients.

Materials and methods: About 2192 patients (256 BPPV and 1936 non-BPPV) who complained of dizziness triggered by movement, accompanied by the symptom of hearing loss or a history of vertigo, participated in this prospective clinical study. All subjects received a caloric test, 213 BPPV patients underwent follow-up for at least 6 months after canalith repositioning procedures (CRPs).

Results: (1) The abnormal canal paresis (CP) prevalence of BPPV was 57%. (2) The curative rate of single CRP decreased during follow-up from 90.1% after 7 days to 61% after 6 months and was significantly lower in patients with (54.1%) than in those without (70.1%) an abnormal CP at 6 months post-treatment (p = .01). (3) The recurrent rate was significantly higher in BPPV patients with abnormal CP (25.2%) than with normal CP (12.5%; p = .017).

Conclusions and significance: Patients with abnormal CP needed more CRPs and were more prone to relapse. The value of the caloric test in treatment planning and predicting recurrence in BPPV patients should be emphasized.

Chinese abstract

背景：对良性阵发性位置性眩晕（BPPV）患者进行热量测试的意义尚不清楚。

目的：分析BPPV患者热量测试的特点及临床意义。

材料与方法：约2192例运动性眩晕患者（256例BPPV, 1936例非BPPV）, 伴有听力丧失症状或眩晕史, 参与本前瞻性临床研究。所有受试者都接受了热量测试；213名BPPV患者在耳石再定位手术后接受了至少6个月的随访。

结果：（1）BPPV异常耳道轻瘫（CP）的发生率为57%。（2）随访期间单个CRP的治愈率从7天后的90.1%下降到6个月后的61%, 治疗后6个月内（54.1%）患者的治愈率明显低于无异常CP患者（70.1%）（P = 0.01）。（3）CP异常的BPPV患者（25.2%）的复发率明显高于CP正常者（9.3%；P = 0.017）。

结论与意义：CP异常患者需要更多的CRP, 并更易复发。应强调热量测试在BPPV患者治疗计划和复发预测中的意义。

Keywords:

• Benign paroxysmal positional vertigo
• caloric test
• canal paresis
• canalith repositioning procedure
• recurrence

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Capital Citizen Health Program to Foster from Beijing Municipal Science & Technology Commission [No. Z151100003915100].