Vestibulotoxicity: strategies for clinical diagnosis and rehabilitation

Figures & data

Table 1. Criteria for each category of vestibular disorders.

Category A: non-lateralised peripheral vestibular disorder	Category B: unilateral vestibular paresis	Category C: bilateral vestibular paresis
Spontaneous nystagmus	Caloric inter-ear asymmetry ≥25%	Each of the four caloric responses <10°/sec
Significant post-head shaking nystagmus	Any combination of Category A results may also be present	Gain reductions in rotational step testing
Significant positional nystagmus		Gain reductions in sinusoidal rotational testing
Short time constants for rotational steps		Any combination of Category A results may also be present
Increased phase leads at any sinusoidal frequency
Significant rotary chair asymmetries

Table 2. This table provides a summary of the various tests that are available for assessing vestibular system function including the test type, dependent variables of interest, and what system in being evaluated.

Test name	Test type	Outcome measure	Generator(s)
DVA	Informal/formal	Decreased visual acuity with head movement	Horizontal canal
Head thrust	Bedside	Catch-up saccades	Horizontal canal
Post head shake	Bedside/hybrid	Nystagmus present	Horizontal canal
Postural control	Bedside	Postural sway/fall reaction or rotation while marching EC	Vertical canals and horizontal canal
VNG (calorics)	Laboratory	VOR gain	Horizontal canal
Sinusoidal rotational tests	Laboratory	VOR phase, gain, and symmetry	Horizontal canal
Rotational step tests	Laboratory	VOR gain and time constant	Horizontal canal
vHIT	Laboratory	VOR gain/presence of covert and overt saccades	Anterior, posterior, and horizontal canals
cVEMP	Laboratory	Response amplitude	Saccule/inferior vestibular nerve
oVEMP	Laboratory	Response amplitude	Utricle/superior vestibular nerve
Posturography SOT	Laboratory	Postural sway/fall reactions	Vision, vestibular, and proprioception