Contralesional subjective visual horizontal predicts endolymphatic hydrops. (1st October 2020)

• Record Type: Journal Article
• Authors: Nham, Benjamin; Welgampola, Miriam S.; Halmagyi, G. Michael
• Is Part Of: Acta oto-laryngologica. Volume 140:Number 10(2020)
• Page Start: 833
• Page End: 837
• Publication Date: 2020-10-01
• Subjects: Ocular torsion -- subjective visual horizontal -- subjective visual vertical -- otolithic function -- canal paresis -- Meniere's disease; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2020.1774650
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: The subjective visual horizontal (SVH) is a test of utricular function that assesses conjugate ocular torsion which is a component of the ocular tilt reaction (OTR). In unilateral destructive peripheral vestibular lesions, the OTR and so the SVH tilt is usually ipsiversive. Aims/objective: Our study aimed to profile the causes of a contraversive SVH tilt in patients with a confirmed unilateral peripheral vestibular deficit. Materials and methods: The clinical records, nystagmus and vestibular investigation characteristics of 52 patients with a unilateral canal paresis (CP) on caloric of ≥30%, a contraversive SVH tilt of ≥4 degrees and at least one pure tone audiometry were retrospectively analysed. Results: The most common diagnosis of patients ( n = 39) with a contraversive SVH and ipsilesional CP was endolymphatic hydrops: 35 (67.3%) had Meniere's disease (MD) and 4 (7.7%) had delayed endolymphatic hydrops (DEH). The remaining 13 (25%) of cases had other peripheral aetiologies or an unknown diagnosis. 16 (30.8%) patients had ictal spontaneous nystagmus at the time of SVH or caloric testing. Conclusions and significance: A contraversive SVH with unilateral CP suggests endolymphatic hydrops.