A closer look at subjective caloric sensations: Is there more to vertigo than spinning?

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A closer look at subjective caloric sensations: Is there more to vertigo than spinning?

J Vestib Res. 2018;27(5-6):271-277

Authors: Mijovic T, Remillard A, Zaia EH, Reid YM, Harrington JK, Westerberg BD, Lea J

Abstract
BACKGROUND: There is a prevailing opinion that spinning sensations signify a peripheral vestibular pathology while non-spinning sensations are not of vestibular origin.
OBJECTIVES: 1) Characterize the subjective sensations reported by patients during caloric testing. 2) Assess if the sensation was correlated with the peak slow phase velocity (SPV).
METHODS: Retrospective chart review at a Canadian adult tertiary-quaternary care balance centre for patients undergoing diagnostic caloric testing between December 2014 and September 2015.
RESULTS: Of 163 patients included, 122 had normal calorics and 41 demonstrated unilateral weakness. Spinning/rotatory movements were the most commonly reported sensations (55-70%). No sensation was reported among 10-20% of patients. Other non-rotatory sensations were reported 20-25% of the time. Both lack of sensation and other sensations were more likely to be correlated with SPVs that were significantly lower than those associated with spinning/rotating sensations. However, 18% of patients with normal calorics and robust SPVs with warm irrigation still reported non-spinning sensations.
CONCLUSIONS: During caloric irrigation, subjective sensations other than spinning and rotating are reported 20-25% of the time and these tend to be associated with lower peak SPV. Non-spinning vertigo is not uncommon as a subjective description of vestibular sensation even in normal patients with strong SPVs.

PMID: 29154301 [PubMed - indexed for MEDLINE]

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