抄録
The study was designed to determine whether a combination of spontaneous and head-shaking nystagmus and the head thrust test could be used in lieu of a caloric test for diagnosis of peripheral vestibular disorder. An analysis of vertigo/dizziness was conducted in 117 patients who visited our department between October 2009 and September 2011. Tests for spontaneous nystagmus, head-shaking nystagmus, head thrust, and electronystagmography including caloric testing were performed. Among the 117 patients, 83 patients were diagnosed as having peripheral disorders and 34 patients had non-peripheral disorders. The positive and negative predictive values for head thrust tests and spontaneous nystagmus were 73% and 85%, respectively, and a significant relationship was observed. Positive and negative predictive values were 80% and 55%, respectively, for canal paresis and spontaneous nystagmus. Of the 26 patients with positive results in head thrust tests, 25 (96%) had peripheral disorders. The positive results of the head thrust test in the peripheral group were significantly higher than that in non-peripheral group. Of the 24 patients with positive results for head-shaking nystagmus, 22 (93%) patients had peripheral disorders. The positive results of head-shaking nystagmus in the peripheral group were significantly higher than that in the non-peripheral group. Thirty-one (37%) of 83 patients with peripheral disorders were positive for head-shaking nystagmus and/or head thrust. On the other hand, of 34 patients with non-peripheral disorders, results were negative for 30 (88%) patients on the head-shaking nystagmus and head thrust tests. Negative results on these tests were more often observed in patients with non-peripheral disorders than in those with peripheral disorders. These results demonstrate that spontaneous nystagmus, head-shaking nystagmus, and head thrust tests are valid measurements and may be effectively used in combination for detection of vestibular disorders in patients with vertigo/dizziness.
