Journal of Neurology

, Volume 266, Issue 12, pp 3162–3162 | Cite as

Letter to the editors: comment on “Dissociation of caloric and head impulse tests: a marker of Meniere’s disease”

  • Niccolò Cerchiai
  • Elena Navari
  • Augusto Pietro CasaniEmail author
Letter to the Editors

Dear Sirs,

We read with interest the paper “Dissociation of Caloric and Head Impulse Tests: A Marker of Menière’s Disease” [1].

The paper highlights the importance of video head impulse test (vHIT) in the instrumental assessment of vestibular disorders, and speculates that a dissociation between vHIT and caloric test findings may represent a diagnostic marker of Menière’s disease.

Menière’s disease, due to its impact on patients’ day life and to the poor response to most of the conservative treatments, represents one of the most challenging disorders in otolaryngologic and neurotological practice.

Our group, aware of the importance to early diagnose Menière’s disease and to exclude bilateral involvement when an ablative therapy is needed, has deeply investigated the instrumental aspects of Meniere’s disease. In 2016, we published a paper titled “Assessment of Vestibulo-oculomotor Reflex in Menière’s Disease: Defining an Instrumental Profile” in the “Otology and Neurotology” journal [2]. Our study found similar results and clearly demonstrated a frequency-dependent behavior of vestibulo-oculomotor reflex in a quite large sample of patients affected by Menière’s disease. Our study already speculated that the dissociation between vHIT and caloric test could represent a sort of instrumental marker of an “untreated Menière’s Disease” (patients treated with intratympanic gentamicin did not show these instrumental aspects).

We congratulate Hannigan and colleagues for their interesting publication; the aim of this letter was just to underline the importance of our work that in our opinion contributed significantly to the scientific research in vestibular disorders.


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interests.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Hannigan IP, Welgampola MS, Watson SRD (2019) Dissociation of caloric and head impulse tests: a marker of Meniere’s disease. J Neurol. CrossRefPubMedGoogle Scholar
  2. 2.
    Cerchiai N, Navari E, Dallan I, Sellari-Franceschini S, Casani AP (2016) Assessment of vestibulo-oculomomotor reflex in Mèniére’s disease: defining an instrumental profile. Otol Neurotol 37(4):380–384PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Niccolò Cerchiai
    • 1
  • Elena Navari
    • 1
  • Augusto Pietro Casani
    • 1
    Email author
  1. 1.Department of Medicine and SurgeryPisa University HospitalPisaItaly

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