Abstract
Background
It is generally accepted that headshake nystagmus (HSN) is generated from an asymmetrical peripheral vestibular input and a correlation exists between HSN and canal paresis. There have been limited reports, however, how HSN correlates with the more recently introduced tests of vestibular function.
Aims/objectives
To evaluate the correlation between HSN and unilateral weakness on caloric testing, high-frequency vestibulo-ocular reflex (VOR) function on video head impulse testing (VHIT) and otolith function determined by vestibular evoked myogenic potentials (VEMPs).
Methods
A retrospective study of all patients who underwent complete vestibular function testing at our tertiary referral center from 2016 to 2019 was performed. Demographic data, clinical diagnosis (where available), the results of video-nystagmography, vHIT, and VEMPs were evaluated.
Results
Of the 1499 patients in the study period, 101 (6.7%) had HSN. Vestibular test abnormalities were more common in patients with HSN. The sensitivity of HSN for underlying pathology was low in comparison with vestibular testing. However, HSN demonstrated a high specificity.
Conclusions and significance
HSN generation is likely more complex than caloric-induced nystagmus, probably due to additional variables within the vestibular system. HSN may provide clinicians with additional information concerning high-frequency VOR function involving lateral semicircular and otolith dysfunction.
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Notes
For the purposes of convenience, the term high frequency will be used to reflect the more accurate description of movements that physically involve repetitive high velocity/acceleration head movements during the head-shake test.
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Kraus, M., Hassannia, F., Bergin, M.J. et al. Post headshake nystagmus: further correlation with other vestibular test results. Eur Arch Otorhinolaryngol 279, 3911–3916 (2022). https://doi.org/10.1007/s00405-021-07155-z
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DOI: https://doi.org/10.1007/s00405-021-07155-z