How is electronystagmography with caloric testing performed in a dizziness evaluation?

Updated: Jun 26, 2018
  • Author: Wayne T Shaia, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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The following tests commonly are performed to evaluate patients with vertigo.

  • Electronystagmography with caloric testing

    • This test has 2 parts, namely, oculomotor testing (pursuit and saccades) and caloric testing. Eye position is monitored by using electro-oculography, which relies on the dipole of the eye. In caloric testing, the ear canals are irrigated with water or air that is 7°C above or below body temperature. The goal of the test is to determine if significant asymmetry is present in the response of the labyrinths, which can indicate peripheral vestibular disease. Evidence of CNS disorders also can be identified on electronystagmography.

    • The caloric test may be helpful in determining the side of the lesion; however, it has several significant limitations. First, the test has a relatively poor reliability; test-retest values change markedly in the same patient. Second, the test can be used to examine only a small portion of the balance system (ie, the lateral canals) through a small range of frequencies. Hence, results of the test may not be generalized to the entire labyrinthine function of the tested subject.

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