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Correlation between nystagmus intensity and vestibular–ocular reflex gain in benign paroxysmal positional vertigo: A prospective, clinical study

June 26, 2023

BACKGROUND:
Video head impulse test (vHIT) and videonystagmography (VNG) provide significant benefits in evaluating benign paroxysmal positional vertigo (BPPV) and determining the semicircular canal localization of the otoconia.
OBJECTIVE:
This study aimed to investigate the relationship between vestibular–ocular reflex (VOR) gains measured viav HIT and the slow-phase velocity (SPV) of nystagmus in patients with the posterior semicircular canal (PSCC)-BPPV.
METHODS:
Sixty-two patients were included in this study and divided into the study (n = 32, patients with isolated PSCC- BPPV) and control (n = 30, age- and sex-matched healthy individuals) groups. While VOR gains were measured with vHIT in both groups and compared between groups, the SPV values of nystagmus observed during the Dix-Hallpike maneuver in the study group were recorded using VNG and compared with the VOR gains of the study group.
RESULTS:
There were significant differences in posterior canal VOR gains between the study and control groups (p < 0.001 and p < 0.01, respectively). Although the affected PSCC had decreased VOR gains versus the control group, it was still within the normal range. However, there was no significant relationship between the VOR gains of the affected PSCC and the SPV of the nystagmus. CONCLUSIONS:
vHIT can help detect semicircular canal dysfunction in patients with PSCC-BPPV. The SPV values of nystagmus on VNG during the Dix–Hallpike maneuver do not correlate with the level of VOR gain.
Keywords: Benign paroxysmal positional vertigo, vestibular function tests, head impulse test, vestibulo–ocular reflex, semicircular canals