Rotational Tests of Vestibular Function

ABSTRACT

Rotational tests are aimed at producing a more natural, precise, repeatable, and broadband evaluation of the vestibular function. Currently, two types of rotation tests are in clinical use: passive whole-body rotation where the stimulus is produced by a motorized chair, and active rotation where the stimulus is produced by voluntary head movements. In both methods, the frequency response of the vestibulo-ocular reflex (VOR) is determined by measuring the eye movements and comparing the head velocity with the slow-phase eye velocity. Rotation tests offer several advantages over other vestibular function tests in patients with bilateral caloric weakness, in young children, or in patients for whom VOR changes have to be assessed over time. In most other patients, rotation tests do not offer a significant advantage because of their low sensitivity to common vestibular abnormalities.

KEYWORDS

Vestibular testing - passive rotation - active rotation - rotary chair - caloric test

REFERENCES

• 1 Baloh R W, Sills A W, Honrubia V. Impulsive and sinusoidal rotatory testing: a comparison with results of caloric testing.  Laryngoscope. 1979;  89(4) 646-654
• 2 Wolfe J W, Engelken E J, Kos C M. Low-frequency harmonic acceleration as a test of labyrinthine function: basic methods and illustrative cases.  Otolaryngology. 1978;  86 130-142
• 3 Peterka R J, Black F O, Schoenhoff M B. Age-related changes in human vestibulo-ocular and optokinetic reflexes: pseudorandom rotation tests.  J Vestib Res. 1991;  1(1) 61-71
• 4 Maes L, Vinck B M, De Vel E, D'haenens W, Bockstael A, Dhooge I. Evaluation of the rotatory vestibular test: exploration of stimulus parameters.  B-ENT. 2007;  3(3) 119-126
• 5 Baloh R, Honrubia V. Clinical Neurophysiology of the Vestibular System. New York, NY; Oxford University Press 2001
• 6 Baloh R W, Honrubia V, Yee R D, Hess K. Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity.  Ann Neurol. 1984;  16(2) 222-228
• 7 Stockwell C, Bojrab D. Interpretation and usefulness of rotational testing. In: Jacobson G, Newman C, Kartush, J Handbook of Balance Function Testing. St. Louis, MO; Mosby Year Book 1993: 249-258
• 8 Shepard N, Telian S. Practical Management of the Balance Disorder Patient. San Diego, CA; Singular 1996
• 9 Raphan T, Matsuo V, Cohen B. Velocity storage in the vestibulo-ocular reflex arc (VOR).  Exp Brain Res. 1979;  35(2) 229-248
• 10 Halmagyi G, Curthoys I. Clinical changes in vestibular function with time after unilateral vestibular loss. In: Herdman SJ Vestibular Rehabilitation. Philadelphia, PA; FA Davis 2000: 172-194
• 11 Wade S W, Halmagyi G M, Black F O, McGarvie L A. Time constant of nystagmus slow-phase velocity to yaw-axis rotation as a function of the severity of unilateral caloric paresis.  Am J Otol. 1999;  20(4) 471-478
• 12 Shepard N. Rotational chair testing. In: Goebel J Practical Management of the Dizzy Patient. Philadelphia, PA; Lippincott Williams & Wilkins 2001: 129-141
• 13 Cyr D G, Brookhouser P E, Valente M, Grossman A. Vestibular evaluation of infants and preschool children.  Otolaryngol Head Neck Surg. 1985;  93(4) 463-468
• 14 Arriaga M A, Chen D A, Cenci K A. Rotational chair (ROTO) instead of electronystagmography (ENG) as the primary vestibular test.  Otolaryngol Head Neck Surg. 2005;  133(3) 329-333
• 15 Stockwell C W. Vestibular testing: past, present, future.  Br J Audiol. 1997;  31(4) 387-398
• 16 Hamid M A. Determining side of vestibular dysfunction with rotatory chair testing.  Otolaryngol Head Neck Surg. 1991;  105(1) 40-43
• 17 O'Leay D, Davis-O'Leay L. Active head rotation testing. In: Jacobson G, Shepard N Balance Function Assessment and Management. San Diego, CA; Plural Publishing 2008: 319-337
• 18 Tirelli G, Bigarini S, Russolo M, Giacomarra V, Sasso F. Test-retest reliability of the VOR as measured via Vorteq in healthy subjects.  Acta Otorhinolaryngol Ital. 2004;  24(2) 58-62
• 19 Corvera J, Corvera-Behar G, Lapilover V, Ysunza A. Evaluation of the vestibular autorotation test (VAT) for measuring vestibular oculomotor reflex in clinical research.  Arch Med Res. 2000;  31(4) 384-387
• 20 Guyot J P, Psillas G. Test-retest reliability of vestibular autorotation testing in healthy subjects.  Otolaryngol Head Neck Surg. 1997;  117(6) 704-707
• 21 Hanson J M, Goebel J A. Head slippage during broad-frequency rotational chair testing.  J Vestib Res. 1995;  5(5) 371-376
• 22 Furman J M, Durrant J D. Somatosensory cuing of head-only rotational testing.  J Vestib Res. 1999;  9(3) 189-195
• 23 Leopold H C, Doerr M, Thoden U. Cervico-ocular responses (COR) during slow sinusoidal head movements in subjects with bilateral labyrinthine lesions.  Arch Psychiatr Nervenkr. 1983;  233(6) 439-447
• 24 Della Santina C C, Cremer P D, Carey J P, Minor L B. Comparison of head thrust test with head autorotation test reveals that the vestibulo-ocular reflex is enhanced during voluntary head movements.  Arch Otolaryngol Head Neck Surg. 2002;  128(9) 1044-1054
• 25 Furman J M, Schor R H, Schumann T L. Off-vertical axis rotation: a test of the otolith-ocular reflex.  Ann Otol Rhinol Laryngol. 1992;  101(8) 643-650
• 26 Paige G D. Otolith function: basis for modern testing.  Ann N Y Acad Sci. 2002;  956 314-323