The Journal of International Advanced Otology
Original Article

Head-Shaking Nystagmus in the Early Stage of Unilateral Meniere’s Disease

1.

Department of Otolaryngology, University of Perugia, Perugia, Italy

2.

Department of Otolaryngology, University of Perugia, Perugia, Italy

3.

Department of Organ of Sense, University La Sapienza, Rome, Italy

4.

Department of Otolaryngology, Silvestrini Hospital, Perugia, Italy

J Int Adv Otol 2019; 15: 425-430
DOI: 10.5152/iao.2019.7338
Read: 167 Downloads: 75 Published: 17 December 2019

OBJECTIVES: The aim of the present study was to evaluate the ability of head-shaking nystagmus (HSNy), evoked after the resolution of a vertigo spell, to predict an imminent crisis in the early stage of Meniere’s disease (MD).

MATERIALS and METHODS: A total of 20 patients in the early stage of MD were included in the study. The head-shaking test (HST) was performed twice, during the first visit within 24 h of vertigo spell (T0) and 48 h later (T1). The onset of a new vertigo episode during the 2 weeks following the first visit was recorded in each patient’s medical record. The sensitivity and specificity of HSNy toward predicting a new vertigo episode were calculated.

RESULTS: At T0, an evoked ipsilesional HSNy in 15 (75%) patients was observed; in four of them, the HSNy had a biphasic component. The HSNy was present and persistent at T1 in 8 (42.1%) patients; among these cases, 6 patients had ipsilesional HSNy, and 2 patients a contralesional HSNy. None of the patients presented with a biphasic HSNy at T1. Seven (36.8%) patients experienced the recurrence of a vertigo crisis. Among these, 6 patients had ipsilesional HSNy at T1. Only 8 patients with ipsilesional HSNy at T0 did not have recurrence. The sensitivity of the ipsilesional HSNy in predicting the recurrence of vertigo in patients with MD was 100% at T0 and 85.7% at T1. The specificity was 46.6% and 100% at T0 and T1, respectively.

CONCLUSION: The HST can be a useful test in the early stages of MD to predict a new vertigo attack.

Cite this article as: Di Stadio A, Ricci G, Ralli M, Paolo T, Agostini G, Faralli M. Head-Shaking Nystagmus in the Early Stage of Unilateral Meniere’s Disease. J Int Adv Otol 2019; 15(3): 425-30.

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ISSN1308-7649 EISSN 2148-3817