Enhancing The Accuracy In Diagnosing Peripheral Vestibular Disorders

Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Therefore, this study was conducted to enhance the accuracy in diagnosing PVD by investigating two new tests, i.e. VEMP and MVVSS to be compared with caloric test and Dix-Hallpike test (DHT). In this study, 40 normal participants and 65 PVD subjects participated. Sensitivity and specificity of each test was then determined using ROC method. Among VEMP parameters, N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity and specificity. In fact, VEMP was found to be the most sensitive test. Surprisingly, the combination of canal paresis (CP) of caloric test and DHT yielded low sensitivity values. The combination of MVVSS and VEMP produced acceptably high sensitivity values. The combination of all four tests yielded the sensitivity of 80% on both sides. The combination of all four tests significantly increases the sensitivity to diagnose PVD patients. Consequently, the accuracy in PVD diagnosis can be enhanced and the number of false negative cases can be reduced greatly.