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Comparison of techniques for identification of peripheral vestibular nystagmus

Published online by Cambridge University Press:  26 October 2012

P D B West ,
Z A Sheppard  and
E V King
P D B West*
Affiliation:
Department of Audiovestibular Medicine, Queen Alexandra Hospital, Portsmouth, UK
Z A Sheppard
Affiliation:
School of Health and Social Care, Bournemouth University, UK
E V King
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Poole Hospital NHS Foundation Trust, UK Cancer Sciences Division, University of Southampton, UK
*
Address for correspondence: Dr P D B West, Department of Audiovestibular Medicine, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK Fax: +44 (0)2392 283238 E-mail: pdbwest@doctors.org.uk
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Abstract

Objective:

To determine the best clinical method for identifying peripheral vestibular nystagmus, by comparing eye movement examination with optic fixation, and with fixation removed using Frenzel's glasses, infra-red video-Frenzel's goggles or an ophthalmoscope, with results of electronystagmography.

Method:

One hundred patients referred for electronystagmography from the audiovestibular medicine clinic at Queen Alexandra Hospital, Portsmouth, were examined immediately before undergoing electronystagmography.

Results:

Video-Frenzel's goggles were highly effective at detecting peripheral vestibular nystagmus, with a sensitivity of 85 per cent (95 per cent confidence interval, 62.1–96.8 per cent) and a specificity of 65 per cent (53.5–75.3 per cent), compared with electronystagmography. Ophthalmoscopy had comparable sensitivity to Frenzel's glasses (used in the dark), i.e. 26.3 per cent (9.1–51.2 per cent) compared with 31.6 per cent (12.6–56.6 per cent), respectively. Frenzel's glasses as normally used in ENT clinics (i.e. in dim lighting) were ineffective, with a sensitivity of just 10 per cent (1.2–31.7 per cent).

Conclusion:

Video-Frenzel's goggles should be used in all clinics with substantial numbers of balance-impaired patients. Traditional Frenzel's glasses have no place in clinical practice unless formal black-out facilities are available.

Keywords

VertigoDiagnosisNystagmusElectronystagmographyFrenzel's Glasses

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 12 , December 2012 , pp. 1209 - 1215
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented in abridged, poster form at the British Society of Audiology Annual Conference, 8–10 September 2010, Manchester, UK

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