Mediterr. J. Otol 2008; 4:(1)

Head shake posturography in peripheral vestibular disorders

Abdel Matin Moussa, Somia Tawfik, Wafaa El Kholi, Mostafa Al-Haggagy

Otolaryngology Dept., Sohag University. wafaa_elkholi@yahoo.com

Objective: The Sensory Organization Test is specifically designed to measure the functional integration between different senses responsible for balance. Alterations in test protocol using changes in head position have been attempted in order to increase its sensitivity. The aim of this research was to study the value of Head Shake-Sensory Organization Test in pitch, yaw and roll axes in patients with peripheral vestibular disorders, and to measure its sensitivity and specificity.

Materials and method: Twenty patients with confirmed unilateral peripheral disorders constituted the study group. They were age- and sex-matched to 20 normal subjects. The study group differed significantly from the control group in head shake posturography condition 5 in all 3 axes and in condition 2 in both pitch and roll axes.

Results: There were significant differences between patients with negative and positive Sharpened Fukuda test, and between Benign Paroxysmal Positional Vertigo patients and those with caloric weakness, in condition 5 in the three tested axes. The most sensitive conditions were 5 in the pitch axis followed by 5 in the roll axis, with relatively poor specificity.

Conclusion: Based on results of the present study, head shake posturography test can be considered a good enhancement to the standard Sensory Organization Test, being appropriate for patients who perform within the normal range on the standard test, yet remain symptomatic. It can objectively measure an individual’s impairments with head movements and postural control, thereby providing evidence and guidelines for designing a more deficit-oriented rehabilitation for some dizzy patients.