The Torsion Swing as a Vestibular Test

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Abstract
A total of 677 patients complaining of dizziness were tested electronystagmographically with the torsion swing. The results were compared to those of the bithermal caloric examination obtained for the same patients. Only 38.9% responded similarly to both tests. It was found that only 52.9% of patients with no preponderance on the torsion swing had no preponderance on the caloric test. Only 27.4% of patients that had directional preponderance on the torsion swing had directional preponderance in the same direction on the caloric test. A patient with acoustic neuroma had a normal response to torsion-swing stimulation but was found to have labyrinthine preponderance and directional preponderance by caloric examination. This illustrates that it is impossible to rely solely on the torsion-swing test and that torsion-swing stimulation cannot replace caloric stimulation as a clinical test. The test should be used with the understanding that a positive test expresses labyrinthine activity, while a negative test does not indicate inactive labyrinthine function.

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