Diagnostic Potential of the Simple Cold Caloric Test

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Abstract
The simple cold caloric test with 5 ml of 20°C water (simple test) and then the alternate cold and hot caloric test of Fitzgerald and Hallpike (alternate test) were performed following the spontaneous and the positional nystagmus test in 46 patients complaining of vertigo. The eye movements were recorded with eyes open in darkness on an electronystagmogram.Canal paresis (CP) was diagnosed by the simple test and the alternate test in 35 of the 46 patients. Of the remaining 11, 3 showed CP in the simple test, but not in the alternate test, and 8 showed CP in the alternate test, but not in the simple test. In 5 of these 8 patients, the simple test demonstrated substantial differences in the maximum slow phase velocity of caloric nystagmus between the right and the left sides; however, the maximum slow phase velocities on the side showing a lesser reaction were not considered as being abnormally weak. Thirteen of the 26 patients showing spontaneous nystagmus had no DP in the alternate test, but all 13 patients showing DP had spontaneous nystagmus.These findings demonstrate that application of the simple cold caloric test together with the spontaneous and positional nystagmus tests provides sufficient information, so that the alternate cold and hot caloric test is not necessary.

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