Patients with Bilateral Loss of Caloric Response

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Abstract
Forty-three of 2500 consecutive ENG monitored caloric-induced nystagmus examinations gave no response to 5 cc of ice water in either ear. Among these, nine had CNS neoplasms, of which six were in the midline posterior fossa, six had autoimmune or collagen disease, six were caused by infections (meningitis, otitis, syphilis), five were congenital involving only the ear, five were drug induced, four had combined visual and eighth nerve hereditary disorders. Infection excepted, hearing losses were an irregular associated finding in roughly 50% and were less common in the CNS and systemic disease categories. Neither clinical symptoms nor other ENG findings were good predictors for finding no response to caloric tests.

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