Clinical evaluation of the hot caloric test as a screening procedure

A clinical assessment of the relative values of the hot, the cold and the bithermal hot and cold caloric tests was carried out in a group of normals as compared to patients suffering from vestibular neuronitis, Ménière's disease, head injuries and acoustic neuromas. Results indicate that the hot or the cold test alone does not provide as much information as the bithermal test. A correlation of this result was made to the presence of a spontaneous nystagmus, positional nystagmus and directional preponderance. These forms of nystagmus present are unable to predict the indication for the hot caloric test alone. It is concluded that bithermal tests be continued until further progress on standardization and normal data are available for each of the three sets of tests, obtained separately.