Assessment: Vestibular testing techniques in adults and children - Report of the Therapeutics and Technology Assessment Subcommitte of the American Academy of Neurology

Quantitative vestibular testing, whether caloric or rotational, may be used as a confirmatory test when the clinical history and examination suggest vestibular dysfunction. For suspected unilateral peripheral vestibular lesions (e.g., Meniere's or vestibular neuronitis) caloric testing as done with electronystagmography is the most helpful. Patients suspected of having bilateral peripheral vestibular dysfunction (e.g., gentamicin ototoxicity) are best studied using rotational chair testing, though caloric testing is acceptable and AHR shows promise. Passive rotational testing without a motorized chair apparatus shows some promise as an alternative to a rotational chair testing in some instances, but the data in support of this are still limited. AHR techniques appear promising for detecting bilateral peripheral vestibular loss, but there is insufficient evidence to support recommending it to detect unilateral peripheral vestibular loss. Children can be tested using any of the techniques used in adults. There is more variability in the range of normal in children, but caloric and rotational vestibular studies can be performed in children with modest technique modifications.