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caloric testing

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Caloric testing
Flushing warm and cold water into the ear stimulates the labyrinth and causes vertigo and nystagmus if all the nerve pathways are intact.
Mentioned in: Gulf War Syndrome

caloric testing 
A neuro-ophthalmic technique in which cold and warm water is used to stimulate the vestibular system creating horizontal nystagmus (called caloric nystagmus or Barany's nystagmus). Cold water placed in the ear induces a fast-beating vestibular nystagmus with the fast phase moving away from the stimulated ear, while warm water causes the fast phase to move in the direction of the stimulated ear. The mnemonic COWS (cold-opposite, warm-same) is used to describe this effect. By placing the subject at a 30-degree upright position, heated or cooled water stimulates the now vertical horizontal semicircular canals.


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All patients underwent otologic historytaking, physical examination, audiography, caloric testing (baseline warm only), and magnetic resonance imaging (to exclude a retrocochlear lesion) before the initial injection.
Follow-up ENG showed nystagmus in the right lateral position, and caloric testing elicited no warm or cool responses in the right ear.
Electronystagmography (ENG) revealed a direction-changing positional nystagmus, a 35% reduced vestibular response (RVR) left on alternate binaural bithermal caloric testing, and a type 2 response that revealed the RVR left on simultaneous binaural bithermal testing (figure 1).
 
 
 
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