Nonspecific vertigo with normal otoneurological examination. The role of vestibular laboratory tests

Vestibular laboratory tests are not generally necessary in the diagnosis of patients with a clear description of vertigo accompanied by positive otoneurological examination findings. The purpose of the study was to investigate the role of conventional vestibular laboratory tests in the diagnosis of patients complaining of nonspecific vertigo, despite their having a documented normal otoneurological examination. The results of the standard electronystagmography (ENG) and sinusoidal harmonic acceleration (SHA) tests of 52 patients referred for ambulatory vestibular laboratory tests due to a nonspecific illusion of movement, but with a normal otoneurological examination, were reviewed. Abnormalities were found in the vestibular tests of 35 patients (67 per cent), 22 of whom (63 per cent) were finally diagnosed as having a unilateral peripheral vestibular lesion, and 13 (37 per cent) benign positional vertigo. These results suggest that a high percentage of patients with nonspecific vertigo and a normal otoneurological examination probably suffer from peripheral vestibular dysfunction, which can be objectively documented by the ENG and SHA tests.