Subjective visual vertical and subjective visual horizontal measures in patients with chronic dizziness

Abstract

Objectives: We aimed to find the frequency of otolith organ pathologies in the clinical picture of common dizziness etiologies in the chronic stage. Method: Subjective visual vertical and subjective visual horizontal measures were assessed in patients who had persistent or recurrent dizziness at least 2 months after the acute period. Every patient was tested in three head positions: neutral, right, or left deviation in the roll plane. Test results were compared with those of the control group. Results: Seventy-three patients and 18 controls were examined. Fifty-eight of the patients had peripheral vestibular disease; 15 of them had central vestibular disease. Left subjective visual horizontal (SVH) and right SVH measures of the peripheral group were significantly different from those of the control group (p < .01). There was no difference in any test between the peripheral and central groups. When we put a cut off point for abnormality (0, 1) according to mean ± 2 SD of the control group, the peripheral and central groups had very high significant differences from the control group. Approximately 25 to 50% of our patients had pathologic subjective visual vertical or SVH measures according to test type. Conclusion: These results showed that the otolith system must be evaluated in the chronic period of dizziness, especially in patients who frequently visit their physician, and modifications in treatment programs must be conducted.