Section: 
Historical Section
Historical SectionOn some bright pages in the history of vestibulology of the twentieth century. (Historical review, discussion questions). Part 5. Changing approaches in justification of the causes of vestibular dysfunction — from Barany’s tests
A. A. Vavilova (1)
(1) Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, Saint Petersburg, 194044, Russian Federation
UDK: УДК 616.281:617.761-009.24(091)
DOI: https://doi.org/10.18692/1810-4800-2024-2-115-124
ABSTRACT
Part 5 continues the series of publications dedicated to the bright pages of the history of vestibulology of the XX century. The article examines changes in approaches to justification of the causes of dizziness over the last century — from the development of pathognomonic tests by scientists-vestibulologists in the XX century to the introduction of a symptomatic criterion approach by researchers in recent decades. As examples of the objective, morphofunctional approach of scientists of the XX century in substantiating vestibular disorders, the following are given: the use of Robert Barany's caloric test and radiography to identify acoustic neuroma; experiments by K. L. Khilov to confirm the role of otoliths in motion sickness; pathohistological studies of H. F. Schucknech (1969) and S. F. Hall (1979) when explaining the mechanisms of otolithiasis; the works of K. S. Hallpike, H. Cairns (1938) and K. Yamakawa, who showed endolymphatic hydrops in Meniere's disease. The importance of the development by scientists of the XX century of pathognomonic tests for the diagnosis of vestibular diseases is emphasized — for example, the Dix—Hallpike, Pagnini—McClure and others tests for BPPV, the Halmagyi test for the diagnosis of vestibular neuritis. There is debate about the insufficiency of the symptomatic approach, which is based on complaints and patient`s history, but does not offer objective tests in the diagnosis of such relatively new nosologies as vestibular paroxysmia, vestibular migraine, functional vertigo or persistent postural perceptual vertigo (PPV). It is assumed that in the practice of an ordinary otolaryngologist and neurologist, without the use of objective techniques — videooculography (VOG), electronystagmography (ENG), etc., as well as without examination by a vestibulologist, a patient with supposed “functional vertigo” may turn out to be an “underexamined” patient, and the existing objective cause of dizziness may be missed. There is hope that in the future new objective methods will appear that will allow, firstly, to establish new vestibular diseases, and, secondly, to objectify and better describe the already proposed new nosologies with the symptomatic composition of criteria (vestibular migraine, vestibular paroxysmia, etc.).
Publication date:
17.04.2024
Keywords:
symptoms, vertigo, vestibular, pathognomonic symptom, morpho-functional justification, Dix—Hallpike test; benign paroxysmal positional vertigo (BPPV), otolithiasis, Meniere’s disease, endolymphatic hydrops, vestibular neuritis, Halmagyi—Curthous test, video head-impulse test (vHIT) For citation:
Vavilova A. A. A On some bright pages in the history of vestibulology of the twentieth century. (Historical review, discussion questions). Part 5. Changing approaches in justification of the causes of vestibular dysfunction — from Barany’s tests to functional vertigo Russian Otorhinolaryngology. 2024;23(2):115-124. https://doi.org/10.18692/1810-4800-2024-2-115-124