Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study
BACKGROUND: Assessment of nystagmus fixation suppression can be used as an additional diagnostic tool for patients with an acute vestibular syndrome to distinguish between a central or peripheral cause. We investigated the ability of physicians to detect fixation suppression using a nystagmus simula...
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| Format: | Article |
| Language: | English |
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2024-05-01
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| Series: | Journal of International Advanced Otology |
| Online Access: | https://www.advancedotology.org/en/clinical-assessment-of-the-nystagmus-fixation-suppression-test-an-experimental-study-131925 |
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| author | Stefanie Siegrist Thomas Wyss Athanasia Korda Georgios Mantokoudis |
| author_facet | Stefanie Siegrist Thomas Wyss Athanasia Korda Georgios Mantokoudis |
| author_sort | Stefanie Siegrist |
| collection | DOAJ |
| description | BACKGROUND: Assessment of nystagmus fixation suppression can be used as an additional diagnostic tool for patients with an acute vestibular syndrome to distinguish between a central or peripheral cause. We investigated the ability of physicians to detect fixation suppression using a nystagmus simulation model.
METHODS: We used a nystagmus simulator to measure the accuracy of the nystagmus fixation suppression test. Fixation suppression was assessed randomly in 6170 trials by 20 otorhinolaryngologists and neurologists, segregated into 2 groups based on their neurootological experience, a beginner and an experienced group. The simulator presented random nystagmus slow velocity (SPV) reductions and presented 3 conditions with either changed nystagmus frequency, amplitude, or both.
RESULTS: The cutoff for the discernment of fixation suppression ranged from 1.2 to 14°/s nystagmus velocity difference. The more intense the baseline nystagmus was, the more difficult was the detection of fixation suppression. There was not significant difference (P > .05) in the cutoff values in the experts group compared to the novices for all 3 different conditions. Both, novices and experts, detected frequency changes easier than differences of the nystagmus amplitude. Test sensitivity was very low (19%-65%) for discernment of small nystagmus velocity differences of ≤2°/s by experts.
CONCLUSION: In our study, there was no difference between experts and novices in detection of nystagmus suppression by visual fixation. The examiners could only detect large suppression effects at low-intensity baseline nystagmus. Overall, the sensitivity and accuracy of a clinical fixation suppression test is low and the assistance with a video-oculography device is highly recommended. |
| format | Article |
| id | doaj-art-9fb8ba91c5624b3fb46b51cc20d5fcca |
| institution | Kabale University |
| issn | 2148-3817 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | AVES |
| record_format | Article |
| series | Journal of International Advanced Otology |
| spelling | doaj-art-9fb8ba91c5624b3fb46b51cc20d5fcca2025-02-03T11:20:46ZengAVESJournal of International Advanced Otology2148-38172024-05-0120324124610.5152/iao.2024.231249Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental StudyStefanie Siegrist0Thomas Wyss1Athanasia Korda2Georgios Mantokoudis3Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, SwitzerlandDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, SwitzerlandDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, SwitzerlandDepartment of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, SwitzerlandBACKGROUND: Assessment of nystagmus fixation suppression can be used as an additional diagnostic tool for patients with an acute vestibular syndrome to distinguish between a central or peripheral cause. We investigated the ability of physicians to detect fixation suppression using a nystagmus simulation model. METHODS: We used a nystagmus simulator to measure the accuracy of the nystagmus fixation suppression test. Fixation suppression was assessed randomly in 6170 trials by 20 otorhinolaryngologists and neurologists, segregated into 2 groups based on their neurootological experience, a beginner and an experienced group. The simulator presented random nystagmus slow velocity (SPV) reductions and presented 3 conditions with either changed nystagmus frequency, amplitude, or both. RESULTS: The cutoff for the discernment of fixation suppression ranged from 1.2 to 14°/s nystagmus velocity difference. The more intense the baseline nystagmus was, the more difficult was the detection of fixation suppression. There was not significant difference (P > .05) in the cutoff values in the experts group compared to the novices for all 3 different conditions. Both, novices and experts, detected frequency changes easier than differences of the nystagmus amplitude. Test sensitivity was very low (19%-65%) for discernment of small nystagmus velocity differences of ≤2°/s by experts. CONCLUSION: In our study, there was no difference between experts and novices in detection of nystagmus suppression by visual fixation. The examiners could only detect large suppression effects at low-intensity baseline nystagmus. Overall, the sensitivity and accuracy of a clinical fixation suppression test is low and the assistance with a video-oculography device is highly recommended.https://www.advancedotology.org/en/clinical-assessment-of-the-nystagmus-fixation-suppression-test-an-experimental-study-131925 |
| spellingShingle | Stefanie Siegrist Thomas Wyss Athanasia Korda Georgios Mantokoudis Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study Journal of International Advanced Otology |
| title | Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study |
| title_full | Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study |
| title_fullStr | Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study |
| title_full_unstemmed | Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study |
| title_short | Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study |
| title_sort | clinical assessment of the nystagmus fixation suppression test an experimental study |
| url | https://www.advancedotology.org/en/clinical-assessment-of-the-nystagmus-fixation-suppression-test-an-experimental-study-131925 |
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