Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study.

Siegrist, Stefanie; Wyss, Thomas; Korda, Athanasia; Mantokoudis, Georgios (2024). Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study. The journal of international advanced otology, 20(3), pp. 241-246. AVES 10.5152/iao.2024.231249

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Siegrist, Stefanie Ninette, Wyss, Thomas Werner, Korda, Athanasia, Mantokoudis, Georgios

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2148-3817

Publisher:

AVES

Language:

English

Submitter:

Pubmed Import

Date Deposited:

14 Aug 2024 11:42

Last Modified:

14 Aug 2024 11:42

Publisher DOI:

10.5152/iao.2024.231249

PubMed ID:

39128107

URI:

https://boris.unibe.ch/id/eprint/199636

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