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Results of caloric tests

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Cold water reduces the vestibular output from one side, creating an imbalance and producing eye drift towards the irrigated ear - nystagmus results from rapid corrective movements.

Hot water increases the vestibular output, reverses the correction current and changes the direction of the nystagmus.

Remember COWS - Cold Opposite Warm Same.

Abnormalities on caloric testing encompass:

  • canal paresis - responses to hot and cold on one side are diminished or absent
  • directional preponderance - nystagmus to one side is easier to induce than nystagmus to the other side, irrespective of which ear is irrigated

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