Results of caloric tests
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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