Despite the importance of symptomatology in the diagnosis of vestibular dysfunction, the qualitative nature of the symptoms related to semicircular canal (canal) versus otolith dysfunction is not fully understood. The purpose of this study was to compare symptoms, and their severity, in individuals with canal versus otolith peripheral vestibular dysfunction. A subjective tool, the Descriptive Symptom Index (DSI), was developed to enable categorization of symptoms as rotary, linear, imbalance or falls, and nondistinct. Fourteen adults were recruited and grouped based on vestibular function testing: canal only dysfunction, otolith only dysfunction, or canal and otolith dysfunction. Also, the Dizziness Handicap Inventory (DHI) was used to grade the severity of perceived limitations due to symptoms. The DSI was reliable and differentiated those with canal (rotary symptoms) versus otolith (linear symptoms) dysfunction. Most individuals with otolith only dysfunction did not report rotary symptoms. DHI scores were significantly higher in those with otolith dysfunction, regardless of canal functional status. All who experienced falls had otolith dysfunction and none had canal only dysfunction. Results support the importance of using linear and rotary descriptors of perceived disorientation as part of diagnosing vestibular dysfunction. 1. Introduction A comprehensive patient history, which includes the qualitative nature of symptoms, is paramount when making the diagnosis of peripheral vestibulopathy (P-VeD) in adults who report dizziness and/or imbalance [1–3]. Rotary vertigo has traditionally been accepted as the primary descriptor related to P-VeD [2, 4–6]. The diagnosis is often confirmed with objective measurement of the functional integrity of the semicircular canals (canals) using calorics, rotational chair, head impulse, and/or Dix-Hallpike testing [4]. However, the clinical diagnostic process has been limited because measurement of otolith function has not been readily available. Also, the qualitative nature of the symptoms of otolith dysfunction has not been formally investigated and determined [7, 8]. Tomanovic and Bergenius [3], who studied the prevalence of different types of dizziness symptoms in subjects with P-VeD, expanded the understanding of subjective descriptors by concluding that in addition to the classic symptoms of vertigo, the presence of “nonclassical” symptoms, such as drop attacks, unsteadiness like walking on a boat, walking on pillows, stepping into a hole, and feeling like being pulled to one side, occur in these individuals. In
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