[Exploration of the value of VAS score in the diagnosis and treatment of patients with vestibular diseases during caloric test].

Objective

To identify the factors influencing the visual analogue scale（VAS） scores for distress experienced by patients with vestibular diseases during caloric tests, and to explore the value of VAS scores in disease diagnosis and treatment.

Methods

A retrospective analysis was performed on 420 patients diagnosed with vestibular migraine（VM）, Meniere's disease（MD）, persistent postural-perceptual dizziness（PPPD）, vestibular neuritis（VN）, and sudden deafness with vertigo, respectively, who underwent caloric tests. The patients were asked to rate the most severe subjective discomfort they experienced during the test using the VAS. Statistical analysis was conducted to explore the correlations between VAS scores（dependent variable） and potential influencing factors, including disease type, gender, age, and maximum slow-phase velocity（SPV[max]）of the caloric test.

Results

①The subjective VAS scores of patients during the caloric test, ranked from highest to lowest, were as follows: VM（5.83）>PPPD（4.56）>MD（3.84）>VN（3.24）>sudden deafness with vertigo（2.60）. ②The results of univariate analysis showed that age, SPV, gender, and disease type all had a significant impact on the dependent variable VAS. ③Multivariate analysis revealed that there were significant differences in VAS scores among patients with different vestibular diseases（P<0.01）; VAS scores were significantly negatively correlated with age（P<0.001） and significantly positively correlated with SPV（max） values（P<0.001）; the VAS scores of female patients were significantly higher than those of male patients（P=0.004）.

Conclusion

The subjective degree of distress in response to similar vestibular stimulation varies considerably among patients with different vestibular disorders. Patients with VM and PPPD, which are associated with central nervous system dysfunction-experience higher distress levels than those with MD and VN. Additionally, female patients and younger patients tend to have more severe subjective distress.