Acronym “COWS” is used for?
Correct Answer: Bithermal caloric test
Description: ANSWER: (C) Bithermal caloric testREF: Dhingra 4th ed page 43FITZGERALD-H ALLPIKE TEST (BITHERMAL CALORIC TEST).In this test, patient lies supine with head tilted 30" forward so that horizontal canal is vertical. Ears are irrigated for 40 seconds alternately with water at 30degC and at 44"C (i.e. 7deg below and above normal body temperature) and eyes observed for appearance of nystagmus till its end point. Time taken from the start of irrigation to the end point of nystagmus is recorded and charted on a calorigram. If no nystagmus is elicited from any ear, test is repeated with water at 20degC for 4 minutes for labelling the labyrinth dead. A gap of 5 minutes should be allowed between two ears . Cold water induces nystagmus to opposite side and warm water to the same side (remember mnemonic COWS: Cold- Opposite, Warm-Same). Depending on response to the caloric test, we can find canal paresis or dead labyrinth, directional preponderance, i.e. nystagmus is more in one particular direction than in the other, or both canal paresis and directional preponderance
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