Correlation between clinical diagnosis and claussens butterfly chart patterns in patients with vertigo


  • Sunderaswaran Meenakshi Department of Otorhinolaryngology, Sree Balaji Medical College and Hospital, Madras Medical College, Chennai, Tamil Nadu
  • Mohankumar Venugopal Department of Otorhinolaryngology, Rajiv Gandhi Govt General Hospital, Chennai, Tamil Nadu
  • Mcdonald Choultry Rajasekar Department of Otorhinolaryngology, Sree Balaji Medical College and Hospital, Madras Medical College, Chennai, Tamil Nadu



Butterfly chart, Electronystagmography, Vertigo


Background: Neurotology forms the grey area between otologists and neurologists. Vertigo is also a complex symptom that often has multiple pathologies leading to the presentation. Electronystagmography is a complex investigation that cannot be comprehended by many other doctors. The Claussens butterfly chart offers a simple pictoral representation of the caloric test that can be easily and immediately Understood by patients and other doctors.

Methods: 50 patients presenting to the Neurotology OPD with complaints of vertigo were subjected to this investigation and the butterfly chart derived. The correlation between the clinical diagnosis and the butterfly chart patterns studied.  

Results: The sensitivity and specificity of the butterfly code for central lesions is 75% and 73% respectively. The sensitivity and specificity of the butterfly code for peripheral lesions is 64.3% and 50% respectively.

Conclusions: The butterfly chart is a very simple and useful investigation that can help classify the etiology of vertigo as central or peripheral and thus help in treatment. It is also the only investigation that is helpful to localize the side of lesion in vertigo of any etiology.

Author Biography

Sunderaswaran Meenakshi, Department of Otorhinolaryngology, Sree Balaji Medical College and Hospital, Madras Medical College, Chennai, Tamil Nadu

Senior resident, Department of Otorhinolaryngology


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Original Research Articles