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Updated: Jun 19, 2026
08:38
Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
Published on: April 18, 2019
The video head impulse test: diagnostic accuracy in peripheral vestibulopathy
H G MacDougall1, K P Weber, L A McGarvie
1Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, Australia.
Neurology
|October 7, 2009
Summary
The video head impulse test (vHIT) accurately identifies vestibular deficits, matching the gold standard search coil method. This user-friendly vHIT is ideal for clinical use, even in acute cases.
Area of Science:
- Neurology
- Ophthalmology
- Audiology
Background:
- The bedside head impulse test (HIT) detects peripheral vestibular deficits.
- Subtle vestibulo-ocular reflex (VOR) deficits may be missed without precise measurement.
- Scleral search coils, the gold standard, are impractical for routine clinical use due to discomfort.
Purpose of the Study:
- To develop an easy-to-use video head impulse test (vHIT) for clinical identification of peripheral vestibular deficits.
- To validate vHIT diagnostic accuracy against simultaneous search coil recordings in healthy subjects and patients.
Main Methods:
- Horizontal HIT was recorded simultaneously using vHIT (250 Hz) and search coils (1,000 Hz).
- Participants included 8 normal subjects and 14 patients with various peripheral vestibular deficits.
Main Results:
- vHIT and search coil recordings showed high comparability (concordance correlation coefficient r(c) = 0.930).
- No significant differences in mean VOR gain were found between vHIT and search coils in normal subjects or patients.
- vHIT demonstrated high sensitivity and specificity (1.0) in detecting peripheral vestibular deficits, accurately identifying overt and covert saccades.
Conclusions:
- The video head impulse test (vHIT) is a clinically viable tool equivalent to search coils for diagnosing peripheral vestibular deficits.
- vHIT offers a practical, user-friendly alternative for routine vestibular assessment, including in patients with acute vestibular neuritis.
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