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Updated: Feb 27, 2026

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Testing of all Six Semicircular Canals with Video Head Impulse Test Systems

Published on: April 18, 2019

The Video Head Impulse Test.

G M Halmagyi¹, Luke Chen¹, Hamish G MacDougall²

¹Neurology Department, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Frontiers in Neurology

|June 27, 2017

Summary

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Video Head Impulse Testing (vHIT) offers a precise method for assessing semicircular canal (SCC) function, evolving from cumbersome scleral search coils to a widely adopted clinical tool for vestibular disorders.

Area of Science:

Neuroscience
Ophthalmology
Otorhinolaryngology

Background:

Semicircular canal (SCC) function assessment historically relied on scleral search coils, a complex and inaccessible research tool.
Impulsive testing of SCC function evolved from scleral search coils to video Head Impulse Testing (vHIT).
vHIT has become a primary diagnostic tool in many dizzy clinics, replacing caloric testing.

Purpose of the Study:

To review the evolution and current status of Head Impulse Testing (HIT) for vestibular disorders.
To discuss advancements from the original head impulse protocol (HIMPs) to suppression head impulse protocol (SHIMPs).
To explore the physiological basis, practical aspects, and controversies surrounding vHIT.

Main Methods:

The study reviews the historical development of impulsive testing for SCC function.

Keywords:

SHIMP VOR head impulse test semicircular canal vestibular vestibulo-ocular reflex video head impulse test

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It details the transition from scleral search coil systems to video-based Head Impulse Testing (vHIT).

The abstract outlines key areas of discussion including HIMPs, SHIMPs, physiological basis, practical pitfalls, gain calculations, and application in central vestibular disorders.

Main Results:

vHIT has become a globally adopted clinical method for assessing individual SCC function.
It has demonstrated superior accuracy and reliability compared to previous methods.
vHIT is increasingly supplanting caloric testing in the diagnosis of vestibular disorders.

Conclusions:

Video Head Impulse Testing (vHIT) represents a significant advancement in vestibular diagnostics.
The technique is highly effective for evaluating all six semicircular canals individually.
Ongoing research continues to refine vHIT applications and uncover new clinical insights into vestibular disorders.