The Video Head Impulse Test: Our Experience in 45 Cases

Area of Science:

• Neurology
• Otolaryngology
• Vestibular System Diagnostics

Background:

• Peripheral vestibular disorders affect balance and spatial orientation.
• Accurate diagnosis is crucial for effective treatment and management.
• Clinical head impulse test (cHIT) has limitations in assessing vestibular function.

Purpose of the Study:

• To evaluate the diagnostic role of the video head impulse test (vHIT) in peripheral vestibular disorders.
• To compare the diagnostic accuracy of vHIT with the conventional clinical head impulse test (cHIT).

Main Methods:

• An observational study was conducted in an outpatient tertiary care setting.
• 45 patients with suspected peripheral vestibular disorders underwent both cHIT and vHIT.
• Results from both tests were individually correlated for each ear.

Main Results:

• Abnormalities were detected in 12 out of 90 ears using cHIT for lateral semicircular canals.
• Abnormalities were detected in 27 out of 90 ears using vHIT for lateral semicircular canals.
• vHIT provided an additional diagnostic accuracy of 21.1% compared to cHIT for lateral semicircular canals.

Conclusions:

• vHIT is a valuable, quick, and well-tolerated test for assessing vestibular function.
• vHIT offers superior diagnostic capabilities, especially for vertical semicircular canal function.
• vHIT provides objective data on vestibulo-ocular reflex gain and covert refixation saccades, enhancing lesion localization.