Video head impulse test in bilateral vestibulopathy.

Area of Science:

• Neuroscience
• Ophthalmology
• Audiology

Background:

• Bilateral vestibulopathy is a rare chronic condition causing unsteadiness and oscillopsia.
• The impact of bilateral vestibulopathy on quality of life is variable and debated.
• Current diagnostic tools may not fully capture functional deficits.

Purpose of the Study:

• To evaluate the video Head Impulse Test (vHIT) for quantifying vestibular deficits.
• To determine the impact of vHIT parameters on patients' quality of life.

Main Methods:

• Twenty patients with bilateral vestibulopathy were assessed using the Situational Vertigo Questionnaire.
• Vestibular examination included fixation, positional tests, oculomotor tests, and vHIT.
• Statistical analysis correlated vHIT parameters with quality of life scores.

Main Results:

• Patients exhibiting covert saccades on vHIT reported better quality of life than those with overt saccades.
• The presence of covert saccades correlated with improved quality of life, irrespective of vestibulo-ocular reflex (VOR) gain.
• VOR gain measured by vHIT did not correlate with the severity of quality of life impairment.

Conclusions:

• Covert saccades represent an adaptive strategy that enhances vision during head movements, improving quality of life.
• vHIT is a valuable tool for assessing adaptive mechanisms in bilateral vestibulopathy.
• vHIT should be incorporated into the routine diagnostic evaluation of bilateral vestibulopathy.