Related Experiment Video
Updated: Aug 26, 2025
Testing of all Six Semicircular Canals with Video Head Impulse Test Systems
Published on: April 18, 2019
Video head impulse testing: Pitfalls in neurological patients
Nehzat Koohi1, Surangi Mendis2, Amy Lennox3
1Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, Queen Square, London, UK; The Ear Institute, University College London, London, UK.
Abstract:
The video head impulse test (vHIT) assesses the vestibulo-ocular reflex (VOR) during a rapid high-velocity low amplitude (10°-20°) head rotation. Patients with peripheral vestibulopathy have a reduced VOR gain with corrective catch-up saccades during the head turn. There are several pitfalls, mainly technical, which may interfere with interpretation of vHIT data. In addition, intrusive eye movement disorders such as spontaneous nystagmus that affect normal eye position and tracking can affect the vHIT results. To date there has been little study of neurological saccadic eye movements that may interfere with the interpretation of vHIT data. Here, in ten patients with a range of central neurological disorders, we describe oculomotor abnormalities on vHIT in the presence of normal range VOR gain values, recorded at a tertiary vestibular neurology service.
