Video head impulse and suppression head impulse test in vestibular migraine

Area of Science:

• Neurology
• Ophthalmology
• Vestibular System Function

Background:

• Vestibular Migraine (VM) is a common cause of recurrent vertigo.
• The Video Head Impulse Test (vHIT) can be performed using two methods: HIMP and SHIMP.
• Previous studies show conflicting results regarding vHIT findings in VM patients.

Purpose of the Study:

• To compare HIMP and SHIMP paradigms in VM patients versus healthy controls.
• To investigate potential differences in vHIT outcomes between these groups.
• To clarify the diagnostic utility of vHIT in VM.

Main Methods:

• 48 VM patients and 27 healthy controls were tested.
• Both HIMP (earth-fixed target) and SHIMP (head-fixed target) paradigms were employed.
• Vestibulo-ocular reflex (VOR) gain was measured for each semicircular canal.

Main Results:

• VM patients exhibited normal mean VOR gain in both HIMP and SHIMP paradigms.
• Some individual semicircular canals showed VOR impairments in VM patients.
• VM patients with motion sickness had lower horizontal VOR gain with HIMP compared to those without.

Conclusions:

• Vestibular migraine patients typically present with normal VOR gain on vHIT using either paradigm.
• A significantly abnormal vHIT result is unlikely to be solely due to VM.
• Alternative diagnoses should be considered when vHIT is markedly abnormal in suspected VM.