The video head impulse test: first clinical experiences

• Published in: HNO 2013-04, Vol.61 (4), p.327-334
• Main Authors: Blödow, A, Helbig, R, Wichmann, N, Bloching, M, Walther, L E
• Format: Article
• Language: ger
• Subjects: Acceleration; Eye Movements - physiology; Female; Head Movements - physiology; Humans; Male; Middle Aged; Physical Examination; Physical Stimulation - methods; Pilot Projects; Reflex, Vestibulo-Ocular - physiology; Reproducibility of Results; Sensitivity and Specificity; Vestibular Function Tests - methods; Video Recording - methods
• ISSN: 1433-0458
• DOI: 10.1007/s00106-012-2592-0

Side-specific test procedures are mandatory in order to assess the function of peripheral vestibular receptors. Semicircular canals (SCC) and vestibulo-ocular reflex (VOR) can be tested by the Halmagyi and Curthoy head impulse test (HIT) and recently by means of the video head impulse test (vHIT). The vHIT procedure is a new method to measure eye and head velocity during brief and rapid head impulses. This method provides objective information of VOR and detects both overt and covert catch-up saccades. As clinical experiences with vHIT are limited, in this study the horizontal VOR (hVOR) was examined by means of the vHIT in 142 consecutive patients with acute or chronic vestibular syndrome. A total of 20 healthy volunteers served as a control group and exhibited a normal average VOR gain of 0.97 ± 0.09 without re-fixation saccades. In patients, 47.6% showed a pathological vHIT whereas 52.4% revealed a normal test result. Covert catch-up saccades could be revealed in 13.7% by means of vHIT whereas in 86.3% overt catch-up saccades alone or in combination with covert catch-up saccades were found in the majority of catch-up saccades in peripheral vestibular disorders. By means of the vHIT it is possible to obtain a side-specific and quantitative assessment of hVOR. Video-head impulse test is a reliable tool for vestibular testing even in bedside examinations of patients suffering from dizziness.