scholarly journals The Video Head Impulse Test in a Case of Suspected Bilateral Loss of Vestibular Function

2014 ◽  
Vol 20 (01) ◽  
pp. 084-086 ◽  
Author(s):  
Pedro Albernaz ◽  
Flavia Cusin
Keyword(s):  
Vestibular Function ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Caloric Tests

Introduction A patient who had no symptoms suggestive of bilateral loss of vestibular function presented no responses in rotational and caloric tests. Objectives To demonstrate the importance of the video head impulse test in neuro-otologic diagnosis. Resumed Report This patient had a neuro-otologic evaluation and presented no responses in torsion swing tests, caloric tests, and rotational tests in a Bárány chair. The video head impulse test elicited responses in four of the six semicircular canals. Conclusion Absent responses in caloric and rotatory tests alone are not sufficient to diagnose bilateral loss of vestibular function.

scholarly journals Vestibular Function Measured Using the Video Head Impulse Test in Congenital Nystagmus and Vertigo: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Antonio Denia-Lafuente ◽  
Belén Lombardero
Keyword(s):  
Vestibular Function ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Congenital Nystagmus ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Vertical Semicircular Canals

In patients with congenital nystagmus (CN), the study of vestibular function is complicated by many factors related to the measurement of the vestibulo-ocular reflex (VOR) by means of caloric testing and the video head impulse test (vHIT), and to date no such studies have successfully employed the vHIT to evaluate vestibular function in these patients. We present a case with CN and vertigo in which peripheral vestibular function was evaluated using the vHIT system, including head impulse testing and the suppression head impulse protocol. We show that it is possible (a) to identify lateral VOR changes such as abnormalities resembling those produced by bilateral vestibular lesions, though not necessarily related to the same mechanism; (b) to identify peripheral VOR lesions of the vertical semicircular canals (SCC); and (c) to document compensation and recovery subsequent to these peripheral lesions during follow-up of patients with CN. vHIT is a useful tool that should be used to study vestibular function in patients with CN and vertigo, which could constitute a new clinical application of this technique.

Vestibular semicircular canal function as detected by video Head Impulse Test (vHIT) is essentially unchanged in people with Parkinson’s disease compared to healthy controls

2021 ◽  
pp. 1-9
Author(s):  
Kim E. Hawkins ◽  
Elodie Chiarovano ◽  
Serene S. Paul ◽  
Ann M Burgess ◽  
Hamish G. MacDougall ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Semicircular Canal ◽  
Neurodegenerative Disorder ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Healthy Controls ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Vestibulo Ocular Reflex

BACKGROUND: Parkinson’s disease (PD) is a common multi-system neurodegenerative disorder with possible vestibular system dysfunction, but prior vestibular function test findings are equivocal. OBJECTIVE: To report and compare vestibulo-ocular reflex (VOR) gain as measured by the video head impulse test (vHIT) in participants with PD, including tremor dominant and postural instability/gait dysfunction phenotypes, with healthy controls (HC). METHODS: Forty participants with PD and 40 age- and gender-matched HC had their vestibular function assessed. Lateral and vertical semicircular canal VOR gains were measured with vHIT. VOR canal gains between PD participants and HC were compared with independent samples t-tests. Two distinct PD phenotypes were compared to HC using Tukey’s ANOVA. The relationship of VOR gain with PD duration, phenotype, severity and age were investigated using logistic regression. RESULTS: There were no significant differences between groups in vHIT VOR gain for lateral or vertical canals. There was no evidence of an effect of PD severity, phenotype or age on VOR gains in the PD group. CONCLUSION: The impulsive angular VOR pathways are not significantly affected by the pathophysiological changes associated with mild to moderate PD.

Vestibular function assessment of Susac syndrome patients by the video head impulse test and cervical vestibular-evoked myogenic potentials

2020 ◽  
Vol 30 (6) ◽  
pp. 393-399
Author(s):  
Yahav Oron ◽  
Ophir Handzel ◽  
Zohar Habot-Wilner ◽  
Keren Regev ◽  
Arnon Karni ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Vestibular Function ◽  
Pure Tone Audiometry ◽  
Sensorineural Hearing ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Susac Syndrome

BACKGROUND: Susac syndrome (retino-cochleo-cerebral vasculopathy, SuS) is an autoimmune endotheliopathy characterized by the clinical triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss. In contrast to data regarding auditory function, data measuring vestibular function is sparse and the cervical vestibular-evoked myogenic potentials (cVEMPs). OBJECTIVE: To determine whether the video head impulse test (vHIT) can serve as a confirmatory assessment of vestibulocochlear dysfunction in cases of suspected SuS. METHODS: Seven patients diagnosed with SuS underwent pure tone audiometry, a word recognition test, cVEMPs and the vHIT. RESULTS: Five patients were diagnosed with definite SuS, and two with probable SuS. Two patients were asymptomatic for hearing loss or tinnitus, and no sensorineural hearing loss was detected by audiograms. Four patients complained of tinnitus, and three patients reported experiencing vertigo. Three patients had abnormal cVEMPs results. All seven patients’ vHIT results were normal, except for patient #2, who was one of the three who complained of vertigo. The calculated gain of her left anterior semicircular canal was 0.5, without saccades. CONCLUSIONS: This is the first study to describe the results of the vHIT and cVEMPs among a group of patients with SuS. The results suggest that the vHIT should not be the only exam used to assess the function of the vestibular system of SuS patients.

Acute vertigo in the ENT emergency

2021 ◽  
Vol 70 (3) ◽  
pp. 146-155
Author(s):  
Václav Albrecht ◽  
Lukáš Školoudík ◽  
Peter Sila ◽  
Jan Mejzlík ◽  
Michal Janouch ◽  
...  
Keyword(s):  
Emergency Department ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Video Assisted ◽  
Vestibular Testing ◽  
Group A ◽  
The Difference ◽  
Group B

Summary Introduction: Acute vertigo ranks among the common reasons for visiting the emergency department. The aim of this study was to evaluate the rate of peripheral vestibular syndrome (PVS) in patients with acute vertigo examined at the ENT emergency department and to compare the agreement of physical ENT examination with video-assisted vestibular testing. Methods: Patients eamined at the ENT emergency department from January to December 2019 were evaluated retrospectively. The patients who underwent basic ENT examination without video-assisted vestibular testing form group A. The patients who underwent basic ENT examination which was followed by video head impulse test (vHIT) and videonystagmography in the next four days form group B. Results: A total of 117 patients with acute vertigo were included in group A, PVS was found in 31 patients (27%). In total, 50 patients were included in group B; PVS was found in 15 patients (30%), vestibular neuronitis was dia­gnosed most often (10 patients). The difference in the dia­gnosis of PVS by basic ENT examination (27 patients, 54%) and by video-assisted vestibular testing (15 patients, 30%) was statistically significant (P = 0.0030). The gain of the lateral (P = 0.0101) and superior (P = 0.0043) semicircular canal proved to be statistically significant, while vHIT was lower in PVS in comparison to other causes of vertigo. Conclusion: After basic ENT examination, PVS as a cause of acute vertigo was dia­gnosed in 27%. Video-assisted vestibular testing proved a statistically significant lower incidence of PVS in comparison to basic ENT examination. Accessibility of video- -assisted vestibular testing in the emergency department might allow for higher accuracy in the dia­gnosis of acute vertigo. Key words acute vertigo – vestibular function tests – video head impulse test – videonystagmography

scholarly journals Effects of Device on Video Head Impulse Test (vHIT) Gain

2017 ◽  
Vol 28 (09) ◽  
pp. 778-785 ◽  
Author(s):  
Kristen L. Janky ◽  
Jessie N. Patterson ◽  
Neil T. Shepard ◽  
Megan L. A. Thomas ◽  
Julie A. Honaker
Keyword(s):  
Normal Control ◽  
Vestibular Function ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Vestibular Loss ◽  
Directional Bias ◽  
Horizontal Canal ◽  
Head Impulse ◽  
Control Subjects ◽  
Bilateral Vestibular Loss

AbstractNumerous video head impulse test (vHIT) devices are available commercially; however, gain is not calculated uniformly. An evaluation of these devices/algorithms in healthy controls and patients with vestibular loss is necessary for comparing and synthesizing work that utilizes different devices and gain calculations.Using three commercially available vHIT devices/algorithms, the purpose of the present study was to compare: (1) horizontal canal vHIT gain among devices/algorithms in normal control subjects; (2) the effects of age on vHIT gain for each device/algorithm in normal control subjects; and (3) the clinical performance of horizontal canal vHIT gain between devices/algorithms for differentiating normal versus abnormal vestibular function.Prospective.Sixty-one normal control adult subjects (range 20–78) and eleven adults with unilateral or bilateral vestibular loss (range 32–79).vHIT was administered using three different devices/algorithms, randomized in order, for each subject on the same day: (1) Impulse (Otometrics, Schaumberg, IL; monocular eye recording, right eye only; using area under the curve gain), (2) EyeSeeCam (Interacoustics, Denmark; monocular eye recording, left eye only; using instantaneous gain), and (3) VisualEyes (MicroMedical, Chatham, IL, binocular eye recording; using position gain).There was a significant mean difference in vHIT gain among devices/algorithms for both the normal control and vestibular loss groups. vHIT gain was significantly larger in the ipsilateral direction of the eye used to measure gain; however, in spite of the significant mean differences in vHIT gain among devices/algorithms and the significant directional bias, classification of “normal” versus “abnormal” gain is consistent across all compared devices/algorithms, with the exception of instantaneous gain at 40 msec. There was not an effect of age on vHIT gain up to 78 years regardless of the device/algorithm.These findings support that vHIT gain is significantly different between devices/algorithms, suggesting that care should be taken when making direct comparisons of absolute gain values between devices/algorithms.

scholarly journals Effect of steroid therapy on saccule and semicircular canals function in patients with unilateral sudden sensorineural hearing loss

2020 ◽  
Author(s):  
Fahimeh Esmaeili ◽  
Mansoureh Adel Ghahraman ◽  
Reza Hoseinabadi ◽  
Reza Hoseinabadi ◽  
Shohreh Jalaie ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Steroid Therapy ◽  
Semicircular Canals ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Before And After

Background and Aim: In unilateral sudden sensorineural hearing loss (SSNHL), the ves­tibular system may be involved in addition to the auditory system. Several hearing assess­ments have shown that the disease course and the patient's improvement, at least two step of vestibular assessments can help in better control of the patient's balance function. The aim of this study was to evaluate the results of cervical ves­tibular evoked myogenic potentials (cVEMP) and video head impulse test (vHIT) used for assessment of saccule and semicircular canals before and after steroid therapy. Methods: Twenty three patients with SSNHL were evaluated for auditory and vestibular func­tion before and after steroid therapy. The results of cVEMP and vHIT were compared between intact and impaired ears and between pretest/posttest stages before and after treatment. Results: For 26.08% of patients, the cVEMP response was absent in the affected ear, but after treatment it was reported for all patients. There was a significant difference in vestibulo-ocular reflex (VOR) gain for both posterior and ante­rior semicircular canals of affected ear before and after treatment, but it was not significantly different after treatment as VOR gain increased. Conclusion: Dysfunction of nervous and vesti­bular systems in SSNHL is possible. Steroid therapy can improve the vestibular function and hearing of these patients. Therefore, vestibular evaluation can be used to determine the extent of lesions in SSNHL.   Keywords: Unilateral sudden sensorineural hearing loss; vestibular evoked myogenic potentials; saccule; semicircular canals; video head impulse test

scholarly journals Vestibulo-ocular reflex gain and compensatory saccades in three semicircular canals by video head impulse test

2019 ◽  
Author(s):  
Homa Zarrinkoob ◽  
Hadi Behzad ◽  
Seyed Mehdi Tabatabaee
Keyword(s):  
High Velocity ◽  
Semicircular Canals ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Low Velocity ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Vestibulo Ocular Reflex ◽  
Reflex Gain ◽  
The Right

Background and Aim: One of the tools for ass­essing the vestibulo-ocular reflex (VOR) is using video head impulse test (vHIT). In this test by placing the head at different angles and shaking the head, three semicircular canals of the vestibular system in each ear can be exami­ned separately. The purpose of this study was to investigate the relationship between the low and high velocities of the vHIT test with VOR and its compensatory saccades. Methods: The vHIT test was performed by an examiner in 49 normal individuals aged 23–39 at low and high velocities. All participants had normal hearing, visual, and vestibular systems. Results: Mean gains in the horizontal, anterior and posterior semicircular canals in the right ear respectively were 0.92, 1 and 0.90 and in the left ear 0.93, 0.99 and 0.95 for low velocity and 0.78, 0.92 and 0.79 in the right ear and 0.80, 0.85 and 0.86 in the left ear for high velocity. Also, the number of compensatory saccade at high velocity was higher than those at the low velocity and the latency of compensatory sacc­ade was lower at the higher velocity. Conclusion: In the vHIT test, VOR gain decreases at high velocity that is statistically significant. Also, compensatory saccades are more likely to occur at high velocity with sma­ller delay. Therefore, high-velocity vHIT test is not recommended for the purpose of examining the VOR gain and compensatory saccade.

scholarly journals Comparison of two systems for the video head impulse test (vHIT) for the lateral semicircular canal: description of results from normal and pathological subjects

2021 ◽  
Vol 79 (7) ◽  
pp. 571-578
Author(s):  
Lilian Felipe
Keyword(s):  
Objective Assessment ◽  
Semicircular Canals ◽  
Small Sample ◽  
Head Impulse Test ◽  
Functional Evaluation ◽  
Video Head Impulse Test ◽  
Vestibular Disorder ◽  
Head Impulse ◽  
Two Systems ◽  
Head Impulses

ABSTRACT Background: The video head impulse test (vHIT) is a recent technique for functional evaluation of semicircular canals (SSCs). The vHIT examines eye movements at high frequencies of stimulation and provides an objective assessment of the functioning of the high-frequency domain of the vestibular system. Objective: To describe the results from vHIT performed using two systems. Methods: All subjects were evaluated through an audiological and otoneurological battery of tests and were diagnosed as normal or abnormal by an otorhinolaryngologist. The results from two systems: 1. ICS Impulse (Otometrics/Natus, Denmark) and 2. EyeSeeCam (InterAcoustics, Denmark) were recorded. The same operator delivered every impulse to every subject. The head impulses were performed while the operator was standing behind the subject, using both hands on the top of the subject’s head, well away from the goggles strap and forehead skin. Two calibrations were completed in each system, prior to beginning the test. Results: Test parameters were recorded through both systems for healthy subjects with no history or complaint of any vestibular disorder (N = 12; M/F = 5/7; age 35.1 ± 13.5 y) and for pathological subjects with a diagnosis of unilateral or bilateral vestibular disorder (N = 15; M/F = 7/8; age 53.4 ± 16.7 y). Conclusions: The vHIT is an important tool for otoneurological complementary evaluation. Both systems are reliable for vestibular disorders. The EyeSeeCam seems to reject fewer data and provides more information to include in diagnostics. Because of the small sample, there is a need for further in-depth comparison of both systems.

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