scholarly journals Clinical Implication of Corrective Saccades in the Video Head Impulse Test for the Diagnosis of Posterior Inferior Cerebellar Artery Infarction

2021 ◽  
Vol 12 ◽  
Author(s):  
Gi-Sung Nam ◽  
Hyun-June Shin ◽  
Jin-Ju Kang ◽  
Na-Ri Lee ◽  
Sun-Young Oh
Keyword(s):  
Semicircular Canal ◽  
Posterior Inferior Cerebellar Artery ◽  
Mean Amplitude ◽  
Head Impulse Test ◽  
Stroke Patients ◽  
Horizontal Semicircular Canal ◽  
Head Impulse ◽  
Cerebellar Artery ◽  
Corrective Saccades ◽  
The Mean

Objective: In the present study, we characterized the vestibulo-ocular reflex (VOR) gain and properties of corrective saccades (CS) in patients with posterior inferior cerebellar artery (PICA) stroke and determined the best parameter to differentiate PICA stroke from benign peripheral vestibular neuritis (VN). In particular, we studied CS amplitude and asymmetry in video head impulse tests (vHITs) to discriminate these two less-studied disease conditions.Methods: The vHITs were performed within 1 week from symptom onset in patients with PICA stroke (n = 17), patients with VN (n = 17), and healthy subjects (HS, n = 17).Results: PICA stroke patients had bilaterally reduced VOR gains in the horizontal semicircular canal (HC) and the posterior semicircular canal (PC) compared with HSs. When compared with VN patients, PICA stroke patients showed preserved gains in the HC and anterior semicircular canal (AC) bilaterally (i.e., symmetric VOR gain). Similar to VOR gain, smaller but bilaterally symmetric CS in the HC and AC were observed in PICA stroke patients compared with VN patients; the mean amplitude of CS for the ipsilesional HC was reduced (p < 0.001, Mann–Whitney U-test), but the mean amplitude of CS for the contralesional HC was increased (p < 0.03, Mann–Whitney U-test) in PICA stroke compared with VN. The receiver operating characteristic (ROC) curve showed that CS amplitude asymmetry (CSs) and VOR gain asymmetry (Gs) of HC are excellent parameters to distinguish PICA stroke from VN.Conclusion: In the current study, we quantitatively investigated the VOR gain and CS using vHITs for three semicircular canals in PICA stroke and VN patients. In addition to VOR gain, quantitative assessments of CS using vHITs can provide sensitive and objective parameters to distinguish between peripheral and central vestibulopathies.

Video Head Impulse Testing (vHIT) and the Assessment of Horizontal Semicircular Canal Function

2015 ◽  
Vol 26 (05) ◽  
pp. 518-523 ◽  
Author(s):  
Kristal M. Riska ◽  
Owen Murnane ◽  
Faith W. Akin ◽  
Courtney Hall
Keyword(s):  
Semicircular Canal ◽  
Objective Assessment ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potentials ◽  
Head Impulse Test ◽  
Clinical Test ◽  
Horizontal Semicircular Canal ◽  
Head Impulse ◽  
New Instrument ◽  
Qualitative Test

Background: Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been developed to provide an objective assessment to the clinical test. Questions persist regarding how this test may be used in the overall vestibular test battery. Purpose: The purpose of this case report is to describe vestibular test results (vHIT, rotational testing, vestibular evoked myogenic potentials, and balance and gait performance) in an individual with a 100% unilateral caloric weakness who was asymptomatic for dizziness, vertigo or imbalance. Data Collection and/or Analysis: Comprehensive assessment was completed to evaluate vestibular function. Caloric irrigations, rotary chair testing, vHIT, and vestibular evoked myogenic potentials were completed. Results: A 100% left-sided unilateral caloric weakness was observed in an asymptomatic individual. vHIT produced normal gain with covert saccades. Conclusions: This case demonstrates the clinical usefulness of vHIT as a diagnostic tool and indicator of vestibular compensation and functional status.

scholarly journals Head Impulse Test

2012 ◽  
Vol 4 (2) ◽  
pp. 106-111 ◽  
Keyword(s):  
Semicircular Canal ◽  
Prognostic Significance ◽  
The Other ◽  
Reliable Indicator ◽  
Head Impulse Test ◽  
Caloric Test ◽  
Horizontal Semicircular Canal ◽  
Head Impulse ◽  
Vestibular Deficit ◽  
Simple Bedside

ABSTRACT In 1988, Michael Halmagyi and Ian Curthuoys described a simple yet reliable indicator of unilateral peripheral vestibular deficits at the bedside. This ‘head impulse test’ (HIT) as is has been known since, has stood the test of being a reliable indicator of vestibular deficit, especially for the horizontal semicircular canal. The test has been described using various techniques, such as the scleral search coil, the video HIT, etc. but even a simple bedside clinical evaluation with a little amount of experience usually sufficed to detect overt vestibular deficits. Numerous studies have compared the efficacy of the HIT as compared with other tests of vestibular deficit, the caloric test (CT) being the most commonly compared one. A look at the physiology behind the two tests reveals the differing pathways tested by the two tests in mention, and hence it would be wise to say that the two are complimentary, rather than exclusive of the other. The HIT today forms a vital part of the armamentarium of the otologist to arrive at rapid understanding of the nature of the vestibular deficit, the laterality of the lesion, and the probable prognostic significance. How to cite this article Khattar VS, Hathiram BT. Head Impulse Test. Otorhinolaryngol Clin Int J 2012;4(2):106-111.

scholarly journals Does vestibulo-ocular reflex gain measured by video head impulse test decrease with age?

2021 ◽  
Vol 7 (5) ◽  
pp. 712
Author(s):  
Yijin Jereme Gan ◽  
Yih Meei Heng ◽  
Shailesh Khode ◽  
Aruni Seneviratna ◽  
Annabelle Leong
Keyword(s):  
Semicircular Canal ◽  
Semicircular Canals ◽  
Community Dwelling ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Ocular Reflex ◽  
Age Dependent ◽  
Vestibulo Ocular Reflex ◽  
The Mean

<p class="abstract"><strong>Backgrounds:</strong> The Video Head Impulse Test (vHIT) is used to test the function of each of the six semicircular canals. Each semicircular canal is tested by measuring eye rotation in response to head movements in the plane of the canal and is calculated as the Vestibulo-ocular reflex (VOR) gain. The aims of the study were firstly, to determine age-dependent normative values of VOR gain for the vHIT of semicircular canal function in healthy Asian subjects in each decade year of life. Secondly, to investigate if vHIT measured VOR gain decreases with age.</p><p class="abstract"><strong>Methods: </strong>A prospective cohort study of 60 healthy voluntary community-dwelling subjects, between 21 to 80 years of age. Subjects with prior history of vertigo were excluded. vHIT was conducted on each subject and analysed with the Interacoustics (EyeSeeCam) video goggles by the senior audiologist. The VOR gain for all six semicircular canals were calculated for each subject.</p><p class="abstract"><strong>Results: </strong>The mean (SD) vHIT (VOR) gain of all the 6 semicircular canals for the entire population were 1.18 (0.19). The mean of the VOR gain for each of the six semicircular canals were analysed to develop a normative guide. The mean VOR gain per decade year did not vary significantly with age (p=0.417). The correlation between age and mean VOR values was negligible (pearson’s r=0.121).</p><p class="abstract"><strong>Conclusions: </strong>We propose that our normative age-dependent data guide be used to improve the differentiation between normal and abnormal values of VOR gain in an Asian population. Our study shows that VOR gain is not associated with aging.</p>

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.

Hemifacial Spasm: Endoscopic Vascular Decompression

1997 ◽  
Vol 117 (4) ◽  
pp. 308-314 ◽  
Author(s):  
J. Magnan ◽  
F. Caces ◽  
P. Locatelli ◽  
A. Chays
Keyword(s):  
Hemifacial Spasm ◽  
Marked Improvement ◽  
Cerebellopontine Angle ◽  
Posterior Inferior Cerebellar Artery ◽  
Endoscopic Examination ◽  
Anterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
The Mean ◽  
Vascular Decompression

Sixty patients with primitive hemifacial spasm were treated by means of a minimally invasive retrosigmoid approach in which endoscopic and microsurgical procedures were combined. Intraoperative endoscopic examination of the cerebellopontine angle showed that for 56 of the patients vessel-nerve conflict was the cause of hemifacial spasm. The most common offending vessel was the posterior inferior cerebellar artery (39 patients), next was the vertebral artery (23 patients), and last was the anterior inferior cerebellar artery (16 patients). Nineteen of the patients had multiple offending vascular loops. In one patient, another cause of hemifacial spasm was an epidermoid tumor of the cerebellopontine angle. For three patients, it was not possible to determine the exact cause of the facial disorder. Follow-up information was reviewed for 54 of 60 patients; the mean follow-up period was 14 months. Fifty of the patients were in the vessel-nerve conflict group. Forty of the 50 were free of symptoms, and four had marked improvement. The overall success rate was 88%, and there was minimal morbidity (no facial palsy, two cases of severe hearing loss).

scholarly journals The Video Head Impulse Test (vHIT) Detects Vertical Semicircular Canal Dysfunction

PLoS ONE ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. e61488 ◽  
Author(s):  
Hamish Gavin MacDougall ◽  
Leigh Andrew McGarvie ◽  
Gabor Michael Halmagyi ◽  
Ian Stewart Curthoys ◽  
Konrad Peter Weber
Keyword(s):  
Semicircular Canal ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Vertical Semicircular Canal

Comparison of three diagnostic tests in detecting vestibular deficit in patients with peripheral vestibulopathy

2015 ◽  
Vol 130 (2) ◽  
pp. 145-150 ◽  
Author(s):  
P Eza-Nuñez ◽  
C Fariñas-Alvarez ◽  
N Perez Fernandez
Keyword(s):  
Statistical Power ◽  
Laboratory Data ◽  
Head Impulse Test ◽  
Video Head Impulse Test ◽  
Test Results ◽  
Horizontal Semicircular Canal ◽  
Predictive Values ◽  
Head Impulse ◽  
Peripheral Vestibulopathy ◽  
Line Test

AbstractObjectives:This study aimed to evaluate the results of the video head impulse test and of the caloric and rotatory chair tests in patients with dizziness. Agreement between test results was assessed and the best protocol for detecting peripheral vestibulopathy was identified.Methods:Participants comprised 116 patients, 75 with a peripheral vestibulopathy and 41 with non-peripheral vestibulopathy. The main outcome measures were classified as normal or abnormal according to our laboratory data.Results:Agreement between tests was low. Vestibulopathy testing that required all three results to be abnormal had a sensitivity of 0.547, a specificity of 0.878, and positive and negative predictive values of 0.891 and 0.514, respectively. Vestibulopathy testing that required just one result to be abnormal had a sensitivity of 0.933, a specificity of 0.292, and positive and negative predictive values of 0.701 and 0.705, respectively.Conclusion:In peripheral vestibulopathy, there was weak concordance in the assessment of horizontal semicircular canal function among the different tests. However, the video head impulse test had sufficient statistical power to be recommended as the first-line test.

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