Advertisement

A paradox in the video head impulse test

  • Ken Johkura
    Correspondence
    Corresponding author at: Department of Neurology, Yokohama Brain and Spine Center, 1-2-1 Takigashira, Isogo-ku, Yokohama 235-0012, Japan.
    Affiliations
    Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan

    Department of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan
    Search for articles by this author
  • Koji Takahashi
    Affiliations
    Department of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan
    Search for articles by this author
Published:August 02, 2022DOI:https://doi.org/10.1016/j.jns.2022.120378
      Dizziness is one of the most common complaints in the general population. The caloric test has long been considered the gold standard for identifying peripheral vestibular deficits in the differential diagnosis of dizziness. In 1988, the head impulse test was reported as a test to detect peripheral vestibular deficits [
      • Halmagyi G.M.
      • Curthoys I.S.
      A clinical sign of canal paresis.
      ]. With the help of high-speed video recording and quantitative head velocity measurement, the head impulse test with video assistance (video head impulse test; vHIT) is now becoming a new gold standard for estimating peripheral vestibular function. Especially in the emergency room, the vHIT may have a greater impact on dizziness diagnosis than the caloric test because it is simpler and non-invasive: a head thrust test with goggles. During vHIT, the strap attaching the goggle to the head should be as tight as possible because goggle slippage may lead to inaccurate measurement [
      • Suh M.W.
      • Park J.H.
      • Kang S.I.
      • Lim J.H.
      • Park M.K.
      • Kwon S.K.
      Effect of goggle slippage on the video head impulse test outcome and its mechanisms.
      ]. However, we found that strap tightness also affects the results of vHIT.

      Keywords

      Abbreviations:

      VOR (vestibulo-ocular reflex), LC (lateral semicircular canal), vHIT (video head impulse test)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Halmagyi G.M.
        • Curthoys I.S.
        A clinical sign of canal paresis.
        Arch. Neurol. 1988; 45: 737-739https://doi.org/10.1001/archneur.1988.00520310043015
        • Suh M.W.
        • Park J.H.
        • Kang S.I.
        • Lim J.H.
        • Park M.K.
        • Kwon S.K.
        Effect of goggle slippage on the video head impulse test outcome and its mechanisms.
        Otol. Neurotol. 2017; 38: 102-109https://doi.org/10.1097/MAO.0000000000001233
        • Christensen J.E.
        New treatment of spasmodic torticollis?.
        Lancet. 1991; 338: 573https://doi.org/10.1016/0140-6736(91)91138-k
        • Takahashi K.
        • Johkura K.
        Vestibulo-ocular reflex gain changes in the hanger reflex.
        J. Neurol. Sci. 2022; 438 (May 11): 120277https://doi.org/10.1016/j.jns.2022.120277
        • Cabolis K.
        • Steinberg A.
        • Ferrè E.R.
        Somatosensory modulation of perceptual vestibular detection.
        Exp. Brain Res. 2018; 236: 859-865https://doi.org/10.1007/s00221-018-5167-9