Research Article

Diagnostic Value of the Video Head Impulse Test in Patients with Vertigo: Can It Be Used as a Screening Tool?

Abstract

Background and Aim: Several laboratory tools are used to evaluate balance disorders but, there is still no screening test to determine the site and the severity of the lesion. The aim was to investigate whether video Head Impulse Test (vHIT) can be used as a screening test in patients with chronic or recurrent vertigo and dizziness.
Methods: The files of 965 patients who were followed up in our vertigo outpatient clinic were reviewed retrospectively. Vestibulo-Ocular Reflex (VOR) gains and saccadic movements of the right and left lateral canals in the vHIT test, and Canal Paresis (CP) in the Caloric Testing (CT) were noted.
Results: A total of 325 patients were included in our study. In CT results, the group that CP was most frequently detected was Menière’s Disease (MD) group (71 patients (74.7%). While vHIT results were found to be pathological in the vast majority of patients in the Vestibular Neuritis (VN) group (72.7%), the results were found to be normal at the highest rate in the vestibular migraine group (77.9%). Correlation analysis showed a significant but weak correlation between the degree of CP in the CT and the VOR gains of the lateral canals in vHIT in all groups.
Conclusion: Although it has high sensitivity in cases with VN and vestibulopathy, we think that vHIT cannot be used as a screening tool in patients with vertigo, especially for chronic cases, since its sensitivity rate differs in the long term according to the cause of the disease.

1. Neuhauser HK. The epidemiology of dizziness and vertigo. In: Furman JM, Lempert T, editors. Handbook of Clinical Neurology. Elsevier; 2016. p. 67-82. [DOI:10.1016/B978-0-444-63437-5.00005-4]
2. Walther LE. Current diagnostic procedures for diagnosing vertigo and dizziness. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16:Doc02. [DOI:10.3205/cto000141]
3. Halmagyi GM, Chen L, MacDougall HG, Weber KP, McGarvie LA, Curthoys IS. The Video Head Impulse Test. Front Neurol. 2017;8:258. [DOI:10.3389/fneur.2017.00258]
4. Bartolomeo M, Biboulet R, Pierre G, Mondain M, Uziel A, Venail F. Value of the video head impulse test in assessing vestibular deficits following vestibular neuritis. Eur Arch Otorhinolaryngol. 2014;271(4):681-8. [DOI:10.1007/s00405-013-2451-y]
5. Blödow A, Heinze M, Bloching MB, von Brevern M, Radtke A, Lempert T. Caloric stimulation and video-head impulse testing in Ménière’s disease and vestibular migraine. Acta Otolaryngol. 2014;134(12):1239-44. [DOI:10.3109/00016489.2014.939300]
6. Mahringer A, Rambold HA. Caloric test and video-headimpulse: a study of vertigo/dizziness patients in a community hospital. Eur Arch Otorhinolaryngol. 2014;271(3):463-72. [DOI:10.1007/s00405-013-2376-5]
7. Yilmaz MS, Egilmez OK, Kara A, Guven M, Demir D, Genc Elden S. Comparison of the results of caloric and video head impulse tests in patients with Meniere’s disease and vestibular migraine. Eur Arch Otorhinolaryngol. 2021;278(6):1829-34. [DOI:10.1007/s00405-020-06272-5]
8. van de Berg R, van Tilburg M, Kingma H. Bilateral Vestibular Hypofunction: Challenges in Establishing the Diagnosis in Adults. ORL J Otorhinolaryngol Relat Spec. 2015;77(4):197- 218. [DOI:10.1159/000433549]
9. McCaslin DL, Rivas A, Jacobson GP, Bennett ML. The dissociation of video head impulse test (vHIT) and bithermal caloric test results provide topological localization of vestibular system impairment in patients with “definite” Ménière’s disease. Am J Audiol. 2015;24(1):1-10. [DOI:10.1044/2014_AJA-14-0040]
10. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995;113(3):181-5. [DOI:10.1016/S0194-5998(95)70102-8]
11. Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001;56(4):436-41. [DOI:10.1212/wnl.56.4.436]
12. Vallim MGB, Gabriel GP, Mezzalira R, Stoler G, Chone CT. Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis. Braz J Otorhinolaryngol. 2021;87(6):733-41. [DOI:10.1016/j.bjorl.2021.01.002]
13. Park P, Park JH, Kim JS, Koo JW. Role of video-head impulse test in lateralization of vestibulopathy: Comparative study with caloric test. Auris Nasus Larynx. 2017;44(6):648-54. [DOI:10.1016/j.anl.2016.12.003]
14. Alhabib SF, Saliba I. Video head impulse test: a review of the literature. Eur Arch Otorhinolaryngol. 2017;274(3):1215-22. [DOI:10.1007/s00405-016-4157-4]
15. MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology. 2009;73(14):1134-41. [DOI:10.1212/WNL.0b013e3181bacf85]
16. van Esch BF, Nobel-Hoff GE, van Benthem PP, van der Zaag-Loonen HJ, Bruintjes TD. Determining vestibular hypofunction: start with the video-head impulse test. Eur Arch Otorhinolaryngol. 2016;273(11):3733-9. [DOI:10.1007/s00405-016-4055-9]
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IssueVol 33 No 2 (2024) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/avr.v33i2.14818
Keywords
Video head impulse test videonystagmography screening tool correlation vestibulopathy caloric testing
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How to Cite
1.
Eğilmez OK, Yılmaz MS, Elden SG, Koçoğlu M, Kara A, Güven M. Diagnostic Value of the Video Head Impulse Test in Patients with Vertigo: Can It Be Used as a Screening Tool?. Aud Vestib Res. 2023;33(2):152-161.