Experience with Video Head Impulse Testing (vHIT)
Abstract Introduction and objective: The diagnosis and study of vestibular pathology has been always guided by the medical history, exploration and caloric test. The caloric test has some limitations because it only allows the study of horizontal semicircular canal and it is also poorly tolerated by patients. Alternatively, the vHIT (Video Head Impulse Test), allows the analysis of all semicircular channels being quicker to perform and less obtrusive. The objective of the following study is to reflect our initial experience with the vHIT and compare it with another diagnosis tests. Method: This is a observational, prospective and descriptive study, of one year of observation in our Healthcare center for all patients who described symptoms of dizziness, unsteadiness or vertigo. Results: A total of 155 patients were included. There was a clear predominance of females, being Meniere's disease the most frequently diagnosed entity. The diagnosis was reached by vHIT. Caloric test was also performed in patients without definite or doubt in the diagnosis. With the data, the statistical relationships were established, being significant between sex with vestibular neuritis and vestibular migraine. There was a statistically significant relationship between vestibule-ocular reflex and caloric test associated with the previous pathologies. Discussion: The head impulse assisted video is a quick, simple and well tolerated technique without adverse symptoms like the caloric test. The disparities of results are due to differences in the stimulated frequencies, being the vHIT more physiological. Conclusions: vHIT facilitates the complementary diagnosis of acute pathology, being a well-tolerated technique. However, in pathologies with central compensation the results by vHIT may be normal, requiring the caloric test for better diagnostic approach.
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Batuecas Caletrío A, Mu-oz Herrera A, Bronstein AM. Importancia de la maniobra de impulso óculo-cefálico o Head impulse test en la con-sulta otorrinolaringológica general. Rev Soc Oo-rrinolaringol Castilla Leon Cantab La Rioja. 2012; 3 (32): 266-70. Disponible en: http://hdl.handle.net/10366/124477. [Citado el 30-09-2016].
Becker W, Heinz Naumann H, Rudolf Pfaltz C. Otorrinolaringología, Manual ilustrado. Barcelo-na: Doyma; 1992.
Bell SL, Barker F, Heselton H, MacKenzie E, Dewhurst D, Sanderson A. A study of the rela-tionship between the video head impulse test and air calorics. Eur Arch Otorhinolaryngol. 2015;272(5):1287-94. https://doi.org/10.1007/s00405-014-3397-4
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50. https://doi.org/10.1016/j.ncl.2015.04.010
Breinbauer H, Anabalón JL. Prueba de Impulso Cefálico. Rev Otorrinolaringol Cir Cabeza Cuello 2011;71:123-30. https://doi.org/10.4067/S0718-48162011000200004
Carriel C, Rojas M. Prueba de impulso cefálico: Bases fisiológicas y métodos de registro del reflejo vestíbulo oculomotor. Rev Otorrinolaringol Cir Cabeza Cuello. 2013;73(2):206-12. https://doi.org/10.4067/S0718-48162013000200014
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Hamilton SS, Zhou G, Brodsky JR. Video head impulse testing (VHIT) in the pediatric population. Int J Pediatr Otorhinolaryngol. 2015;79(8):1283-7. https://doi.org/10.1016/j.ijporl.2015.05.033
Hülse R, Hörmann K, Servais JJ, Hülse M, Wen-zel A. Clinical experience with video Head Impul-se Test in children. Int J Pediatr Otorhinolaryngol. 2015;79(8):1288-93. https://doi.org/10.1016/j.ijporl.2015.05.034
MacDougall H.G, Weber KP, McGarvie LA, Halmagyi GM., Curthoys IS. The video head impulse test. Diagnostic accuracy in peripheral vestibulopathy. Ann Neurol. 2009;73(14):1134-41. https://doi.org/10.1212/WNL.0b013e3181bacf85
MacDougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. Application of the video head impulse test to detect vertical semicircular canal dysfunction. Otol Neurotol. 2013;34(6):974-9. https://doi.org/10.1097/MAO.0b013e31828d676d
Magliulo G, Iannella G, Gagliardi S, Massimo R. A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vesti-bular neuritis. Eur Arch Otorhinolaryngol. 2014; 272(11):3277-81. https://doi.org/10.1007/s00405-014-3404-9
Maheu M, Houde MS, Landry SP, Champoux F. The Effects of Aging on Clinical Vestibular Evaluations. Front Neurol. 2015; 22;6:205.
Mi?o?ski J, Pietkiewicz P, Bieli?ska M, Ku?mierczyk K, Olszewski J. The use of vi-deonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo. Int J Occup Med Environ Health. 2014;27(4):583-90.
Murdin L, Schilder AG. Epidemiology of balance symptoms and disorders in the community: a systematic review. Otol Neurotol. 2015;36(3):387-92. https://doi.org/10.1097/MAO.0000000000000691
Newman-Toker DE, Saber Tehrani AS, Manto-koudis G, Pula JH, Guede CI, Kerber KA, Blitz A, Ying SH, Hsieh YH, Rothman RE, Hanley DF, Zee DS, Kattah JC. Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes. Stroke. 2013;44(4):1158-61. https://doi.org/10.1161/STROKEAHA.111.000033
Pe-a A. El examen vestibular abreviado, de-scripción, interpretación y análisis. Rev Otorrinola-ringol Cir Cabeza Cuello 2011;71: 135-44. https://doi.org/10.4067/S0718-48162011000200006
Pérez-Fernández N, Gallegos-Constantino V, Barona Lleo L, Manrique Huarte R. Exploración Clínica y videoasistida del reflejo vestíbulo-oculomotor: análisis comparativo. Acta Otorrino-laringol. 2012;63(6): 429-35. https://doi.org/10.1016/j.otorri.2012.04.010
Rambold Holger A. Economic management of vertigo/dizziness disease in a county hospital: video-head-impulse test vs. caloric irrigation. Eur Arch Oto-rhinolaryngol. 2015;272(10):2621-8. https://doi.org/10.1007/s00405-014-3205-1
Suárez C, Gil-Carcedo LM, Medina JE, Marco J, Ortega P, Trinidad J. Tratado de Otorrinolaringo-logía y Cirugía de Cabeza Y Cuello. Tomo II: Madrid; Panamericana. 2008.
Weber KP, MacDougall HG, Halmagyi GM, Curthoys IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci. 2009;1164:486-91. https://doi.org/10.1111/j.1749-6632.2008.03730.x
Yang CJ, Lee JY, Kang BC, Lee HS, Yoo MH, Park HJ. Quantitative analysis of gains and catch-up saccades of video-head-impulse te-sting by age in normal subjects. Clin Otolaryngol. 2016;41(5):532-8. https://doi.org/10.1111/coa.12558
Yoo MH, Kim SH, Lee JY, Yang CJ, Lee HS, Park HJ. Results of video head impulse and caloric tests in 36 patients with vestibular migraine and 23 patients with vestibular neuritis: A preliminary report. Clin Otolaryngol. 2015; 9. https://doi.org/10.1111/coa.12556
Batuecas Caletrío A, Martín Sanz E, Trinidad Ruiz G, Espinosa Sánchez JM, Alemán López O. Migra-a vestibular: Diagnóstico y tratamiento. Rev Soc Otorrinolaringol Castilla Leon Cantab La Rioja. 2013; 4(5):21-9. Di-sponible en: http://hdl.handle.net/10366/124501. [Citado el 30-09-2016].
Batuecas Caletrío A, Mu-oz Herrera A, Bronstein AM. Importancia de la maniobra de impulso óculo-cefálico o Head impulse test en la con-sulta otorrinolaringológica general. Rev Soc Oo-rrinolaringol Castilla Leon Cantab La Rioja. 2012; 3 (32): 266-70. Disponible en: http://hdl.handle.net/10366/124477. [Citado el 30-09-2016].
Becker W, Heinz Naumann H, Rudolf Pfaltz C. Otorrinolaringología, Manual ilustrado. Barcelo-na: Doyma; 1992.
Bell SL, Barker F, Heselton H, MacKenzie E, Dewhurst D, Sanderson A. A study of the rela-tionship between the video head impulse test and air calorics. Eur Arch Otorhinolaryngol. 2015;272(5):1287-94. https://doi.org/10.1007/s00405-014-3397-4
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50. https://doi.org/10.1016/j.ncl.2015.04.010
Breinbauer H, Anabalón JL. Prueba de Impulso Cefálico. Rev Otorrinolaringol Cir Cabeza Cuello 2011;71:123-30. https://doi.org/10.4067/S0718-48162011000200004
Carriel C, Rojas M. Prueba de impulso cefálico: Bases fisiológicas y métodos de registro del reflejo vestíbulo oculomotor. Rev Otorrinolaringol Cir Cabeza Cuello. 2013;73(2):206-12. https://doi.org/10.4067/S0718-48162013000200014
Furman J, JS Barton J, Evaluation of the patient with vertigo. UpToDate. 2014. Disponible en: www.uptodate.com. [Citado el 08-12- 2014].
Hamilton SS, Zhou G, Brodsky JR. Video head impulse testing (VHIT) in the pediatric population. Int J Pediatr Otorhinolaryngol. 2015;79(8):1283-7. https://doi.org/10.1016/j.ijporl.2015.05.033
Hülse R, Hörmann K, Servais JJ, Hülse M, Wen-zel A. Clinical experience with video Head Impul-se Test in children. Int J Pediatr Otorhinolaryngol. 2015;79(8):1288-93. https://doi.org/10.1016/j.ijporl.2015.05.034
MacDougall H.G, Weber KP, McGarvie LA, Halmagyi GM., Curthoys IS. The video head impulse test. Diagnostic accuracy in peripheral vestibulopathy. Ann Neurol. 2009;73(14):1134-41. https://doi.org/10.1212/WNL.0b013e3181bacf85
MacDougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. Application of the video head impulse test to detect vertical semicircular canal dysfunction. Otol Neurotol. 2013;34(6):974-9. https://doi.org/10.1097/MAO.0b013e31828d676d
Magliulo G, Iannella G, Gagliardi S, Massimo R. A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vesti-bular neuritis. Eur Arch Otorhinolaryngol. 2014; 272(11):3277-81. https://doi.org/10.1007/s00405-014-3404-9
Maheu M, Houde MS, Landry SP, Champoux F. The Effects of Aging on Clinical Vestibular Evaluations. Front Neurol. 2015; 22;6:205.
Mi?o?ski J, Pietkiewicz P, Bieli?ska M, Ku?mierczyk K, Olszewski J. The use of vi-deonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo. Int J Occup Med Environ Health. 2014;27(4):583-90.
Murdin L, Schilder AG. Epidemiology of balance symptoms and disorders in the community: a systematic review. Otol Neurotol. 2015;36(3):387-92. https://doi.org/10.1097/MAO.0000000000000691
Newman-Toker DE, Saber Tehrani AS, Manto-koudis G, Pula JH, Guede CI, Kerber KA, Blitz A, Ying SH, Hsieh YH, Rothman RE, Hanley DF, Zee DS, Kattah JC. Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes. Stroke. 2013;44(4):1158-61. https://doi.org/10.1161/STROKEAHA.111.000033
Pe-a A. El examen vestibular abreviado, de-scripción, interpretación y análisis. Rev Otorrinola-ringol Cir Cabeza Cuello 2011;71: 135-44. https://doi.org/10.4067/S0718-48162011000200006
Pérez-Fernández N, Gallegos-Constantino V, Barona Lleo L, Manrique Huarte R. Exploración Clínica y videoasistida del reflejo vestíbulo-oculomotor: análisis comparativo. Acta Otorrino-laringol. 2012;63(6): 429-35. https://doi.org/10.1016/j.otorri.2012.04.010
Rambold Holger A. Economic management of vertigo/dizziness disease in a county hospital: video-head-impulse test vs. caloric irrigation. Eur Arch Oto-rhinolaryngol. 2015;272(10):2621-8. https://doi.org/10.1007/s00405-014-3205-1
Suárez C, Gil-Carcedo LM, Medina JE, Marco J, Ortega P, Trinidad J. Tratado de Otorrinolaringo-logía y Cirugía de Cabeza Y Cuello. Tomo II: Madrid; Panamericana. 2008.
Weber KP, MacDougall HG, Halmagyi GM, Curthoys IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci. 2009;1164:486-91. https://doi.org/10.1111/j.1749-6632.2008.03730.x
Yang CJ, Lee JY, Kang BC, Lee HS, Yoo MH, Park HJ. Quantitative analysis of gains and catch-up saccades of video-head-impulse te-sting by age in normal subjects. Clin Otolaryngol. 2016;41(5):532-8. https://doi.org/10.1111/coa.12558
Yoo MH, Kim SH, Lee JY, Yang CJ, Lee HS, Park HJ. Results of video head impulse and caloric tests in 36 patients with vestibular migraine and 23 patients with vestibular neuritis: A preliminary report. Clin Otolaryngol. 2015; 9. https://doi.org/10.1111/coa.12556
Álvarez-Santacruz, C., López-Robles, M., & Hellín-Messeguer, D. (2017). Experience with Video Head Impulse Testing (vHIT). Revista ORL, 8(1), 5–15. https://doi.org/10.14201/orl.14992
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