Objectives We investigated changes in video head impulse test (vHIT) gains and corrective saccades (CSs) at the acute and follow-up stages of vestibular neuritis to assess the diagnostic value of vHIT. Study Design Case series with chart review. Setting Tertiary medical center. Subjects and Methods Sixty-three patients with vestibular neuritis who underwent vHIT at an initial presentation and an approximately 1-month follow-up were included. vHIT gains, gain asymmetry (GA), peak velocities of CS, and interaural difference of CS (CSD) were analyzed. Results Mean vHIT gains increased significantly from the acute stage to the follow-up exam. The mean GA, peak velocities of CS, and CSD had decreased significantly at the follow-up. The incidence of CSs was also significantly decreased at the follow-up. The abnormal rate (87%) considering both gain and CS value was significantly higher than that (62%) considering vHIT gain only at the follow-up, although the abnormal rates did not differ at the acute stage (97% vs 87%). Conclusion The abnormal rates based on both vHIT gains and CS measurements are similar at the acute stage of VN but are considerably higher at the follow-up stage compared with the abnormal rates based on vHIT gains alone. It is thus advisable to check both CS and vHIT gain while performing vHIT to detect vestibular hypofunction.
Objective: To investigate the effect of the right/left and outward/inward head impulses on video head impulse test (vHIT) gains.Methods: Video head impulse test gains were calculated by recording the right eye movements with an infrared camera in a cohort of 24 healthy subjects (26-39 years old, 30 ± 9 years old). We compared the vHIT gains in four different situations in which the right and left lateral semicircular canals (LSCC) were stimulated through outward or inward head impulses.Results: The vHIT gains from stimulating the right LSCC were significantly larger than those stimulating the left LSCC, regardless of whether the head impulse was outward or inward (1.06 ± 0.1 by right outward vs. 0.98 ± 0.08 by left outward, P = 0.003; 1.02 ± 0.1 by right inward vs. 0.92 ± 0.07 by left inward, P < 0.0001). The mean difference in vHIT gain between stimulating the right or left LSCC was 0.09. The gains from outward vHITs were significantly larger than those from the inward tests, regardless of the LSCC side stimulated (1.06 ± 0.1 from right outward vs. 1.02 ± 0.1 from right inward, both stimulating the right LSCC, P = 0.013; 0.98 ± 0.08 from left outward vs. 0.92 ± 0.07 from left inward, both stimulating the left LSCC, P = 0.001). The mean difference in the vHIT gains between the outward and inward tests was 0.05.Conclusion: The right/left vHIT gain difference (0.09) is higher than the outward/inward vHIT gain difference (0.05). These are independently significant differences when using a vHIT system, which records movements in the right eye. An understanding of these differences may be helpful when interpreting vHIT results.
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