Evaluation of video head impulse test during vertiginous attack in vestibular migraine

Abstract

SUMMARY Objective The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixation saccades were found in 52.3% of VM patients and in 10.2% of healthy individuals. Conclusions When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed during the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.

Characteristics of vestibular migraine, probable vestibular migraine, and recurrent vertigo of childhood in caloric and video head impulse tests

“…The CT is a traditional tool to reflect the function of the left and right horizontal semicircular canals (HSCs) and evaluate the status of vestibular function at ultralow frequencies by detecting the vestibulo-ocular reflex (VOR) function in HSCs (6). A new tool, vHIT, comprehensively assesses the function of the three pairs of semicircular canals (HSCs, posterior semicircular canals [PSCs], and anterior semicircular canals [ASC]) at physiological frequencies (7)(8)(9)(10). The vHIT and CT are useful in determining the side and severity of affliction in patients with unilateral lesions.…”