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.   Keywords: Video head impulse test; videonystagmography; screening tool; correlation; vestibulopathy; caloric testing