BackgroundFunctional and anatomic changes occur during pregnancy. Some of these changes are in the auditory and vestibular systems. However, there is a lack of information about the functional changes to critical structures that contribute to balance and proprioception. This study aims to evaluate the functions and shifts to the semicircular canals throughout gestation. MethodologyThis is a cross-sectional study. A video head impulse test (vHIT) was performed on all healthy pregnant patients with gestational periods ranging from the 20th to 40th weeks who were admitted to a maternal-fetal care unit. Vestibulo-ocular reflex (VOR) gains in the lateral, posterior, and anterior semicircular canals and gains in asymmetry were obtained. ResultsA significant positive relationship was observed in the right ( R = 0.1064; P = 0.0110) and left (R = 0.2993; P = 0.0001) lateral semicircular canals as gestational weeks increased. Lower gains were seen at the start of the second trimester for the lateral canals. No significant gains were seen in the anterior or posterior canals throughout pregnancies until labor. No significant gains in asymmetry were detected. ConclusionsPregnant females may present vestibular changes in the semicircular lateral canals starting from the 20th week of gestation until labor. Increased gains may be associated with volumetric changes probably given by hormonal actions.

HINTS (head impulse, nystagmus, and test of skew) protocol is widely used at emergency rooms and outpatients’ settings to differentiate central from peripheral vertigo. Doctors usually get experience during their training on the basic concepts of the test. However, there is a lack of information about the current understanding of the test and its application by future practitioners, who will be the first responders to vertigo patients. We conducted a quasi-experimental study to assess the understanding, applicability, and comprehension of HINTS in medical students after a theory and practice session and follow-up 1-month after. Twenty-one students were evaluated with pre-test and post-tests. Comprehension (Δ40%), understanding (Δ60%) and applicability (Δ48%) were increased after the session. Head impulse (Δ 39%), nystagmus evaluation (Δ 10%) and test of skew (Δ 39%) showed a better understanding and comprehension even 1-month after. Findings have educational implications of this protocol in future healthcare professionals.

Vertigo is a common complaint in the general population affecting 5% of adults in one year. At least 29.5% of adults have referred vertigo during life. Even though the prevalence of vertigo is well known in adults the epidemiologic data in adolescents is sparse. To date, it is known that adolescent females are usually affected by vertigo and some conditions such as depression and anxiety are found in this population. However, the lack of information about the prevalence of most common types of vertigo in adolescents, predisposing factors, challenges, and controversies in clinics in the literature, present a challenge for clinicians regarding the approach and follow-up of this population. Herein, we performed a literature review including data about the prevalence, most common types of vertigo and controversial events in the approach of vertigo in adolescents over the last two decades.

Pregnancy includes several physical, hormonal, and psychological changes from conception to labor. The vestibular system is also affected during this life cycle and several challenges in patients who present vertigo or vestibular disorders during this time still being unregistered and there is a lack of information about how the vestibular system is affected during pregnancy, clinical and physiological correlation, and the expected results of vestibular testing in this population. Herein, we performed a review of expected physiological, clinical and vestibular testing results in pregnant patients to get the deepest understanding of the vestibular phenomenon during this time.