Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation

Abstract

Introduction: The aim of the paper was the comparative analysis of the diagnostic value of the Video Head Impulse Testing (VHIT) Ulmer I and Dix-Hallpike Test in patients with balance system disorders in out-patient practice and expertise preparation. Material and methods: The examination was performed in 63 patients aged 20-79, including 28 women aged 20-72 and 35 men aged 23-79, divided into two groups: Group I (study group) – 33 patients with mixed cause vertigo (on the basis of the Fitzgerald-Hallpike caloric test during the VNG examination), and Group II (reference group) – 30 healthy patients. After the ENT interview and physical examination, exclusion of pathological lesions in the external acoustic meatus and middle ear, each patient was subjected to a Fitzgerald-Hallpike caloric test during VNG examination, as well as a VHIT test and Dix-Hallpike test, with the evaluation of eyeball reaction during head rotation. Results: In the group of patients with mixed-cause vertigo (Group I), the Fitzgerald-Hallpike caloric test showed unilateral labyrinth deficiencies in 90.9% of the patients (with the average value of 41.8%) and relative directional preponderance with the average value of 19.0%, while in 9.1% of the patients, the detected values of labyrinth excitability were normal. In the examination of patients with vertigo, benign paroxysmal positional vertigo was diagnosed in 9.1% of cases. This diagnosis was based on the positive response to the Dix-Hallpike manoeuvre and indicative of damage to the posterior semicircular canal in the VHIT test (without signs of deficiency in the VNG examination). Conclusion: The VHIT test and Dix-Hallpike test enable quick and precise detection of benign paroxysmal positional vertigo in out-patient practice and expertise preparation.