Video head impulse test (vHIT) in migraine dizziness

Elsherif, Mayada; Reda, Mohamed Ihab Samy; Saadallah, Horeya; Mourad, Mohamed I.

doi:10.1016/j.joto.2017.12.002

Cited by 21 publications

(22 citation statements)

References 21 publications

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“…The study of vestibular-oculomotor reflex with v-HIT in our series was normal in all subjects with MV, including those who developed fluctuation of hearing during followup. v-HIT applied to MV patients did not show a clinical importance as reported by ElSherif et al who compared healthy subjects and MV patients and found no alterations in gain or other parameters, underscoring the normality of vestibular-ocular reflex in MV patients 12 .…”

Section: Discussionsupporting

confidence: 50%

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

Immordino

Priola

Salvago

et al. 2021

Acta Otorhinolaryngol Ital

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Introduction. Migraine vertigo (MV) and Ménière's disease (MD) share several signs and symptoms such as tinnitus, fullness, photophobia, phonophobia, headache and vertigo spells lasting hours. Objective. The aim of the present study was to prospectively observe patients with MV with a sporadic audiological symptom evaluated with clinical examination, Vestibular Evoked Myogenic Potentials (VEMPs), ECochG and v-HIT. Results. The finding of VEMP asymmetry, according to our cut-off of 33% of difference between sides, resulted in 20 cases, of which 6 had asymmetry of both c-VEMPs and o-VEMPS, all with development of fluctuating hearing during follow-up. ECochG was positive for endolymphatic hydrops in 12 patients. Conclusions. The evolution of MV may have a variable course in which some patients may develop symptoms typical of MD. The two diseases may be contextually present at the same time configuring an overlapping syndrome, and asymmetric VEMPs might predict development of fluctuating hearing.

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Section: Discussionsupporting

confidence: 50%

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

Immordino

Priola

Salvago

et al. 2021

Acta Otorhinolaryngol Ital

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“…VOR gain in the video head impulse tests was defined as the ratio of the area under the velocity curves of the right eye to that of the head ( 13 ). According to previous studies ( 14 , 15 ), normal VOR gain is specified by the video head impulse test (ICS Impulse®, GN Otometrics, Denmark) as >0.8 for the lateral canals and >0.7 for the vertical canals. Subjects who underwent surgical plugging were instructed to undergo serial video head impulse tests before surgery; immediately after surgery (within 1 week); and at 2, 6, and 12 months after surgery, if available.…”

Section: Methodsmentioning

confidence: 99%

Changes in Vestibulo-Ocular Reflex Gain After Surgical Plugging of Superior Semicircular Canal Dehiscence

et al. 2020

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Superior semicircular canal dehiscence (SCD), which is characterized by a "third mobile window" in the inner ear, causes various vestibular and auditory symptoms and signs. Surgical plugging of the superior semicircular canal (SC) can eliminate the symptoms associated with increased perilymph mobility due to the presence of the third window. However, the natural course of vestibular function after surgical plugging remains unknown. Therefore, we explored longitudinal vestibular function after surgery in 11 subjects with SCD who underwent SC plugging using the middle cranial fossa approach. Changes in vestibulo-ocular reflex (VOR) gain in all planes were measured over 1 year with the video head impulse test. We also evaluated surgical outcomes, including changes in symptoms, audiometric results, and electrophysiological tests, to assess whether plugging eliminated third mobile window effects. The mean VOR gain for the plugged SC decreased from 0.81 ± 0.05 before surgery to 0.65 ± 0.08 on examinations performed within 1 week after surgery but normalized thereafter. Four of seven subjects who were able to perform both VOR tests before surgery and immediately after surgery had pathologic values (SC VOR gain < 0.70). Conversely, the mean VOR gain in the other canals remained unchanged over 1 year. The majority of symptoms and signs were absent or markedly decreased at the last follow-up evaluation, and no complications associated with the surgery were reported. Surgical plugging significantly attenuated the air-bone gap, in particular at low frequencies, because of increased bone conduction thresholds and deceased air conduction thresholds. Moreover, surgical plugging significantly increased vestibular-evoked myogenic potential thresholds and decreased the ratio of summating potential to action potential in plugged ears. Postoperative heavily T2-weighted images were available for two subjects and showed complete obliteration of the T2-bright signal intensity in the patent SC lumen in preoperative imaging based on filling defect at the site of plugging. Our results suggest that successful plugging of dehiscent SCs is closely associated with a transient, rather than persistent, disturbance of labyrinthine activity exclusively involved in plugged SCs, which may have clinical implications for timely and individualized vestibular rehabilitation.

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“…They found that caloric test was abnormal in 22% of patients while the vHIT showed horizontal VOR deficit in 9% of patients. Also ElSherif et al, 22 reported that 26%of the vestibular migraine group exhibited abnormal vHIT results in the form of refixation saccades with normal VOR gain (18%), and low VOR gain with refixation saccades in (7.5%). They reportd that the presence of covert saccades despite normal VOR gain is a correction of eye drifts to the target position and it has been suggested that the presence of refixation saccades with normal VOR gain is part of the process of aging of the vestibular system.…”

Section: Discussionmentioning

confidence: 97%

Video head impulse test finding in vestibular lesions

Ismail¹,

Behairy²,

Brakat³

2019

JOENTR

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Introduction of video head impulse test (vHIT) as a new objective quantitative test of vestibular function, provides a new dimension in vestibular evaluation. 1vHIT is a simple fast clinical vestibular test. It has the ability to detect specific vestibular lesion by using physiologic high frequency stimuli and measure the gain of the vestibulo-occular reflex (VOR). If there is abnormal VOR response, the test can measure the gain of VOR and detect any refixation saccade (overt and covert saccades. 2The vestibular hair cells respond to frequencies from 0 to 16 Hz, being particularly active in the range of 0.1-10 Hz. The caloric test is usually in the area ranging from 0.003 to 0.05 Hz, but rotational tests are in the area of high frequencies. 3 The vHIT is a more physiological stimulus testing higher frequencies (>1Hz) Heuberger et al. 4 It is therefore possible that a subject may have a normal caloric test, but manifest VOR deficits during head movements within a higher frequency range. 5 Bartolomeo et al., 6 found the sensitivity of vHIT increased up to 86.7 % and specificity to 100 % when the caloric deficit is between 40 and 65 % in case of VN. The sensitivity of vHIT increased to 100 % if caloric deficit is more than 65.2 %. McCaslin et al., 7 found dissociation between caloric test and vHIT in MD as caloric tests showed a vestibular deficit, while the vHIT was normal in 45 % of the cases. Manzari et al., 8 reported an enhanced vHIT lateral canal gain response in all 13 Meniere's patients tested at attack and in 18 of 30 patients tested during quiescence. Their hypothesis was that the enlarged endolymph volume causes enhanced displacement and enhanced return of the cupula which might lead to enhanced response in MD patients.Caloric testing and the video head impulse test (vHIT) are reliable tests, caloric testing can evaluate the function of the lateral semicircular canal and superior vestibular nerve, However, vHIT can detect abnormalities in all six semicircular canals and it can be used in patients who do not tolerate caloric test such as some elder patient, children or patient with perforated tympanic membrane. 9 The vHIT can be used as a screening tool for vestibular deficits due to gentamicin toxicity. 10The simplicity of vHIT and its relatively innocuous character for patients means that it can be used even during vertigo attacks. So it has been used to show in patients with Menière's disease how semicircular canal function fluctuates during and around the time of the attack of vertigo Manzari et al. 8 Also there is need to have objective measure of the VOR during HIT by using a system fast enough and accurate enough to detect any type of saccades because some patients were missed by bedside head impulse test, even by expert examiners. 11 So this study is conducted to compare video head impulse test results among different vestibular lesions and healthy subjects and correlate between video head impulse test and caloric test results. MethodsThis study was carried out in the Audio vestibular unit at the A...

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Video head impulse test (vHIT) in migraine dizziness

Cited by 21 publications

References 21 publications

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

Changes in Vestibulo-Ocular Reflex Gain After Surgical Plugging of Superior Semicircular Canal Dehiscence

Video head impulse test finding in vestibular lesions

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