Caloric Test and Video‐Head‐Impulse (v‐HIT): Usefulness as Screening Tool of Vestibular Pathology

Abstract

Objectives: Investigate the horizontal vestibulo-ocular reflex (VOR) by means of vHIT in peripheral vestibular disorders. Methods: Prospective clinical trial at a university hospital. Using 2 vHIT equipments (Otometrics(R) and Ullmer(R)), and the caloric response as gold standard, we examined the VOR in a group of 73 patients, and a control group of 18 healthy subjects. The group of patients included BPPV (n = 26), vestibular neuritis (VN) (n = 12), Ménière’s disease (MD) (n = 10), and idiopatic vestibulopathy (IV) (n = 25). Results: An abnormal VOR gain (less than 0.60) was found in 70.4% of all cases, whereas healthy subjects showed a normal gain in 94.44% of cases. An abnormal vHIT was found more commonly in VN (91.66%) and MD (80%), P < .05. Isolated covert saccades and/or isolated overt saccades were present in all cases showing poor VOR gain. Caloric responses were paretic in 75% of cases showing poor VOR gain in vHIT, showing good correlation. Conclusions: The vHIT detects abnormal VOR changes in the combination of gain assessment and refixation saccades. vHIT might be a good screening tool to assess vestibular disorders, avoiding caloric stimulation in certain patients.