A new and objective test to evaluate functions of the semicircular canals: A review of video head impulse test

Year 2017, Volume: 27 Issue: 5, 241 - 250, 13.11.2017

Numan Kokten Servet Karaca Armağan İncesulu Mahmut Tayyar Kalcıoğlu

Abstract

Vertigo is an illusion of motion that is frequently encountered in the practice of otolaryngology and which the patient perceives as either a self-rotation or the rotation of the surroundings. Due to the fact that numerous peripheral- or central-based diseases may emerge with vertigo, it is important to establish a definitive diagnosis and evaluate the patient promptly with a reliable test. Balance receptors are located in the ampulla of each of the three semicircular canals in both ears and in the macula of the utricle and saccule, also named as the otolith organs. Semicircular canals are sensitive to angular acceleration whereas otolith organs are sensitive to static tilt and dynamic linear accelerations. Vestibuloocular reflex ensures the stabilization of vision in the eye during head movements by stimulating eye movement at equal velocity in the opposite direction of the head movement. On account of its natural stimulus usage, easy and prompt administration, patient adaptation, and high sensitivity in showing the vestibular lesions, video head impulse test has become popular in recent years in the evaluation of patients with vertigo. In this review, we studied the fields and manner of application as well as the interpretation of the video head impulse test.

Keywords

Diagnosis, vertigo, video head impulse test

Semisirküler kanalların fonksiyonlarının değerlendirilmesinde yeni, objektif bir test: Video baş savurma testi ile ilgili bir derleme

Abstract

Vertigo, kulak burun boğaz pratiğinde sıklıkla karşılaşılan ve hastanın kendisinin veya çevresinin döndüğü şeklinde algıladığı bir hareket ilizyonudur. Birçok periferik veya santral kaynaklı hastalık vertigo ile ortaya çıkabildiğinden, ayırıcı tanının yapılması ve objektif bir testle hastanın hızlıca değerlendirilmesi önemlidir. Denge reseptörleri her iki kulakta üçer adet semisirküler kanal ampullasında ve otolit organlar olarak da adlandırılan utrikulus ve sakkulus makülasında yerleşiktir. Semisürküler kanallar açısal, otolit organlar ise statik eğilme ve dinamik doğrusal hızlanmalara karşı duyarlıdır. Vestibülooküler refleks kafa hareketleri esnasında kafanın hareketine eşit hızda karşı tarafa göz hareketi sağlayarak görüntünün gözde sabit kalmasını sağlar. Doğal uyarı kullanımı, kolay ve hızlı bir şekilde uygulanabilmesi, hastanın uyumu ve vestibüler lezyonları göstermedeki yüksek duyarlılığı sayesinde video baş savurma testi son yıllarda vertigolu hastaların değerlendirmesinde popüler hale gelmiştir. Bu derlemede video baş savurma testinin uygulama alanları ve şekli ile yorumlanışı irdelendi

Keywords

Tanı, vertigo, video baş savurma testi

References

• Ardıç FN. Denge sisteminin işleyişi. In: Ardıç FN, editor. Vertigo. İzmir: Güven Kitabevi; 2004. s. 3-28.
• Mangabeira Albernaz PL, Zuma E Maia FC. The video head impulse test. Acta Otolaryngol 2014;134:1245-50.
• Bronstein AM, Patel M, Arshad Q. A brief review of the clinical anatomy of the vestibular-ocular connections- how much do we know? Eye (Lond) 2015;29:163-70.
• Baloh RW. Vertigo. Lancet 1998;352:1841-6.
• Çaylaklı F, Özgirgin N. Vertigolu hastada klinik değerlendirme. Otoscope. 2004;1:17-20.
• Karapolat H, Çelebisoy N, Gökçay F, Bilgen C, Özgen G, Göde S, et al. Establishment and reliability test of a “Vertigo Council Diagnosis Questionnaire” for patients with chronic vestibular dysfunction: preliminary study. Kulak Burun Bogaz Ihtis Derg 2015;25:271-4.
• Strupp M, Dieterich M, Zwergal A, Brandt T. Diagnosis and treatment options in vertigo syndromes. Nervenarzt 2015;86:1277-90. [Abstract]
• Weber KP, Aw ST, Todd MJ, McGarvie LA, Curthoys IS, Halmagyi GM. Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology 2008;70:454-63.
• Tjernström F, Nyström A, Magnusson M. How to uncover the covert saccade during the head impulse test. Otol Neurotol 2012;33:1583-5.
• McCaslin DL, Jacobson GP, Bennett ML, Gruenwald JM, Green AP. Predictive properties of the video head impulse test: measures of caloric symmetry and self- report dizziness handicap. Ear Hear 2014;35:185-91.
• Zellhuber S, Mahringer A, Rambold HA. Relation of video-head-impulse test and caloric irrigation: a study on the recovery in unilateral vestibular neuritis. Eur Arch Otorhinolaryngol 2014;271:2375-83.
• Black RA, Halmagyi GM, Thurtell MJ, Todd MJ, Curthoys IS. The active head-impulse test in unilateral peripheral vestibulopathy. Arch Neurol 2005;62:290-3.
• Cremer PD, Halmagyi GM, Aw ST, Curthoys IS, McGarvie LA, Todd MJ, et al. Semicircular canal plane head impulses detect absent function of individual semicircular canals. Brain 1998;121:699-716.
• Seo YJ, Park YA, Kong TH, Bae MR, Kim SH. Head position and increased head velocity to optimize video head impulse test sensitivity. Eur Arch Otorhinolaryngol 2016;273:3595-602.
• Harvey SA, Wood DJ. The oculocephalic response in the evaluation of the dizzy patient. Laryngoscope 1996;106:6-9.
• Harvey SA, Wood DJ, Feroah TR. Relationship of the head impulse test and head-shake nystagmus in reference to caloric testing. Am J Otol 1997;18:207- 13.
• Tusa RJ, Grant MP, Buettner UW, Herdman SJ, Zee DS. The contribution of the vertical semicircular canals to high-velocity horizontal vestibulo-ocular reflex (VOR) in normal subjects and patients with unilateral vestibular nerve section. Acta Otolaryngol 1996;116:507-12.
• Curthoys IS, Blanks RH, Markham CH. Semicircular canal functional anatomy in cat, guinea pig and man. Acta Otolaryngol 1977;83:258-65.
• Blödow A, Blödow J, Bloching MB, Helbig R, Walther LE. Horizontal VOR function shows frequency dynamics in vestibular schwannoma. Eur Arch Otorhinolaryngol 2015;272:2143-8.
• Macdougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. The video Head Impulse Test (vHIT) detects vertical semicircular canal dysfunction. PLoS One 2013;8:61488.
• Mahringer A, Rambold HA. Caloric test and video- head-impulse: a study of vertigo/dizziness patients in a community hospital. Eur Arch Otorhinolaryngol 2014;271:463-72.
• Cremer PD, Halmagyi GM, Aw ST, Curthoys IS, McGarvie LA, Todd MJ, et al. Semicircular canal plane head impulses detect absent function of individual semicircular canals. Brain 1998;121:699-716.
• Schneider E, Villgrattner T, Vockeroth J, Bartl K, Kohlbecher S, Bardins S, et al. EyeSeeCam: an eye movement-driven head camera for the examination of natural visual exploration. Ann N Y Acad Sci 2009;1164:461-7.
• MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 2009;73:1134-41.
• Halmagyi GM, Aw ST, Cremer PD, Curthoys IS, Todd MJ. Impulsive testing of individual semicircular canal function. Ann N Y Acad Sci 2001;942:192-200.
• Aw ST, Haslwanter T, Halmagyi GM, Curthoys IS, Yavor RA, Todd MJ. Three-dimensional vector analysis of the human vestibuloocular reflex in response to high-acceleration head rotations. I. Responses in normal subjects. J Neurophysiol 1996;76:4009-20.
• Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope 2012;122:1342-52.
• Curthoys IS, Manzari L. Otolithic disease: clinical features and the role of vestibular evoked myogenic potentials. Semin Neurol 2013;33:231-7.