Our Results of VHIT on BPPV

Year 2018, Volume: 1 Issue: 1, 12 - 14, 01.04.2018

Hale Aslan , Ercan Pınar İbrahim Aladağ , Abdülkadir İmre , Murat Songu , Mustafa Yazır , Ayşe Azdamur İzbudak

Abstract

Objective: We reported the differentiation of vestibulo-ocular reflex (VOR) gains and saccades in a video head impulse test (VHIT) of the semicircular canals of 49 patients with vertigo. They were diagnosed with benign paroxysmal positional vertigo (BPPV).

Material and Methods: In total, we evaluated 49 patients who were referred to our clinic due to vertigo within the first 10 days based on history between June 2016 and February 2017; of these, 30 patients were diagnosed with vertical canal BPPV according to the Dix–Hallpike test and 19 with lateral canal BPPV using the Roll test. Patients were evaluated according to age, sex, presence of saccades, and VOR gains of all the semicircular canals.

Results: Overall, 17 patients were males and 32 were females. The age ranged between 23 and 73 years (mean age, 50 years). The VOR gains were normal in 17 (34%) patients. Based on the VHIT findings, 20 patients (40%) had low VOR gains in the vertical canal, 12 (24%) in the lateral canal. Saccades was determined in 20 patients with canal pathology.

Conclusion: History and provocation maneuver are gold standards in the diagnosis of BPPV. VHIT was affected by the applied power of the clinician and the angular position of the head. Consequently, this test can be used as supporting diagnostic test.

Keywords

Benign paroxysmal positional vertigo , video head impulse test , vestibulo-ocular reflex gain

References

• Korsager LEH, Schmidt JH, Faber C, Wanscher JH. Reliability and comparison of gain values with occurence of saccades in the EyeSeeCam video head impulse test (vHIT). Eur Arch Otorhinolaryngol 2016; 273: 4273-9.
• Lorne S. Parnes, Sumit K. Agrawal, and Jason Atlas. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003; 169: 681-93.
• Oghalai JS, Manolidis S, Barth JL, Stewart MG, Jenkins HA. Unrecognised benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000; 122: 630-4.
• 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.
• 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.
• Milonski J, Pietkiewicz P, Bielinska M, Kusmierczyk K, Olszewski J. The use of videonystagmography head impulse test (VHIT) in the diagnostics of semicircular canal injuries in patients with vertigo. Int J Occup Med Environ Health 2014; 27: 583-90.
• Murnane O, Mabrey H, Pearson A, Byrd S, Akin F. Normative data and test-retest reliability of the SYNAPSYS video head impulse test. J Am Acad Audiol 2014; 25: 244-52.
• Blöwdow A, Pannasch S, Walther LE. Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders. Auris Nasus Larynx 2013; 40: 348-51.
• Alizadeh S, Rahbar N, Ahadi M, Sameni SJ. Normative vestibulo-ocular reflex data in 6-12 year-old children using video head-impulse test. Aud Vest Res 2017; 26: 145-50.
• Kaźmierczak H. Selected neurootological procedures in vertigo cases. Pol Merk Lek 2005; 19: 459-60.
• Mantokoudis G, Saber Tehrani AS, Wong AL, Agrawal Y, Wenzel A, Carey JP. Adaptation and Compensation of Vestibular Responses Following Superior Canal Dehiscence Surgery. Otol Neurotol 2016; 37: 1399-405.