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Head impulse test

A Thakar
BACKGROUND: Laboratory experiments indicate that changes in retinal image size result in adaptive recalibration or suppression of the vestibulo-ocular reflex. Myopia correction with spectacles or contact lenses also leads to retinal image size changes, and may bring about similar vestibulo-ocular reflex alterations. METHODS: A hypothesis-generating preliminary investigation was conducted. In this cross-sectional study, findings of electronystagmography including bithermal caloric testing were compared between 17 volunteer myopes using spectacles or contact lenses and 17 volunteer emmetropes (with no refractive error)...
October 17, 2016: Journal of Laryngology and Otology
Constantin von Kirschbaum, Robert Gürkov
Introduction. Vestibular schwannomas (VS) are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. Methods. Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. Results. The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS...
2016: BioMed Research International
Woo Seok Kang, Sang Hun Lee, Chan Joo Yang, Joong Ho Ahn, Jong Woo Chung, Hong Ju Park
Vestibular migraine (VM) is one of the most common causes of episodic vertigo. We reviewed the results of multiple vestibular function tests in a cohort of VM patients who were diagnosed with VM according to the diagnostic criteria of the Barany Society and the International Headache Society and assessed the efficacy of each for predicting the prognosis in VM patients. A retrospective chart analysis was performed on 81 VM patients at a tertiary care center from June 2014 to July 2015. Patients were assessed by the video head impulse test (vHIT), caloric test, vestibular-evoked myogenic potentials (VEMPs), and sensory organization test (SOT) at the initial visit and then evaluated for symptomatic improvement after 6 months...
2016: Frontiers in Neurology
Qiwen Shen, Christophe Magnani, Olivier Sterkers, Georges Lamas, Pierre-Paul Vidal, Julien Sadoun, Ian S Curthoys, Catherine de Waele
OBJECTIVE: To determine whether saccadic velocity in the suppression head impulse paradigm (SHIMP) test is a reliable indicator of vestibular loss at the acute and at the chronic stage in patients suffering from different vestibular pathologies. METHODS: Thirty-five normal subjects and 57 patients suffering from different vestibular pathologies associated with unilateral vestibular loss (UVL) or bilateral vestibular loss (BVL) were tested in the SHIMPs paradigm...
2016: Frontiers in Neurology
Rachael L Taylor, Leigh A McGarvie, Nicole Reid, Allison S Young, G Michael Halmagyi, Miriam S Welgampola
OBJECTIVE: To characterize the profiles of afferent dysfunction in a cross section of patients with acute vestibular neuritis using tests of otolith and semicircular canal function sensitive to each of the 5 vestibular end organs. METHODS: Forty-three patients fulfilling clinical criteria for acute vestibular neuritis were recruited between 2010 and 2016 and studied within 10 days of symptom onset. Otolith function was evaluated with air-conducted cervical and bone-conducted ocular/vestibular evoked myogenic potentials and the subjective visual horizontal test...
September 30, 2016: Neurology
Ching-Jen Wang, Chung-Cheng Huang, Hon-Kan Yip, Ya-Ju Yang
BACKGROUND: This study investigated the effects of different dosages of extracorporeal shockwave therapy (ESWT) in early osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: Thirty-three patients (42 hips) were randomly divided into three groups. Group A (10 patients with 16 hips) received 2000 impulses of ESWT at 24 Kv to the affected hip. Group B (11 patients with 14 hips) and Group C (12 patients with 12 hips) received 4000 and 6000 impulses of ESWT respectively...
September 21, 2016: International Journal of Surgery
M Szczupak, M E Hoffer, S Murphy, C D Balaban
Traumatic brain injury is an increasingly common public health issue, with the mild variant most clinically relevant for this chapter. Common causes of mild traumatic brain injury (mTBI) include motor vehicle accidents, athletics, and military training/deployment. Despite a range of clinically available testing platforms, diagnosis of mTBI remains challenging. Symptoms are primarily neurosensory, and include dizziness, hearing problems, headaches, cognitive, and sleep disturbances. Dizziness is nearly universally present in all mTBI patients, and is the easiest symptom to objectify for diagnosis...
2016: Handbook of Clinical Neurology
M Strupp, K Feil, M Dieterich, T Brandt
The leading symptoms of bilateral vestibulopathy (BVP) are postural imbalance and unsteadiness of gait that worsens in darkness and on uneven ground. There are typically no symptoms while sitting or lying under static conditions. A minority of patients also have movement-induced oscillopsia, in particular while walking. The diagnosis of BVP is based on a bilaterally reduced or absent function of the vestibulo-ocular reflex (VOR). This deficit is diagnosed for the high-frequency range of the angular VOR by a bilaterally pathologic bedside head impulse test (HIT) and for the low-frequency range by a bilaterally reduced or absent caloric response...
2016: Handbook of Clinical Neurology
J M Furman
The natural stimulus for the semicircular canals is rotation of the head, which also might stimulate the otolith organs. Vestibular stimulation usually induces eye movements via the vestibulo-ocular reflex (VOR). The orientation of the subject with respect to the axis of rotation and the orientation of the axis of rotation with respect to gravity together determine which labyrinthine receptors are stimulated for particular motion trajectories. Rotational testing usually includes the measurement of eye movements via a video system but might use a subject's perception of motion...
2016: Handbook of Clinical Neurology
Rong-Jian Liu, Catharine Duman, Taro Kato, Brendan Hare, Dora Lopresto, Eunyoung Bang, Jeffery Burgdorf, Joseph Moskal, Jane Taylor, George Aghajanian, Ronald S Duman
GLYX-13 is a putative NMDA receptor modulator with glycine-site partial agonist properties that produces rapid antidepressant effects, but without the psychotomimetic side effects of ketamine. Studies were conducted to examine the molecular, cellular, and behavioral actions of GLYX-13 to further characterize the mechanisms underlying the antidepressant actions of this agent. The results demonstrate that a single dose of GLYX-13 rapidly activates the mTORC1 pathway in the prefrontal cortex (PFC), and that infusion of the selective mTORC1 inhibitor rapamycin into the medial PFC (mPFC) blocks the antidepressant behavioral actions of GLYX-13, indicating a requirement for mTORC1 similar to ketamine...
September 16, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Miriam S Welgampola, Gülden Akdal, G Michael Halmagyi
Vestibular disorders manifesting as vertigo, chronic dizziness and imbalance are common problems in neurological practice. Here, we review some recent interesting and important advances in diagnosis of vestibular disorders using the video head impulse test and in the management of benign positional vertigo and migrainous vertigo.
September 15, 2016: Journal of Neurology
Stephanie M Beeman, Andrew R Kemper, Stefan M Duma
OBJECTIVE: The objective of this study was to quantify the effects of active muscles (e.g. conscious bracing, resting tone, and reflex response) and acceleration severity on the neck forces and moments generated during low-speed frontal sled tests with adult male human volunteers and post mortem human surrogates (PMHSs). METHODS: A total of 24 frontal sled tests were analyzed including male volunteers of approximately 50th percentile height and weight (n = 5) and PMHSs (n = 2)...
September 2016: Traffic Injury Prevention
Roseli Saraiva Moreira Bittar, Eduardo Setsuo Sato, Douglas Jósimo Silva Ribeiro, Robinson Koji Tsuji
INTRODUCTION: Cochlear implants are undeniably an effective method for the recovery of hearing function in patients with hearing loss. OBJECTIVE: To describe the preoperative vestibular assessment protocol in subjects who will be submitted to cochlear implants. METHODS: Our institutional protocol provides the vestibular diagnosis through six simple tests: Romberg and Fukuda tests, assessment for spontaneous nystagmus, Head Impulse Test, evaluation for Head Shaking Nystagmus and caloric test...
July 31, 2016: Brazilian Journal of Otorhinolaryngology
Georgios Mantokoudis, Ali S Saber Tehrani, Aaron L Wong, Yuri Agrawal, Angela Wenzel, John P Carey
OBJECTIVE: To describe vestibulo-ocular function and compensatory mechanisms in the immediate postoperative period after superior canal dehiscence surgery. STUDY DESIGN: Prospective longitudinal study. SETTING: Tertiary medical center. PATIENTS: Five patients who underwent plugging of superior semicircular canal via middle cranial fossa approach. INTERVENTIONS: Bedside quantitative video head impulse testing (vHIT)...
October 2016: Otology & Neurotology
Roeland B van Leeuwen, Bart W Smits, Richard J Rodenburg, Baziel G van Engelen
In patients with a triad of sensory ataxic neuropathy, dysarthria, and ophthalmoparesis (SANDO), the presenting features are mainly ataxia or ptosis. SANDO patients often have impaired balance and gait, which is not surprising considering the combination of sensory ataxic neuropathy, and additional symptoms like cerebellar ataxia and limb girdle weakness. We describe a SANDO patient who noticed an increasingly impaired balance and gait, without any dizziness. Neurological investigation revealed an external ophthalmeplegia and a cerebellar ataxia; the head impulse test was not reliable because of eye movement disorders...
September 2016: Journal of Clinical Neuromuscular Disease
Sergio Carmona, Carlos Martínez, Guillermo Zalazar, Marcela Moro, Angel Batuecas-Caletrio, Leonel Luis, Carlos Gordon
The head impulse, nystagmus type, test of skew (HINTS) protocol set a new paradigm to differentiate peripheral vestibular disease from stroke in patients with acute vestibular syndrome (AVS). The relationship between degree of truncal ataxia and stroke has not been systematically studied in patients with AVS. We studied a group of 114 patients who were admitted to a General Hospital due to AVS, 72 of them with vestibular neuritis (based on positive head impulse, abnormal caloric tests, and negative MRI) and the rest with stroke: 32 in the posterior inferior cerebellar artery (PICA) territory (positive HINTS findings, positive MRI) and 10 in the anterior inferior cerebellar artery (AICA) territory (variable findings and grade 3 ataxia, positive MRI)...
2016: Frontiers in Neurology
Bela Büki, Manuela Hanschek, Heinz Jünger
OBJECTIVE: In this retrospective study, the aim of the authors was to examine the frequency of involvement of the individual semicircular canals (SCCs) in vestibular neuritis (VN) and to assess the degree of long-term recovery. A secondary aim was to retrospectively determine the usefulness of a three-step bedside oculomotor test (the HINTS-test) for the differential diagnosis of peripheral VN. METHODS: 44 cases were evaluated during the acute phase and approximately two months later...
August 18, 2016: Auris, Nasus, Larynx
Tatiana Bremova, Siegbert Krafczyk, Stanislavs Bardins, Jörg Reinke, Michael Strupp
We investigated whether vestibular dysfunction may cause or contribute to postural imbalance and falls in patients with Niemann-Pick type C disease (NP-C). Eight patients with NP-C disease and 20 healthy controls were examined using the video-based head impulse test (vHIT) and caloric irrigation to investigate horizontal canal function as well as ocular- and cervical vestibular evoked myogenic potentials (o- and cVEMP), and binocular subjective visual vertical estimation (SVV) for otolith function, and static posturography...
November 2016: Journal of Neurology
Nancy L Low Choy, Mary-Therese M Lucey, Susan L Lewandowski, Benedict J Panizza
OBJECTIVES/HYPOTHESIS: To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS). STUDY DESIGN: Cross-sectional study with controls. METHODS: The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory...
August 13, 2016: Laryngoscope
Nader Nassif, Cristiano Balzanelli, Luca Oscar Redaelli de Zinis
OBJECTIVE: To evaluate the lateral semicircular canal high frequency vestibulo-oculomotor reflex (LSC HF VOR) in children with cochlear implant. METHODS: 16 children (10 females and 6 males, age range = 5-17 years) receiving a unilateral (n = 12) or a bilateral (n = 4) cochlear implant were included and compared to a control group of 20 age-matched normal-hearing (NH) children. Both implanted and NH children received a vestibular function test battery, including a Vestibulo-Ocular Reflex (VOR) gain assessment by means of a video-Head Impulse Test (vHIT), which represented the main outcome measure...
September 2016: International Journal of Pediatric Otorhinolaryngology
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