Diagnostic Value of Video Head Impulse Test for Patients with Benign
Paroxysmal Positional Vertigo
Abstract
Objectives: This study aims to investigate the value of Video head
impulse test (vHIT) findings in peripheral vertigo diseases, especially
in Benign paroxysmal positional vertigo (BPPV) in the acute period.
Design: A prospective study was designed. Setting: Otorhinolaryngology
and Audiology Clinic of the tertiary university , October 2017-September
2018. Participants: Patients diagnosed with peripheral vertigo included
prospectively and consecutively in the study. Main outcome measures:
Demographic characteristics of the patients and pathological SCC
detected by examination and diagnostic maneuver for BPPV patients were
recorded. Vestibulo-ocular reflex (VOR) gain was calculated in all
patients and all six SCCs. Two sub-study groups were formed according to
age (<50 or >50). Also VOR gain detected for
BPPV, Vestibular neuritis (VN), and Meniere’s disease (MD). Results: 74
(82.2%) of the patients were Benign paroxysmal positional vertigo
(BPPV), eight (8.9%) of patients were vestibular neuritis (VN), and
eight (8.9 %) of them were Meniere’s disease (MD). Pathological
deficiency of VOR for SCCs was detected in 49 of 74 (66.2%) patients
with BPPV, all eight patients with VN (100%), and four of eight
patients with Meniere’s disease (50%). The sensitivity and specificity
calculated as 55.4% and 81.2% for BPPV patients. Conclusions: vHIT is
a new protocol and provides objective findings for SCC functions in
patients with peripheral vertigo. vHIT can be performed faster and
easier than the caloric stimulation test for VN diagnosis with
comparable results. However, vHIT does not provide sufficient results
for BPPV to distinguish from other peripheral vestibular system
diseases.