Comparison of the video head impulse test with the caloric test in patients with sub-acute and chronic vestibular disorders

摘要

Highlights ? Video head impulse and caloric testing are commonly used for vestibular disorders. ? The comparative diagnostic performance of these techniques is different. ? Video head impulse testing was less sensitive for unilateral hypofunction. ? Video head impulse testing was more sensitive for bilateral hypofunction. Abstract The aim of this prospective register-based study was to compare video Head Impulse Tests (vHIT) with caloric tests on 173 patients assessed by a tertiary Neurology referral centre who had been referred for investigation of dizziness or vertigo and whose symptom duration was one month or longer. Abnormal vHIT was defined as angular velocity gain (peak eye velocity/peak head velocity) less than 0.79 at 80?ms and 0.75 at 60?ms, which was two standard deviations below our institutions’ lower limit of normal; together with refixation saccades. Abnormal bi-thermal caloric testing defined unilateral hypofunction as a 25% difference using Jongkee’s formula and bilateral hypofunction was defined by the sum of the peak slow phase velocities over the four irrigations being