What is the role of the head impulse test in the evaluation of vestibular neuronitis?

Updated: Jul 16, 2018
  • Author: Keith A Marill, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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The head impulse test is a test for normal ocular fixation in association with rapid passive head rotation. An abnormal response is indicated by an inability to maintain fixation during head rotation with a corrective gaze shift after the head stops moving. An abnormal test seems to be sensitive, but not perfectly specific, for a peripheral vestibular disorder. [7, 8]

One group has combined the head impulse test with an assessment of nystagmus type and a test of skew to form the HINTS test, a three component eye movement battery of tests. [8, 9, 10] This clinical battery of tests appears helpful in differentiating vestibular neuritis from a more dangerous central process such as cerebellar stroke, though it awaits further independent confirmation. [8, 9]

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