Dataset Information

Video head impulse test (vHIT) in migraine dizziness.

ABSTRACT: Background and objective: Migraine is an extremely prevalent primary headache disorder that frequently associates parallel symptoms such as dizziness, tinnitus and hearing loss. Our aim is to investigate differences in video head impulse (vHIT) results with patients suffering from vestibular migraine (VM) and healthy people, taking into consideration mean values of vestibule ocular reflex (VOR) gain, occurrence of the compensatory saccades latency and amplitude. According to the results, determine the usefulness of vHIT in vestibular migraine diagnostics.

Methods: A total number of 120 subjects were enrolled in the study, 80 of them were vestibular migraine patients (VM), while the other 40 were a control group of age matched healthy subjects. History was taking during the evaluation; videonystagmography and the video head impulse test were done.

Results: The rate of saccades is much more higher in the VM group compared to the healthy subjects group, only 7.5% of the VM group showed a low VOR gain with compensatory saccades denoting a vestibular deficit.

Conclusion: The refixation saccades are an important sign that could underlie different vestibular problems. vHIT result can contribute to the completion of full mosaic of vestibular migraine diagnostics.

SUBMITTER: ElSherif M

PROVIDER: S-EPMC6291630 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Video head impulse test (vHIT) in migraine dizziness.

ElSherif Mayada M Reda Mohamed Ihab MI Saadallah Horeya H Mourad Mona M

Journal of otology 20180209 2

<h4>Background and objective</h4>Migraine is an extremely prevalent primary headache disorder that frequently associates parallel symptoms such as dizziness, tinnitus and hearing loss. Our aim is to investigate differences in video head impulse (vHIT) results with patients suffering from vestibular migraine (VM) and healthy people, taking into consideration mean values of vestibule ocular reflex (VOR) gain, occurrence of the compensatory saccades latency and amplitude. According to the results, ...[more]

PMID: 30559767

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Project description:Background/hypothesisThe video Head Impulse Test (vHIT) is now widely used to test the function of each of the six semicircular canals individually by measuring the eye rotation response to an abrupt head rotation in the plane of the canal. The main measure of canal adequacy is the ratio of the eye movement response to the head movement stimulus, i.e., the gain of the vestibulo-ocular reflex (VOR). However, there is a need for normative data about how VOR gain is affected by age and also by head velocity, to allow the response of any particular patient to be compared to the responses of healthy subjects in their age range. In this study, we determined for all six semicircular canals, normative values of VOR gain, for each canal across a range of head velocities, for healthy subjects in each decade of life.Study designThe VOR gain was measured for all canals across a range of head velocities for at least 10 healthy subjects in decade age bands: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89.MethodsThe compensatory eye movement response to a small, unpredictable, abrupt head rotation (head impulse) was measured by the ICS impulse prototype system. The same operator delivered every impulse to every subject.ResultsVestibulo-ocular reflex gain decreased at high head velocities, but was largely unaffected by age into the 80- to 89-year age group. There were some small but systematic differences between the two directions of head rotation, which appear to be largely due to the fact that in this study only the right eye was measured. The results are considered in relation to recent evidence about the effect of age on VOR performance.ConclusionThese normative values allow the results of any particular patient to be compared to the values of healthy people in their age range and so allow, for example, detection of whether a patient has a bilateral vestibular loss. VOR gain, as measured directly by the eye movement response to head rotation, seems largely unaffected by aging.

Project description:Importance:It is important to know whether recovery of the vestibuloocular reflex (VOR) as measured by the video head impulse test (vHIT) is associated with the recovery of dynamic balance. It is also critical to know how much change in VOR gain is clinically relevant for establishing the recovery of dynamic balance. Objectives:To investigate the association between improved VOR gain as measured by the vHIT and improved dynamic balance (reduced fall risk) as measured by the dynamic gait index (DGI) and to calculate the minimal clinically important difference of VOR gain. Design, Setting, and Participants:This retrospective case series study was performed at a tertiary referral center at the Johns Hopkins University School of Medicine. Thirty-eight consecutive patients with subacute or chronic dizziness from January 1, 2014, through May 31, 2017, who visited the vestibular physical therapy clinic were included in the study. Interventions:Each patient was evaluated with room light and video-infrared oculomotor examination, vHIT, and balance testing before and after vestibular physical therapy. Main Outcomes and Measures:Gain of the lesioned VOR and score on the DGI. Results:Among the 38 patients (25 women [66%]; mean [SD] age, 65 [14] years), the mean (SD) initial lesioned VOR gain was 0.66?(0.23) and initial DGI score was 16?(3). No correlation was found between initial VOR gain and initial DGI score (r?=?-0.04; 95% CI, -0.35 to 0.28). At follow-up, 15 patients (39%) had an improved VOR gain and 30 (79%) had an improved DGI score, which was correlated (r?=?0.49; 95% CI, 0.20-0.69). In those 15 patients with improved VOR gain, 14 (93%) had improvement of DGI score. In the 23 patients without improvement of VOR gain, 16 (70%) still showed improvement in their DGI score. When using VOR gain to estimate improvement of DGI, the minimal clinically important difference of VOR gain was -0.06. Conclusions and Relevance:The change of VOR gain in the vHIT was moderately associated with the change of DGI score. Improved VOR gain was associated with a high probability of improved dynamic balance. However, in most of the patients whose VOR gains did not improve, balance improvement occurred putatively through sensory reweighting strategies.

Dataset Information

Video head impulse test (vHIT) in migraine dizziness.

Publications

Video head impulse test (vHIT) in migraine dizziness.

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