The video Head Impulse Test (vHIT) is a relatively new test that provides diagnostic and functional information about the vestibular system, specifically the vestibular ocular reflex (VOR.) The vHIT has its roots in the head impulse test (HIT), during which the evaluator quickly moves the patients head from side to side as the patient fixates on a point. The evaluator watches the patient’s eyes to verify that they remain fixated throughout the movement. If the patient is unable to maintain fixation, catch-up saccades will be observed which are indicative of a vestibular deficit. The challenge with the HIT is that, while it is possible to observe catch-up saccades after the head movement has stopped (called overt saccades), it is not possible to see catch-up saccades that occur during the head movement (covert saccades.)
Loss of balance is an all-too-common symptom in medical conditions associated with aging. The brain, muscles, bones, nerves and inner ear all work together to maintain the body’s balance. Because vestibular dysfunction makes it difficult for a person to maintain their balance, they are highly susceptible to falling, which makes it extremely important for them to remain active.
The Video Head Impulse Test, or vHIT, is an instrumented technique that is used to help diagnose reduction in vestibular function in one ear versus the other. Using a lightweight, high-speed video goggle to measure left or right eye velocity and record any abnormalities, vHIT gives hearing health professionals the ability to quickly and objectively measure the vestibular ocular reflex (VOR) in response to a patient’s head movements within the normal range of daily motions.
Vestibular Rehabilitation Therapy (VRT) has proven to be effective in improving symptoms related to vestibular and balance disorders (BPPV, Meniere’s disease, vestibular neuritis, etc.). Specifically, VRT aims to address issues such as vertigo, dizziness, visual disturbance, and imbalance. The ultimate goal of this type of therapy is to help patients beat these symptoms and restore their quality of life.
When a patient comes in for a routine hearing check and mentions they’ve struggled with dizziness and poor balance, a door to another opportunity for you to help opens. With so many innovative technologies available, accurately diagnosing balance disorders, which generally stem from the vestibular system, has never been easier. Using this equipment will help you better understand your patient’s dizziness issues, which, in turn, will allow you to create a more effective treatment plan.
Vestibular Rehabilitation Therapy (VRT) has proven to be effective for improving vestibular disorder-related symptoms, such as vertigo, imbalance, dizziness, migraines, and visual disturbances. But is it the right therapy for all your vestibular patients?
Most of us probably take balance for granted. Like breathing, it’s not something we have think about unless, or until, something happens to disrupt our innate sense of balance.
When you think about it, the balance humans have on two feet is remarkable. It may take us a few months to get the hang of it, but once we do, it becomes involuntary. That is unless one suffers from a balance disorder.
Many clinics that do diagnostic vestibular testing will benefit from adding Vestibular Evoked Myogenic Potential (VEMP) recordings to the battery of tests they perform on patients with dizzy/balance issues. Adding VEMP testing, along with the Video Head Impulse Test (vHIT), can provide a more comprehensive look into the function of the individual components of the vestibular system and, therefore, greatly improve the sensitivity of the test battery for detecting vestibular disorders.