Video Head Impulse Testing (vHIT): A Deep Dive

In this presentation, Dr. Kamran Barin, Ph.D, will discuss video head impulse testing (vHIT).
This talk will cover the pathophysiology of vHIT, test parameters for performing vHIT as well as interpretation of the results with consideration of the impact of artifacts, and the clinical application of vHIT.
Timestamps:
0:00 Agenda
0:32 What is the head impulse test (HIT)?
1:24 Normal HIT responses
3:13 HIT responses in patients with unilateral lesions
5:02 What is the video head impulse test (vHIT)?
6:00 Lateral head impulse test
6:43 Vertical head impulse test
8:04 EyeSeeCam vHIT vs ICS Impulse
9:03 Gaze direction in vertical vHIT
10:30 Pathophysiology of vHIT
12:31 Normal vHIT responses
15:00 vHIT responses in patients with unilateral lesions
17:17 Catch-up saccades
18:24 Covert saccades
20:30 vHIT response patterns
25:22 Suppression head impulse paradigm (SHIMP)
27:19 vHIT test parameters
37:35 vHIT interpretation
53:46 Clinical applications of vHIT
1:01:07 vHIT vs caloric test
1:03:45 Summary
#vHIT #VideoHeadImpulseTest
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[@raghavjha3267]

I had a question. For unilateral vestib lesions, the VOR gain would be less on ipsi-lesional side. I understood that but Why would gain on that side decrease with increasing velocity. Will not the inhibitory side get clipped, and if it gets clipped how would it interfere when we stimulate the ipsi-lesional side?? So should not the gain be static even with increasing velocity

[@InteracousticsTV]

Hello Raghav. Thank you for your interest. We have posed your question to Michelle Petrak Ph.D, Clinical Director of Audiology at Interacoustics. This is her reply:
"Referring to the slide at 13:30, it is clear that the inhibitory neural firings saturate for high head velocities. Once the inhibitory responses saturate, they do not increase no matter how much the head velocity increases. As a result, eye velocities do not increase and VOR gains decrease with increasing head velocities beyond that point. This happens in normal individuals and patients with canal dysfunction but it is more noticeable in patients because the saturation occurs at lower head velocities."

[@ghukifymooth3827]

Tomorrow I am taking that test in the hospital and I am so nervous

[@Rozzawood]

Heya, can you let me know how it goes please as I have one of these coming up at somepoint. Good luck :)

[@saurabhsuman8423]

Cost?