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Assessment of Vestibular Functional Recovery Using Video Head
Impulse Test in Vestibular Neuritis
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Jun Hyun Kim, Tae Kyeong Lee, Sang Woo Lee, Nari Choi, Seungcheol Lee, Ki Bum Sung
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Res Vestib Sci. 2015;14(4):132-138.
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 Abstract
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- Objective: The video head impulse test (vHIT) is useful for evaluation of high
frequency vestibulo-ocular reflex. There are a few reports regarding the recovery of
head impulse test in vestibular neuritis (VN) but the factors for the recovery were not
studied. The study aimed to identify the recovery patterns of vHIT in VN and the
factors influencing the recovery.
Methods
Among 31 patients with acute VN, 18 patients with identified recovery
pattern were selected. We conducted serial checks of subjective vertigo and spontaneous
nystagmus until discharged (1?8 days), and scheduled vHITs. We found three patterns
in serial vHITs during follow-ups and analyzed the relationship of initial vestibular
function tests, serial check-ups of subjective vertigo, bedside neuro-otologic tests, and
vHITs.
Results
Five patients showed normal vHIT gain in acute stage (non-damaged pattern)
and 8 patients’ gains were recovered after 30 days after symptom onset (early recovered
pattern). Poor recovery pattern was found in 5 patients (poorly recovered pattern). There
were relationship between vHIT recovery patterns and the severity of vestibular dysfunctions.
Duration of spontaneous nystagmus (until grade 1), degree of subjective
visual vertical tilt, ocular vestibular myogenic potential abnormalities, and abnormality
of rotatory chair test were all related to poorly recovered vHIT patterns. All poor
recovery patients had residual symptom at 30 days after symptom onset.
Conclusion
The vHIT may give clinicians useful hints in predicting prognosis in VN,
and the recovery of vHIT would be delayed if the damage were more extensive.
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KBS
