The Role of Video Head Impulse Test (Vhit) in Diagnosing Benign Paroxysmal Positional Vertigo (BPPV)

Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):506-510. doi: 10.1007/s12070-020-02351-5. Epub 2021 Jan 8.

Abstract

Benign paroxysmal positional vertigo (BPPV) is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes. General treatment for BPPV is by clinical examination by Dix-Hallpike maneuver, Video head impulse test (VHIT) is a novel test that enhances diagnostic opportunities and enables a clinician to precisely localize the site of vestibular disorders. This interested us to investigate its potential in diagnosis of BPPV.The aim of the present study is to assess the role of Video head impulse test (VHIT) in confirming the clinically diagnosed case of BPPV.All patients above the age of 18 years who were clinically diagnosed with BPPV underwent VHIT and results were correlated with clinical findings. Total 60 patients were studied in the period of 2016-2018.Among the 60 patients clinically diagnosed with BPPV, 41 were males and 19 were females. Majority of patients were in the age group of 51-60 years. Posterior canal is most commonly affected (97%) than anterior and lateral canals in BPPV. In unilateral posterior canal BPPV and bilateral posterior canal BPPV VOR (Vestibulo- ocular reflex) gains was reduced but were not statistically significant. Saccades were present only in 17 cases. There is no relationship between the presence of saccades, the canal involved and the side of the lesion.From the present study we conclude that the currently available equipment for VHIT is not useful in diagnosing BPPV. Also, strongly recommends advanced research on this to record minute changes in VOR gain.

Keywords: Benign paroxysmal positional vertigo; Semi-circular canals; Video head impulse test.