The Video Head Impulse Test in Clinical Practice
Halmagyi Michael1
1Prince Alfred Hospital, Neurology, Sydney

Over the last 10 years the video Head Impulse Test has become the generally accepted initial test vestibular function to be done in patients presenting with vertigo or imbalance. vHIT can give reliable reproducible measurements of the function of each of the 6 semicircular canals individually, in any reasonably cooperative adult or child in about 15 minutes. There are published normative values and the test can be particularly useful in diagnosing: (1) acute unilateral peripheral vestibulopathy (i.e. vestibular neuritis) and differentiating it from cerebellar infarction; and (2) chronic bilateral vestibular vestibulopathy - and differentiating if from the many other causes of persistent imbalance. Here we review the basic physiological principles behind the Head Impulse test and some of the benefits and potential practical problems in video Head Impulse Testing.

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