Clinical Feasibility of Suppression Head Impulse Test in Vestibulopathy Patients
10.3342/kjorl-hns.2017.00353
- Author:
Yun Jin KANG
1
;
Beom Cho JUN
;
Ye Sun CHO
;
Ji Hyung LIM
;
Do Yeon KIM
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. otojun@gmail.com
- Publication Type:Original Article
- Keywords:
Head impulse test;
Saccades;
Vestibular function tests;
Vestibulo-ocular reflex;
Vestibulopathy
- MeSH:
Benign Paroxysmal Positional Vertigo;
Electronystagmography;
Head Impulse Test;
Head;
Humans;
Meniere Disease;
Methods;
Neuroma, Acoustic;
Reflex, Vestibulo-Ocular;
Rehabilitation;
Saccades;
Temporal Bone;
Tuberculosis, Meningeal;
Vestibular Function Tests;
Vestibular Neuronitis
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2018;61(2):76-84
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The suppression head impulse (SHIMP) test has emerged as one of the new vestibular function tests. The SHIMP test is an analysis of anti-compensatory saccadic movements in gazing moving targets as the head moves. In this study, we investigated the accuracy and sensitivity of the test. SUBJECTS AND METHOD: We analyzed the results of SHIMP test (gain, amplitude, and latency) in 24 cases, which included normal, vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Meniere's disease, bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis and acoustic schwannoma patients. We also carried out a physical exam, audiologic study, video electronystagmography (vENG) and a conventional video head impulse test to evaluate the feasibility of SHIMP test in cases of vesitibulopathy. RESULTS: In patients with vestibulopathy, the analysis of SHIMP test indicated high sensitivity and accuracy, which were supported by accompanying audio-vestibular studies. Patients suspected with BPPV, vestibular neuronitis and Meniere's disease showed low vestibulo ocular reflex (VOR) gain and delayed anticompensatory saccade with smaller and more scattered amplitudes than the control. Patients with bilateral vestibular function loss, temporal bone fracture, tuberculosis meningitis, and acoustic schwannoma showed delayed latency, and small amplitude or few anticompensatory saccades. Finally, changes in the SHIMP test values might be a hint that patients had recovered from vestibular neuronitis and tuberculosis meningitis. CONCLUSION: We found the feasibility of SHIMP test in detecting the pathologic condition of VOR in vestibulopathy patients. We argue that the usefulness of SHIMP test might be extended to evaluating the effectiveness of rehabilitation.
