The Application Of Video Head Impulse Test In Vestibular Neuritis

BackgroundTo assess the application value of video head impulse test(vHIT)in vestibular neuritis(VN)among acute vertigo.MethodsFrom October 15th 2014 to September 10th 2015,33 cases of VN patients(VN group),96 cases with other acute vertigo patients(AV group)dignosed in Sir Run Run Shaw Hospital affiliated to Medical College of Zhejiang University and Ningbo No.2 Hospital,in addition,the staff from Sir Run Run Shaw Hospital and Ningbo NO.2 Hospital,relatives of the patients and social volunteers as normal controls at the same period were used vHIT to quantitatively test a pair of horizontal VOR gains,two pairs of vertical VOR gains,and the three corresponding VOR gain asymmetries.The results and difference of VOR between these three groups by vHIT were collected and analyzed,saccades information was also recorded simultaneously.Results1.The mean values of the six VOR gains in NC group were close to the theoretical value of 1 and the corresponding 3 asymmetries were all less than 10%,the difference was no statistically significance(P>0.05),indicating that the VOR data of normal people by vHIT in this study was in agreement with the theoretical value.2.There was significant difference of the 3 affected VOR gains and corresponding asymmetries between VN group and NC group(P<0.01).There was significant difference of the 3 affected VOR gains and corresponding asymmetries between VN group and AV group(P<0.01).3.The VOR gain asymmetry of the damaged horizontal semicircular canal was(40.5 ± 12.42)%and the VOR gain asymmetry of the damaged vertical semicircular canal was(36.50 ± 12.10)%in VN,which were significantly higher than normal and there was statistically significant difference(P<0.01).4.The sensitivity was 87.9%and the specificity was 94.9%by vHIT in diagnosing VN among acute vertigo when more than 20%of VOR gain asymmetry was defined positive in horizontal semicircular canal and more than 25%of VOR gain asymmetry was defined positive in vertical semicircular canal.5.vHIT could record catch-up saccades keenly,the abnormal saccades rate in VN group was 100%and the catch-up saccades were all continuous and with high amplitude.6.The follow-up results indicated that the reviewed data in VN patients by vHIT was consistent to their vestibular compensation.ConclusionThis study shows vHIT can quantitatively test vestibular function of six semicircular canals quickly and safely,vHIT has advantages in the diagnosis of VN among acute vertigo in early stage with good sensitivity and specificity which indicates it a good clinical application prospect.vHIT enables the location of vestibular damage of VN and helps to confirm inferior vestibular neuritis and guide the prognosis of VN patients.