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'ECG for the eyes' to help dx vertigo/stroke


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Very interesting. I am not familiar with this technology, nor have I ever tried or seen the horizontal head impulse test done in a clinical setting (only seen a few videos on Youtube). I have performed and worked with neurologists in the ED using Dix-Hallpike... with limited success (few neurologists attempt it), most just went by history and doing a complete neuro exam (checking for ataxia and to walk the patient).

 

A study from Neurology showed that several patients with a positive horizontal head impulse test (hHIT) had a posterior circulation stroke. It appears, a positive hHIT does not rule out a vertebrobasilar CVA.

 

"Forty-three subjects enrolled. One had an equivocal h-HIT. Patients with APV (acute vestibulopathy) had a positive h-HIT (n = 8/8, 100%). Most patients with stroke had a negative h-HIT (n = 31/34, 91%). However, contrary to conventional wisdom, three patients with stroke (9%) demonstrated a positive h-HIT (1 vestibulocerebellar, 1 pontocerebellar, 1 pontocerebello-labyrinthine stroke)."

http://www.ncbi.nlm.nih.gov/pubmed/18541870

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