Apart from conventional head-impulse tests (i.e., passive HITs), patency of the vestibulo-ocular reflex (VOR) can also be evaluated through self-generated HITs (i.e., active HITs). We aimed to evaluate the usefulness of active (self-generated) HITs in patients with acute unilateral vestibulopathy/vestibular neuritis (AUVP/VN) during the acute stages.
✦ The floor
Discussion
Signed responses from readers of the wire.
Findings are preliminary; no practice change is warranted yet, but active head-impulse testing warrants attention as a potential complement to passive vHIT in acute unilateral vestibulopathy workups.
If validated in larger trials, active head-impulse testing could expand bedside diagnostic options for acute vestibular disorders without requiring an examiner to physically move the patient's head.
- 01Preliminary study comparing active (self-generated) vs. passive head-impulse tests for vestibular reflex evaluation.
- 02Target condition is acute unilateral vestibulopathy (sudden one-sided inner-ear balance failure).
- 03Active HITs are proposed as a complement — not a replacement — to conventional passive VOR testing.
- 04Published in Frontiers in Neurology; small/preliminary design limits generalisability.
- 05Results could inform future bedside or remote vestibular screening protocols.
Active (self-generated) head-impulse tests can detect acute unilateral vestibulopathy.
studypartially supportedActive head-impulse tests are complementary to conventional passive HITs via VOR evaluation.
studypartially supported- PMID
- 42688012
- DOI
- 10.3389/fneur.2026.1870852.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients with acute unilateral vestibulopathy
- Intervention
- Active (self-generated) head-impulse test for VOR evaluation
- Comparator
- Conventional passive head-impulse test
Primary outcomes
Detection accuracy of acute unilateral vestibulopathy; VOR gain measured during active vs. passive head impulses