The video head impulse test (vHIT) is a standard tool for assessing semicircular canal function through vestibulo-ocular reflex (VOR) gain and corrective saccades (CS). Although reduced gain accompanied by CS typically indicates vestibular hypofunction, a paradoxical pattern-normal gain with CS-is occasionally observed, and its clinical significance remains unclear.
✦ The floor
Discussion
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Clinicians using vHIT should not dismiss corrective saccades as benign when VOR gain is normal; this pattern may still indicate vestibular dysfunction and warrants further diagnostic workup rather than a straightforward 'normal' interpretation.
Clarifying the diagnostic meaning of normal-gain-plus-corrective-saccades on vHIT is critical for avoiding misdiagnosis of vestibular disorders in everyday audiology and neurotology practice.
- 01Normal VOR gain with coexisting corrective saccades on vHIT is a recognized diagnostic dilemma.
- 02Corrective saccades may reflect compensatory mechanisms despite seemingly normal reflex gain.
- 03The review outlines clinical scenarios where this pattern is most commonly encountered.
- 04Authors discuss how to integrate vHIT findings with other vestibular test results.
- 05Published in Diagnostics (PMID 42510059).
Normal VOR gain on vHIT does not rule out vestibular dysfunction when corrective saccades are present.
studypartially supported- PMID
- 42510059
- DOI
- 10.3390/diagnostics16142195.
- Journal
- Diagnostics
- Publication type
- review
- Evidence level
- 5
- Population
- Patients undergoing video head impulse test (vHIT) evaluation for vestibular function
- Intervention
- Video head impulse test (vHIT) with normal VOR gain and corrective saccades
Primary outcomes
Clinical implications of normal gain with corrective saccades on vHIT; Diagnostic accuracy of vHIT in this presentation