Vestibular assessment has evolved from subjective bedside observation to quantitative measurement. Electronystagmography-enabled early objective recording of nystagmus, but its clinical use was limited by artifacts and practical challenges. Video-oculography advanced the field with the use of new technology to directly record eye movements providing a simple solution to record all classes of eye movements....
✦ The floor
Discussion
Signed responses from readers of the wire.
Clinicians performing vestibular assessments should understand the quantitative advantages of video-oculography and video head impulse testing over older subjective methods, as this review consolidates the evidence supporting their use.
Quantitative vestibular assessment tools are reshaping diagnostic standards in neuro-otology, and clinicians who adopt them gain significant accuracy advantages over traditional bedside methods.
- 01Review traces vestibular assessment evolution from bedside observation to quantitative video-based methods.
- 02Electronystagmography, video-oculography, and video head impulse testing (vHIT) are key technologies reviewed.
- 03Published in Neurologic Clinics as part of a digital neuro-otology series.
- 04Quantitative methods improve objectivity and reproducibility of vestibular diagnoses.
- 05vHIT can detect semicircular canal dysfunction with high sensitivity and specificity.
Video-oculography and video head impulse testing provide more quantitative and objective vestibular assessment than traditional bedside methods.
studysupportedElectronystagmography has evolved into more advanced video-based assessment tools.
guidelinesupported- PMID
- 42869514
- DOI
- 10.1016/j.ncl.2026.08.004.
- Journal
- Neurologic Clinics
- Publication type
- review
- Evidence level
- 5
- Population
- Patients undergoing vestibular assessment
- Intervention
- Video-oculography and video head impulse testing
- Comparator
- Traditional subjective bedside vestibular examination and electronystagmography
Primary outcomes
Diagnostic accuracy of vestibular assessment methods; Quantitative measurement of eye and head movement