AND OBJECTIVE: In interictal Ménière's disease (MD), a caloric-vHIT dissociation is well established: caloric testing reveals vestibular hypofunction, yet video head impulse test (vHIT) gains in the lateral canal are preserved. Whether this preservation corresponds to preserved functional gaze stabilization remains unknown....
✦ The floor
Discussion
Signed responses from readers of the wire.
Preliminary findings suggest the functional head impulse test may help distinguish interictal Ménière's disease from inferior vestibular neuritis when caloric-vHIT dissociation is present, but the study is preliminary and not yet sufficient to change routine diagnostic protocols.
Differentiating Ménière's disease from inferior vestibular neuritis remains a clinical challenge, and identifying whether functional or video head impulse tests can resolve caloric-vHIT dissociation could meaningfully streamline vestibular diagnostics.
- 01Compared functional head impulse test (fHIT) and video head impulse test (vHIT) in two vestibular disorders.
- 02Focused on patients in the symptom-free (interictal) phase of Ménière's disease vs. inferior vestibular neuritis.
- 03Investigated caloric-vHIT dissociation — when caloric test is abnormal but vHIT appears normal.
- 04Preliminary study; sample size and methodology limitations likely constrain generalisability.
- 05Published in Frontiers in Neurology (DOI: 10.3389/fneur.2026.1851411).
The functional head impulse test and video head impulse test produce different findings in interictal Ménière's disease versus inferior vestibular neuritis.
studypartially supportedCaloric-vHIT dissociation is a distinguishing feature observable between the two vestibular conditions studied.
studyunclear- PMID
- 42516407
- DOI
- 10.3389/fneur.2026.1851411.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 3
- Population
- Adults with interictal Ménière's disease and adults with inferior vestibular neuritis
- Intervention
- Functional head impulse test (fHIT) and video head impulse test (vHIT)
- Comparator
- Caloric testing (standard reference); comparison between Ménière's disease and inferior vestibular neuritis groups
Primary outcomes
Functional head impulse test findings in each group; Video head impulse test findings in each group; Pattern of caloric-vHIT dissociation across conditions