Head Impulse Test | Peripheral Vestibular Dysfunction

Execution:

  1. Patient sits in front of the examiner
  2. The examiner places a hand on each side of the patient’s head
  3. The patient is instructed to focus on the examiner’s nose and to keep their eyes open even if vertigo symptoms worsen
  4. The examiner focuses on the patient’s eyes and quickly turn the patient’s head towards the side to be tested and slowly returns to the starting position

 

Positive Outcome: Patient’s eyes move away with the head and gaze quickly returns to the examiner’s nose at the end of the rotation. This phenomenon is called “corrective saccade”, which occurs due to an abnormal vestibule-ocular reflex

Study Reliability Sn Sp LR+ LR-
Treleaven et al. (2020) NA NA 98.5 NA NA
Comment: Weber et al. (2008) stress that this test appears to be more sensitive when the rotations are performed quickly and recommend performing repetitions in order to avoid false negative results