The prognostic role of video head-impulse test in the clinical evaluation of chronic vestibular damage: A brief case series

Introduction: The video Head Impulse Test (vHIT) is a valid tool in identifying acute vestibular damage (AVD) and cerebellar vertigo syndromes, but a diagnostic gap remains in identifying those patients who experience persistence of chronic vestibular symptoms. The aim of this brief study was to investigate the ability of vHIT combined with the Italian Dizziness Handicap Inventory (DHI) score to identify AVD patients who develop chronic vestibular deficiency. Case Series: The mean age of the 18 patients enrolled was 56 years (SD ± 12), and among them 10 (55.5%) were males. Improved gain was found in one-third of the cases (6, 33.3%); in addition, we observed that the vHIT 60 ms gain could predict the DHI value at follow-up (p = 0.007). Furthermore, the distribution of Overt and Covert saccades at follow-up between the two iDHI groups was significantly different (p = 0.025), with a greater number of patients without any type of corrective saccade in the low iDHI group. Furthermore, group 1 patients were found to have a significantly higher mean age compared to those of group 0 (p = 0.015), along with a lower vHIT gain at 60 ms at final follow-up (p = 0.062). Conclusions: These results of our study showed that the vHIT 60 ms gain could predict the iDHI score, but the width and latency of the saccades were not correlated with iDHI at follow-up. In addition, patients with low iDHI score had not corrective saccades, while those with high iDHI score were significantly older than those with low iDHI.