Isolated Corrective Saccades in the Bilateral Posterior Canal Stimulation During the Video Head Impulse Test: A Marker of Central Vestibulopathy?

• Published in: Ear and hearing Vol. 46; no. 3; p. 729
• Main Authors: Hurtado, Genoveva, Poth, Elizabeth A, Monaghan, Neil P, Nguyen, Shaun A, Rizk, Habib G
• Format: Journal Article
• Language: English
• Published: United States 01.05.2025
• Subjects: Aged; Aged, 80 and over; Bilateral Vestibulopathy - diagnosis; Bilateral Vestibulopathy - physiopathology; Female; Head Impulse Test - methods; Humans; Male; Middle Aged; Retrospective Studies; Saccades - physiology; Semicircular Canals - physiopathology; Vestibular Evoked Myogenic Potentials - physiology; Posterior semicircular canal; Vestibular testing; vHIT
• DOI: 10.1097/AUD.0000000000001617

This study aimed to determine if the presence of corrective saccades during video head impulse test (vHIT) stimulation of the bilateral posterior semicircular canals (PSCs) correlated with other vestibular test results, demographics, symptoms, or diagnoses. This study was a retrospective chart review where 1006 subjects' vHIT records were screened with 17 subjects meeting inclusion criteria for isolated bilateral PSC saccades. Of the 1006 patients undergoing vHIT testing, only 1.7% had isolated bilateral PSC saccades. The median age of subjects was 73 years, with a range of 61 to 85 years. Statistical significance was identified between groups with abnormal PSC vHIT gain and abnormal ocular vestibular evoked myogenic potential results as well as those with 1 to 2 diagnoses. Our study confirms the rarity of isolated bilateral PSC vHIT saccades and as well as association with central vestibulopathy. Correlations with other vestibular test results, demographics, symptoms, or diagnoses may be strengthened with future large-scale studies. Further understanding of the clinical utility of isolated bilateral PSC vHIT saccades is needed. Patients with bilateral PSC vHIT abnormalities may benefit from a comprehensive neurological evaluation and consultation.