European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 3, pp 463–472 | Cite as

Caloric test and video-head-impulse: a study of vertigo/dizziness patients in a community hospital

  • Andrea Mahringer
  • Holger A. RamboldEmail author


The head-impulse test (HIT) is an important test for examining unilateral vestibular hypofunction. The new video-head-impulse test (vHIT) is more sensitive and specific than the clinical bedside-head-impulse test (bHIT). Alternatively, one can test for vestibular hypofunction with the caloric irrigation test. Various studies showed that both tests may not always identify vestibular hypofunction; instead, the results of the tests might be contradictory. To evaluate the diagnostic value of these tests, we routinely measured patients exhibiting vertigo or dizziness at our community hospital with bithermal caloric irrigation, the bHIT and the vHIT. Only those patients (n = 172) with a pathological caloric irrigation test of more than 25 % unilateral weakness in the Jongkee’s formula were included. Out of these patients, 41 % had a pathologic vHIT. Among the subgroup with acute symptoms (symptom onset within 5 days), 63 % had a pathological video-head-impulse, whereas only 33 % of the non-acute group (symptom onset more than 5 days) tested pathological. A pathological HIT depended on the disease stage, the amount of unilateral weakness in caloric examination and on the test itself.


Vertigo Dizziness Caloric irrigation Head-impulse-test 



The authors thank Mrs. Ribarczyk and Mrs. Goetz for technical assistance and Dr. Blaine Nelson for copyediting the manuscript.

Conflict of interest

  H. Rambold is beta-tester of the Otosuite® vHIT system but has no financial interest in the product.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of NeurologyCommunity Hospitals Altötting-BurghausenAltoettingGermany
  2. 2.Department of NeurologyUniversity of RegensburgRegensburgGermany

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