Ricardo D'Albora1, Rodrigo Noboa2, José Cuervo Road3, Marcos Cvizonas Gutman4, Susana Fernández Fuentes5, Carlos Vicente Alcayaga Palazón2, Ligia Silveira2, Carlos Agustín Fau Moreno6, Maria Julia Monaco7, Guillermo Javier Zalazar8, Sergio Carmona9. 1. Cátedra de Otorrinolaringología. Hospital de Clínicas. Fac. de Medicina. Universidad de la República Oriental del Uruguay (UDELAR); Clínica Neurotológica del Parque; Asistencial Médica Departamental de Maldonado (AMDM IAMPP), Maldonado. 2. ENT Department at Hospital de Clínicas, Fac. de Medicina. Universidad de la República Oriental del Uruguay (UDELAR). 3. Clínica Neurotológica del Parque; Hospital Central de las Fuerzas Armadas. 4. Cátedra de Otorrinolaringología. Hospital de Clínicas. Fac. de Medicina. Universidad de la República Oriental del Uruguay (UDELAR); Clínica Neurotológica del Parque, Montevideo. 5. Clínica Neurotológica del Parque, Montevideo; Corporación Médica de Canelones (COMECA-IAMPP). 6. Asistencial Médica Departamental de Maldonado (AMDM IAMPP), Maldonado. 7. Clínica Neurotológica del Parque, Montevideo, Uruguay. 8. Hospital San Luis, San Luis. 9. Neurotology Department, Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina.
Abstract
OBJECTIVE: We developed a clinical sign that improves the sensitivity, specificity, and predictive values of the Head Impulse Paradigm (HIMP) Test by adding the Suppression Head Impulse Paradigm (SHIMP) Test using a diagnostic headband. METHODS: Prospective and descriptive study analyzing the function of 1,255 horizontal semicircular canals of subjects with differing vestibulo-ocular reflex (VOR) gains who showed-up with symptoms related to neurotology (Montevideo, Uruguay, March 2017 to March 2019). The clinical HIMP and SHIMP tests were assessed and the amplitudes of overt saccades were compared to each other. Clinical findings were contrasted against vHIT gains. CONCLUSION: The HIMP and SHIMP combined test using the H/S headband has high specificity and low sensibility. This test association can identify healthy individuals among individuals typically misdiagnosed as ill by the conventional HIT or HIMP maneuver of the HIMP test, as originally described by Halmagyi and Curthoys. Therefore, we recommend using the headband assisted HIMP/SHIMP test, instead of exclusively relying on positive HIMP results.
OBJECTIVE: We developed a clinical sign that improves the sensitivity, specificity, and predictive values of the Head Impulse Paradigm (HIMP) Test by adding the Suppression Head Impulse Paradigm (SHIMP) Test using a diagnostic headband. METHODS: Prospective and descriptive study analyzing the function of 1,255 horizontal semicircular canals of subjects with differing vestibulo-ocular reflex (VOR) gains who showed-up with symptoms related to neurotology (Montevideo, Uruguay, March 2017 to March 2019). The clinical HIMP and SHIMP tests were assessed and the amplitudes of overt saccades were compared to each other. Clinical findings were contrasted against vHIT gains. CONCLUSION: The HIMP and SHIMP combined test using the H/S headband has high specificity and low sensibility. This test association can identify healthy individuals among individuals typically misdiagnosed as ill by the conventional HIT or HIMP maneuver of the HIMP test, as originally described by Halmagyi and Curthoys. Therefore, we recommend using the headband assisted HIMP/SHIMP test, instead of exclusively relying on positive HIMP results.
Authors: Tessa van Dooren; Dmitrii Starkov; Florence Lucieer; Bieke Dobbels; Miranda Janssen; Nils Guinand; Angelica Pérez Fornos; Herman Kingma; Vincent Van Rompaey; Raymond van de Berg Journal: J Clin Med Date: 2022-04-26 Impact factor: 4.241