Video Head Impulse Test : Impact for Screening Vestibular Diseases for Adults Over 65 Years with Falls. Preliminary Results

Objective: Falls are a common problem in the elderly. Screening a vestibular disease at the time of first fall can improve prevention of other falls with their own complications. The objective of the study was to compare Videonystagmography (VNG) and video head impulse test (VHIT) findings in patients with recent falls and without any previous vestibular disease.

Material and methods: Nineteen adults over 65 years old were included and evaluation contained clinical data, general tests as Time Up and Go test, VNG and VHIT. Subjective dizziness was measured using the dizziness handicap inventory (DHI).

During the same session different tests were performed and the main outcome measures were clinical findings and VHIT, VNG and DHI. For VNG bilateral responses were recorded during caloric tests For VHIT, subjects were classified as normal, unilateral, or bilateral.

Results: Thirteen women and 6 men, aged from 65 to 95 years participated to the study. All of them were examined few hours or days after a fall, and on 12 cases hospitalization was necessary due to fall’s complication. Among theme none reported previous otologic disease. Caloric tests were normal (n=7) with unilateral hyporeflexia (n=2), bilateral hyporeflexia (n=2), bilateral increased responses (n=4) and non contributive (n=4). Due to neck pain or diseases results of VHIT were non contributive on 8 cases. Other cases demonstrated: normal results (n=5), unilateral impairment (n=5) and bilateral impairment (n=1). Correlation beetween clinical data, VG, VHIT and DHI results will be discussed.

Conclusion: VHIT can serve as an initial tool for identifying patients with uni or bilateral vestibular study. On elderly feasibility is not constant. More study are necessary to optimize procedure.