Head Impulse Test | Peripheral Vestibular Dysfunction Assessment
Head Impulse Test | Peripheral Vestibular Dysfunction Assessment
Molnar et al. (2014) describe that most patients with sustained vertigo suffer from vestibular neuronitis, although a few patients (especially elderly patients with cardiovascular risk factors) are having a stroke or other serious disease in the cerebellum and brainstem. A helpful bedside maneuver to help distinguish central and peripheral causes is the head impulse test. Dros et al. (2010) performed an analysis of 7 studies and found a pooled sensitivity of 63% and a pooled specificity of 93%. For this reason, the Head Impulse Test has a high clinical value to confirm peripheral vestibular dysfunction in patients with prolonged dizziness.
Before you start make sure that you only do this test in a patient with prolonged vertigo as brief episodes more likely indicate BPPV and should be tested with the Dix-Hallpike maneuver that you can watch with a click in the top right corner.
To perform the test the examiner sits in front of the patient and places a hand on each side of the patient’s head. The patient is instructed to focus on the examiner’s nose and the examiner focuses on the patient’s eyes. The patient should keep their eyes open even if vertigo symptoms worsen. Now the examiner quickly turns the patient’s head towards the side to be tested while watching the patient’s eyes. Afterward, the head is slowly returned to neutral and the process is repeated several times.
LEARN TO TREAT THE MOST COMMON CAUSE OF VERTIGO IN THIS FREE MINI-VIDEO-SERIES
Dros J, Maarsingh OR, van der Horst HE, Bindels PJ, Ter Riet G, van Weert HC. Tests used to evaluate dizziness in primary care. Cmaj. 2010 Sep 21;182(13):E621-31.
Weber KP, Aw ST, Todd MJ, McGarvie LA, Curthoys IS, Halmagyi GM. Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology. 2008 Feb 5;70(6):454-63.
Molnar A, McGee S. Diagnosing and treating dizziness. Medical Clinics. 2014 May 1;98(3):583-96.
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- Mads Louis25/11/22Vestibular Rehabilitation EXCELLENT COURSE, THAT MAKES YOU READY TO TREAT DIZZINESS WITH CONFIDENCE
This course provides an excellent opportunity to learn how to treat and diagnose vertigo/dizziness patients, who previously were a mystery to treat.Jordi Holierhoek18/08/22Vestibular Rehabilitation EXCELLENT COURSE!
Fantastic course, very practical with enough depth! I learned a lot from first. He is an excellent teacher who knows his stuff. I would totally recommend this course.Stephen08/08/22Vestibular Rehabilitation GREAT COURSE FOR BEGINNERS AND THERAPISTS WITH SOME EXPERIENCE
Loved the course, can be done relatively quickly if you are like me and have a little bit of vestibular knowledge (it took me around 2 weeks), but the basics are all there so you can spend a bit more time getting into it if needed
I luckily had two patients in my ward needing vestibular rehabilitation just as I had finished this course, and I was able to help them straight away
- Kim Hansen30/03/22Vestibular Rehabilitation VESTIBULAR REHABILITATION
Really good and professional layout with Firat's professional experience as well as nice software touches by Physiotutors with questions in some videos for example. Firat approaches you in different ways of teaching with small videos, summaries, lectures and so on. Also fun to see that some of his references are people that I have a cooperation with here in Sweden. Even if there’s a whole division of information regarding vestibular hypofunction it would still be fun to have separate chapter for vestibular neuritis, but that’s just a small note. On the whole I’m totally happy and satisfied with this course, really good job done by Firat and Physiotutors, I will be keeping an eye out for more advanced courses in the future regarding this topic, maybe Firat can do a Masterclass version?Steve van Rijen26/03/22Vestibular Rehabilitation VESTIBULAR REHABILITATION
By far the best course i ever had.
It will take you a lot of time and effort to make it your own.
But i can tell, the reward is great.
you won’t be disappointedMarine Gandin27/01/22Vestibular Rehabilitation REALLY COMPLETE COURSE AND EASY TO LEARN
It takes me 6 full days to finish that course but it was a really good course!
I enjoyed every part of the “vestibular rehabilitation” by Firat.
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I didn’t need any further explanation but I saw that Firat answers very fast to the question on the unit.
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Even if it is in an other language than mine, it was really easy to understand.
- Christiena den Tek28/12/21Vestibular Rehab COMPLETE COURSE ABOUT DIZZINESS AND THE WAY TO TREAT FOR PHYSIO'S
In the past I finished/followed a few courses about dizziness and treatment. I really enjoyed following this course because it’s very complete. There is overall information about the systems involved with dizziness problems, the pathologies, the exams and the overall physiotherapy treatment or other treatments. There is a nice mix between the way the information is given and the information is up to date science. The teacher (Firat) is a teacher that loves helping you out and if you have any questions he is quickly in his response.
I would recommened this course highly not only for those who just start learning things about the dizziness (patient) but also for those who are already working with these patients.Elisabetta12/12/21Vestibular Rehabilitation INCREDIBLY THOROUGH COURSE
Such a fantastic course!
The learning experience is enhanced by interactive material found in each module.
The instructor provides clear information, both theoretical and practical, easy to apply in clinical practice.
This is an excellent course, and I would definitely recommend it!Physiotutors27/08/21Vestibular Rehabilitation Firat really delivered on this course! While we have had some training in vestibular diagnostics and rehab in our own training, this course is on a whole other level! Building this course with Firat has increased our knowledge dramatically and we can absolutely recommend this course to any Physiotherapist as patients with vestibular problems will be among the most grateful patients when treated right.
- Anne Cahill02/08/21Vestibular Rehabilitation Thank You!!
This is a brilliant course. The learning materials are concise, clear and comprehensive. All the information given is easy to navigate, up to date and very useful for daily clinical vestibular rehabilitation practice. It is a much appreciated educational resource. Amazing!! Thank you for this excellent course.Astrid Schubart27/06/21Vestibular Rehabilitation I finished this course Vertigo this weekend and it’s been a long time since I’ve done such a great structured training. Lots of practical content. The lecturer shows in detail what is important. Firat Kesgin offers a lot of additional information and patient information.
I am really excited and looking forward to apply my new knowledge in practice.