Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation

Introduction: This study aimed to perform comparative analysis of the diagnostic value of the Video Head Impulse Testing (VHIT) Ulmer I and Dix-Hallpike Test in patients with balance system disorders in outpatient healthcare practice and medical jurisdiction. Material and methods: The study included 63 patients, aged 20–79, 28 women (20–72 years) and 35 men (23–79 years),
divided into two groups: group I (study group) – 33 patients with vertigo of mixed origin (on the basis of the Fitzgerald-Hallpike caloric test during the VNG), and group II (reference group) – 30 healthy subjects. After the ENT interview and physical examination, exclusion of pathological lesions in the external acoustic meatus and middle ear, each patient underwent the Fitzgerald-Hallpike caloric test in VNG as well as the VHIT and Dix-Hallpike test, with the evaluation of eyeball reaction during head rotation. Results: In the group of patients with mixed origin vertigo (group I), the Fitzgerald-Hallpike caloric test showed unilateral labyrinth disturbances in 90.9% of the patients (mean 41.8%) and relative directional preponderance of the mean value of 19.0%, whereas in 9.1% of the patients, the detected values of labyrinth excitability were normal. Benign paroxysmal positional vertigo was diagnosed in 9.1% of all the examined vertigo cases. This diagnosis was based on the positive response to the Dix-Hallpike maneuver and indicative of damage to the posterior semicircular canal in VHIT (without signs of deficiency in VNG). Conclusion: VHIT and the Dix-Hallpike test enable quick and precise detection of benign paroxysmal positional vertigo in outpatient healthcare practice and medical jurisdiction.