나안 두부충동검사에서 위음성의 원인분석
Causes of False Negative Bedside Head Impulse Test
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background and Objectives The bedside head impulse test (bHIT) in bare eyes often overlooks possible vestibular losses by missing the corrective saccade. This is why it is necessary to compare bHIT against video head impulse test (vHIT), which is more accurate in identifying vestibular losses than the bedside test. Subjects and Method A total of 51 vHIT positive ears underwent the study, and out of those, 47 were diagnosed with dizziness. bHIT and vHIT were performed for patients, and the occurrence rate of overt saccade (OS) was calculated. Results Among the 51 vHIT positive ears, 33 (64.7%) were bHIT positive ears and 18 ears (35.3%) were bHIT negative. Patterns of positive vHIT were classified as A: no corrective saccade, B: covert saccade (CS) only, C: OS only, and D: CS with OS (CS+OS), which were 45 out of 51 ears (88%). The occurrence rate of OS was higher in the bHIT positive group than in the bHIT negative group (p=0.05), and higher in the CS negative group (CS-) than in the CS positive group (CS+) (p＜0.001). Conclusion Possible causes of false negative results of bHIT are seen as following: the absence of corrective (covert and overt) saccade, the occurrence of CS only, and missing the OS during the bHIT (probably due to low occurrence rate of OS). The occurrence of CS should be considered as an important factor in false negative bHIT when lowering the occurrence rate of OS. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(3):107-11
Abstract
Background and Objectives The bedside head impulse test (bHIT) in bare eyes often overlooks possible vestibular losses by missing the corrective saccade. This is why it is necessary to compare bHIT against video head impulse test (vHIT), which is more accurate in identifying vestibular losses than the bedside test. Subjects and Method A total of 51 vHIT positive ears underwent the study, and out of those, 47 were diagnosed with dizziness. bHIT and vHIT were performed for patients, and the occurrence rate of overt saccade (OS) was calculated. Results Among the 51 vHIT positive ears, 33 (64.7%) were bHIT positive ears and 18 ears (35.3%) were bHIT negative. Patterns of positive vHIT were classified as A: no corrective saccade, B: covert saccade (CS) only, C: OS only, and D: CS with OS (CS+OS), which were 45 out of 51 ears (88%). The occurrence rate of OS was higher in the bHIT positive group than in the bHIT negative group (p=0.05), and higher in the CS negative group (CS-) than in the CS positive group (CS+) (p＜0.001). Conclusion Possible causes of false negative results of bHIT are seen as following: the absence of corrective (covert and overt) saccade, the occurrence of CS only, and missing the OS during the bHIT (probably due to low occurrence rate of OS). The occurrence of CS should be considered as an important factor in false negative bHIT when lowering the occurrence rate of OS. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(3):107-11
참고문헌 (9)
- Perez N, "Head-impulse and caloric tests in patients with dizziness", Otol Neurotol, 24(6), pp.913~917 (2003)
- Yip CW, "Comparison of the bedside head-impulse test with the video head-impulse test in a clinical practice setting: a prospective study of 500 outpatients", Front Neurol, 7, pp.58~ (2016)
- MacDougall HG, "The video head impulse test: diagnostic accuracy in peripheral vestibulopathy", Neurology, 73(14), pp.1134~1141 (2009)
- Halmagyi GM, "A clinical sign of canal paresis", Arch Neurol, 45(7), pp.737~739 (1988)
- Kattah JC, "HINTS to diagnose stroke in the acute vestibular syndrome: threestep bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging", Stroke, 40(11), pp.3504~3510 (2009)
- Schmid-Priscoveanu A, "Caloric and search-coil head-impulse testing in patients after vestibular neuritis", J Assoc Res Otolaryngol, 2(1), pp.72~78 (2001)
- Weber KP, "Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades", Neurology, 70(6), pp.454~463 (2008)
- Lee SH, "Compensatory saccade differences between outward versus inward head impulses in chronic unilateral vestibular hypofunction", J Clin Neurosci, 21(10), pp.1744~1749 (2014)
- Blödow A, "Detection of isolated covert saccades with the video head impulse test in peripheral vestibular disorders", Auris Nasus Larynx, 40(4), pp.348~351 (2013)