“Intact vestibulo-ocular reflex function and a negative h-HIT in a patient with acute vestibular syndrome,” he advised, “is a strong predictor of stroke even when initial MRI suggests otherwise.”
Dr. Kattah, of the University of Illinois College of Medicine at Peoria, and colleagues studied data on 43 subjects with acute vestibular syndrome at high risk for stroke who had undergone a variety of testing including MRI and h-HIT. One subject had equivocal h-HIT results, but all eight patients with acute peripheral vestibulopathy had a positive h-HIT test.
“Our study,” said the investigators, “confirms the utility of h-HIT in distinguishing peripheral from central causes of the acute vestibular syndrome, but departs from current neuro-otologic thinking by suggesting that the sign’s absence may be more helpful than its presence.”
Neurology. 2008;70(24 Pt 2):2378-2385.