Suppression Head Impulse Paradigm (SHIMP) in evaluating the vestibulo-saccadic interaction in patients with vestibular n
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SHORT COMMUNICATION
Suppression Head Impulse Paradigm (SHIMP) in evaluating the vestibulo‑saccadic interaction in patients with vestibular neuritis Leonardo Manzari1 · Marco Tramontano2,3 Received: 9 April 2020 / Accepted: 22 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Evaluate the potential clinical application of the Suppression Head Impulse Paradigm (SHIMP) in evaluating the vestibulo-saccadic interaction in patients with vestibular neuritis (VN). Methods A retrospective study was performed. Fifteen patients diagnosed with unilateral VN were identified from a database of ENT vestibular clinic from January 2011 to February 2020. Medical records were reviewed to determine clinical presentation, vestibular testing results, treatment, and recovery. Results Fifteen patients (7 left ear, 8 right ear, mean age 58.73 ± 10.73, six female) met the inclusion criteria and were enrolled in the study. Significant differences were found in the within-subjects analysis at T1 in DHI score (p = 0.001), VOR gain (p 72 h since the acute vestibular syndrome, Meniere disease, bilateral vestibular loss, vestibular migraine, BPPV, etc.), somatic or psychiatric disorders; (2) presence of neurological diseases. At the time of the first evaluation, all patients were instructed to return to the normal daily activities as soon as possible. All patients admitted to MSA ENT Academy Center, Cassino (Italy) with a diagnosis of VN were undergone to a vestibular assessment that included a self-assessment inventory with DHI, an assessment of horizontal and vertical semicircular canals with bed-side HIT + vHIT, and Air Conducted Sound and Bone Conducted Vibration Cervical and Ocular VEMPs. Data on horizontal semicircular VOR gain and on eye velocity, head velocity, and percentages of impulses containing an SHIMPs saccade during the SHIMPs procedure was collected. All patients were evaluated in the first days and at least after 1 month or later after the AVS. VN was diagnosed on the following criteria: (a) a history of acute onset of severe, prolonged, rotatory vertigo, nausea, and postural imbalance; (b) on clinical examination the presence of horizontal spontaneous nystagmus with a rotational component toward the unaffected ear (fast phase) without evidence of a central vestibular lesion; (c) abnormal bed-side HIT showing an ipsilateral deficit of the horizontal semicircular canal [5]; (d) alterations in the VEMPs results and absence of neurological signs; e) an MRI of the brain that showed no lesions that could account for any vestibular disturbance. Demographic characteristics are reported in Table 1.
Dizziness handicap inventory (DHI) The quality of life of all VN patients was assessed by the DHI. The DHI is a self-assessment inventory, including 25 questions to evaluate self-perceived activity limitation and restriction resulting from dizziness [11].
Participants
Video head impulse test
The inclusion criteria in this study were: (1) diagnosis of VN in acute phase (
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