My Labirinthopathy and the VHIT Test
A few months ago I was suffering from a strange ailment that I had never experienced in my life: it all started by blaming panic attacks and a time when due to extreme malaise and dizziness I could not stay standing. I was also suffering from a continuous tachycardia fruit of the anxiety derived from that state. I went to the medical guard who auscultated and checked the pressure, the result was the obvious tachycardia but without abnormal alterations of the heart. I took benzodiazepines and in the days I improved but I had a constant sense of dizziness that I could not pass. I initially blamed benzodiazepines and decided to reduce the doses to the bare minimum. However, the situation did not want to change and after some time we had the idea that this continuous dizziness could come from a form of labyrinthitis. I started with a basic cure and then increased the doses after a specialist visit by an otolaryngologist. We understood that the initial panic attacks were probably not such but a simple anxious response derived from labyrinthine pathology. But what has happened? The annoyance lasted longer than expected even with drug therapy, so the doctor directed me to a relatively new test, described for the first time about thirty years ago in a scientific article.
The VHIT (Video Head Impulse Test) is a test that allows you to evaluate whether there is a labyrinthine pathology by evaluating a normally present reflex, that of the VOR, the Vestibule-Oculomotor Reflex. On the day of the test, the doctor made me sit down and explained to me that until a few years ago these balance assessment tests were done by putting warm water inside the ears to understand the side affected by the pathology. Why this? Because placing hot water in this way causes violent vertigo, thus making it clear if pathology is present and where it is located. This up to the introduction of the VHIT, which is carried out thanks to the help of special eyewear, capable of recording the movements of the eye at very high frequency. In addition to recording them, he is able to sample them and compare them to those of the garment.
How did it go?
I wore these special glasses and there was a light source to create a bright spot on the wall. The goal was to keep my gaze fixed on the wall as the technician began to turn my head in various directions. What was going on in those moments? When the head was moved, the VOR allowed me to move my gaze so that it remained on the bright spot, or at least this should have happened. But the organs of balance are deeply connected with the visual ones and during labyrintopathy there are alterations whereby the gaze undergoes saccadic movements, simply oscillations, which do not allow it to remain fixed on the luminous point and which determine an increase in the time needed to return the gaze on the bright spot. Through the special glasses I wore it was possible to evaluate the VORgain, or the Gain of the VOR, which would be nothing more than a relationship between the speed of the eye and the speed of the head.
What is the result?
The photos inserted below are the test results and show head movements and eye movements through graphs, with all the related gains and their distribution. For example, my test showed that I was suffering from a labyrinthine alteration on the left, especially significant for what concerned the left lateral semicircular canal. This meant a loss of vestibular function not very significant but enough to justify the feeling of dizziness that continued to afflict me.
I had the pleasure of submitting this clinical case to you having experienced it first hand, so as to talk about a test that I had never heard of before and which instead allows you to locate the source of the disorder and take precautions that can prevent attacks of vertigo during daily life. Currently, my situation has improved but having been a slow recovery I will soon have to undergo another VHIT evaluation at the request of the doctor. After a couple of weeks of recovery, I had a relapse that now seems to have come back. I will wait for news from the next evaluation.