Objective: To examine the importance of video head impulse test parameter for recovery of symptoms in acute vestibular neuritis (AVN). Study Design: Prospective study. Setting: Tertiary referral hospital. Patients/Interventions: Twenty-seven patients with AVN were enrolled. We divided patients into two groups according to both dizziness handicap inventory (DHI) score and visual analog scale (VAS) at 6 months: Group F (symptoms free), DHI = 0 and VAS = 0; Group R (symptoms residual), DHI more than zero or VAS more than zero. Main Outcome Measure: All patients underwent video head impulse test paradigm (HIMP), and suppression head impulse test paradigm (SHIMP) initially and at 1 month. Patients were also asked to complete DHI and VAS initially, at 1 month and 6 months. We compared measured parameters between Group F and R. Results: In HIMP, Group F showed higher vestibular-ocular reflex (VOR) gain, higher occurrence of covert corrective saccade (CS), lower occurrence and peak velocity of overt CS, and lower PR score than Group R at 1 month. In SHIMP, Group F showed higher VOR gain, higher occurrence and peak velocity of anti-CS, and higher PR score than Group R at 1 month. Conclusions: Above parameters of both HIMP and SHIMP at 1 month would be important factors to predict the residual symptoms in chronic phase of AVN.

Objective: To compare the results of suppression head impulse paradigm (SHIMP) and head impulse paradigm (HIMP) in acute vestibular neuritis (AVN). Study Design: Retrospective study. Setting: Tertiary otology clinic. Patients and Interventions: We tested 21 patients with AVN with the HIMP, SHIMP, and caloric tests, and we analyzed the relationships between the tests' results. Main Outcome Measures: For this study, we adopted vestihulo-ocular reflex (VOR) gains in the SHIMP and HIMP, peak saccade velocity (PSV) of SHIMP which is another indicator of residual vestibular function, and canal paresis of caloric test. Results: VOR gains showed significant correlation (R-2 = 0.926, p < 0.001) between the SHIMP and HIMP, but VOR gains were slightly lower in the SHIMP than in the HIMP (mean difference 0.07 +/- 0.09, p < 0.001). The difference between the HUMP and SHIMP gains was slightly larger on the affected side (0.10 +/- 0.09) than on the healthy side (0.03 +/- 0.09). The PSV of SHIMP had significant correlation with HIMP gain and canal paresis. Sixteen of 21 patients showed 100% ipsilesional caloric canal paresis, and eight (50%) of them showed no anti-compensatory saccade (direction toward head rotation) in the SHIMP. However, they showed not extremely low VOR gain but variable VOR gain. Conclusion: The new parameters of SHIMP might he used as complement for evaluating vestibular function in AVN. However, the clinical impact of the saccades of SHIMP in AVN has not been revealed clearly yet. This question should he investigated in further studies.

Objective: To compare the results of suppression head impulse paradigm (SHIMP) and head impulse paradigm (HIMP) in acute vestibular neuritis (AVN). Study Design: Retrospective study. Setting: Tertiary otology clinic. Patients and Interventions: We tested 21 patients with AVN with the HIMP, SHIMP, and caloric tests, and we analyzed the relationships between the tests’ results. Main Outcome Measures: For this study, we adopted vestibulo-ocular reflex (VOR) gains in the SHIMP and HIMP, peak saccade velocity (PSV) of SHIMP which is another indicator of residual vestibular function, and canal paresis of caloric test. Results: VOR gains showed significant correlation (R ² = 0.926, p < 0.001) between the SHIMP and HIMP, but VOR gains were slightly lower in the SHIMP than in the HIMP (mean difference 0.07 ± 0.09, p < 0.001). The difference between the HIMP and SHIMP gains was slightly larger on the affected side (0.10 ± 0.09) than on the healthy side (0.03 ± 0.09). The PSV of SHIMP had significant correlation with HIMP gain and canal paresis. Sixteen of 21 patients showed 100% ipsilesional caloric canal paresis, and eight (50%) of them showed no anti-compensatory saccade (direction toward head rotation) in the SHIMP. However, they showed not extremely low VOR gain but variable VOR gain. Conclusion: The new parameters of SHIMP might be used as complement for evaluating vestibular function in AVN. However, the clinical impact of the saccades of SHIMP in AVN has not been revealed clearly yet. This question should be investigated in further studies.

Objectives The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV).Methods We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus.Results This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P0.05). However, CuRM was the only method with a 100% treatment success rate.Conclusion While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term.