HINTS exam Flashcards
What does the HINTS exam distinguish between?
Vestibular neuritis (nerve problem) and stroke (brain problem)
https://www.youtube.com/watch?v=1q-VTKPweuk&ab_channel=PeterJohns
What are the components of the HINTS exam?
Head impulse test - looking for lag shows neuritis
Nystagmus - bidirectional or unidirectional?
Test of skew - cover one eye then the other while patient looks at nose, look for any vertical/diagonal corrective movement
What is a reasurring HINTS exam?
unidirectional nystagmus
no vertical skew
abnormal head impulse test
means it is a NERVE problem (neuritis)
What is a worrying HINTS exam?
bidirectional nystagmus
abnormal test of skew
normal head impulse test
means it is a BRAIN problem
Which patients do you perform the HINTS exam on?
Patients who have had hours or days of continuous, ongoing vertigo AND spontaneous nystagmus
When do you perform the HINTS exam and the Dix-Hallpike test on the same patient?
Never
Dix-Hallpike only done on those who do not have a spontaneous nystagmus and who have short, 30sec periods of vertigo.
