Vertigo

Question 1

Which findings on the HINTS exam suggest a peripheral etiology of vertigo?

Answer 1

(1) Head Impulse Test - Abnormal corrective saccade suggests peripheral etiology.
(2) Nystagmus - Unidirectional, horizontal.
(3) Test of Skew - No skew deviation.

Question 2

Which findings on the HINTS exam suggest a central etiology of vertigo?

Answer 2

(1) Head Impulse - Normal, no corrective saccade.
(2) Nystagmus - Horizontal & direction-changing, vertical or torsional.
(3) Test of Skew - Skew deviation is present (vertical misalignment of the eyes)