Clinical Testing of Head Impulse Paradigm and Suppression Head Impulse Paradigm Using a Diagnostic Headband: Combined Clinical Sign for Improved Performance.

OBJECTIVE: We developed a clinical sign that improves the sensitivity, specificity, and predictive values of the Head Impulse Paradigm (HIMP) Test by adding the Suppression Head Impulse Paradigm (SHIMP) Test using a diagnostic headband. METHODS: Prospective and descriptive study analyzing the function of 1,255 horizontal semicircular canals of subjects with differing vestibulo-ocular reflex (VOR) gains who showed-up with symptoms related to neurotology (Montevideo, Uruguay, March 2017 to March 2019). The clinical HIMP and SHIMP tests were assessed and the amplitudes of overt saccades were compared to each other. Clinical findings were contrasted against vHIT gains. CONCLUSION: The HIMP and SHIMP combined test using the H/S headband has high specificity and low sensibility. This test association can identify healthy individuals among individuals typically misdiagnosed as ill by the conventional HIT or HIMP maneuver of the HIMP test, as originally described by Halmagyi and Curthoys. Therefore, we recommend using the headband assisted HIMP/SHIMP test, instead of exclusively relying on positive HIMP results.