Eye-ECG Approach to Emergencies : Diagnostic Performance of the HINTS Test

Launched by FONDATION HÔPITAL SAINT-JOSEPH · Oct 4, 2019

Keywords

ClinConnect Summary

The HINTS test (Head Impulse, Nystagmus, Test of Skew) is a clinical test composed of 3 oculomotor examinations: the search for high frequency vestibulo-ocular reflex during a passive impulse of the head (Head Impulse test), the detection of a spontaneous nystagmus and a vertical divergence. It has been developed to evaluate patients with AVS defined as vertigo or acute and persistent dizziness sometimes accompanied by nausea or vomiting, and/or gait instability, and/or nystagmus, and/or intolerance to head movements. This time saving is important, as a complete neurological examination usu...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • French-speaking patient.
• • Affiliated with social security or, failing that, with another health insurance system.
• • Patient capable of giving free, informed and express consent
• * Patient with an isolated AVS defined by a progression of more than one hour and less than one month and at least one of the following criteria:
• • Vertigo (illusion of the subject moving in relation to surrounding objects or objects) surrounding with respect to the subject, a sensation of rotation, movement of the body in the plane vertical, unstable, described as a pitch or "rotating head"), sometimes associated with vegetative signs (nausea, vomiting, pallor, sweating, slowing of frequency cardiac),
• • A nystagmus (spontaneous or positional),
• • Ataxia characterized by gait disorders with imbalance type (which can dominate the symptomatology) with sways, a brittle gait or simple instability.
• • A patient may be included several times during the study period provided that they are acute episodes separate.
• Exclusion Criteria:
• • Patient with focal neurological signs concomitantly appearing with AVS: disorder of the language or writing, speech impairment, dysarthria, movement performance disorders voluntary, sensory motor deficit, involuntary abnormal movements. The vertiginous patients with ataxia meet the inclusion criteria provided they do not show any other sign neurological focal, in particular, other signs of cerebellar syndrome.
• • Patient with a Glasgow score \<15 or blood glucose \< 0.70 g/l, MAP \< 65 mm Hg, acute anemia and \<7g/dl, transient dizziness having disappeared upon arrival in the emergency room, acute alcohol abuse, acute alcohol abuse, and acute drug intoxication, a history of oculomotor paralysis.
• • Patient under guardianship or curatorship.
• • Patient deprived of liberty.
• • Patient under the protection of justice.