Accurate diagnosis of vertigo remains a common neurological challenge, with the urgent need to distinguish between benign peripheral causes, such as vestibular neuritis, and potentially life-threatening central causes, like stroke. While the video Head Impulse Test (vHIT) is a key tool for assessing the vestibulo-ocular reflex, its standard parameters can sometimes yield ambiguous results in complex cases.
The research by Fei Li and colleagues, published in ENT Discovery, presents a novel and sophisticated analytical framework for interpreting B-vHIT (bilateral vHIT) results. Moving beyond simple gain measurements, this new protocol incorporates a multi-parameter analysis of saccade patterns, asymmetry, and catch-up dynamics to create a discriminative classification model. Initial validation demonstrates its superior specificity and sensitivity in correctly identifying the origin of vestibular pathology compared to conventional interpretation methods.
The implementation of this framework promises to enhance diagnostic accuracy in emergency and outpatient settings, potentially reducing unnecessary imaging and guiding timely, appropriate treatment. However, further large-scale, multi-center validation is required to solidify its clinical utility and integrate it seamlessly into existing diagnostic pathways. Challenges include standardizing the technical acquisition of vHIT across clinics and training practitioners in the new interpretive paradigm. This work, entitled “A Novel B-vHIT Classification Framework Enhances Discrimination of Non-Peripheral vs. Peripheral Vertigo” was published on ENT Discovery (published on Dec. 31, 2025).
DOI：10.15302/ENTD.2025.120001