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- Title
Use of the Head Impulse, Nystagmus, Test of Skew ('HINTS') assessment to aid differential diagnosis in acute vestibular syndrome in the hyperacute stroke setting.
- Authors
Rayner, Rebecca; Hartley-Palmer, Joseph; Hmu, Chit
- Abstract
Background: Differential diagnosis of acute vertigo syndrome is challenging given the similarities between clinical presentations of posterior circulation stroke and peripheral vestibular dysfunction. The Head Impulse, Nystagmus, Test of Skew ('HINTS') assessment is a clinical bedside test used to aid diagnosis. Methods: Comprehensive training on use of the Head Impulse, Nystagmus, Test of Skew assessment was provided to one stroke consultant, and the effectiveness of the test in that setting was assessed. Further education was completed with more members of the stroke and emergency department multi-disciplinary team. Quality improvement measures including magnetic resonance imaging use and bed utilisation were explored. Results: Following training of one stroke consultant, the Head Impulse, Nystagmus, Test of Skew assessment was found to be a feasible, accurate bedside test within this acute stroke service. Further training for the multi-disciplinary team was completed, but outcome measures were not explored because of the coronavirus disease 2019 pandemic and maternity leave. Conclusion: There is a role for trained members of the multi-disciplinary team to successfully use the Head Impulse, Nystagmus, Test of Skew assessment in hyperacute stroke settings, to aid diagnosis in acute vertigo syndrome.
- Subjects
VERTIGO diagnosis; VERTIGO; HOSPITAL utilization; DIFFERENTIAL diagnosis; NYSTAGMUS; MAGNETIC resonance imaging; INNER ear; POINT-of-care testing; CEREBRAL ischemia; QUALITY assurance; EYE movements; HEALTH care teams; VESTIBULAR function tests; DISEASE complications
- Publication
Journal of Laryngology & Otology, 2024, Vol 138, pS14
- ISSN
0022-2151
- Publication type
Article
- DOI
10.1017/S0022215123002050