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Comment & Response
September 26, 2019

What Does Head Impulse Testing Really Test?—Reply

Author Affiliations
  • 1Department of Otorhinolaryngology–Head and Neck Surgery, University Medicine Mannheim, University of Heidelberg, Mannheim, Germany
  • 2Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
  • 3Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
JAMA Otolaryngol Head Neck Surg. 2019;145(11):1080-1081. doi:10.1001/jamaoto.2019.2779

In Reply We thank Drs Curthoys and Halmagyi for their interest in our recently published scoping review.1 Both have raised some concerns on the validity of our review, which we address herein.

First, we fully agree with Curthoys and Halmagyi that neither the head impulse test (HIT), nor the caloric test, nor any other vestibular test is able to identify the cause of the vestibular deficit. But both (not as stand-alone but complementary tests and possibly with the help of other methods) may be able to localize the side of the lesion in peripheral vestibulopathies.

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