Head Thrust Test

두부충동 검사

  • Choi, Kwang-Dong (Department of Neurology, College of Medicine, Seoul National University) ;
  • Oh, Sun-Young (Seoul National University Bundang Hospital, Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Kim, Ji Soo (Department of Neurology, Chungnam National University Hospital)
  • 최광동 (서울대학교 의과대학 분당서울대병원 신경과학교실) ;
  • 오선영 (부산대학교 의과대학 신경과학교실 의학연구소) ;
  • 김지수 (충남대학교 의과대학 신경과학교실)
  • Published : 2006.06.30

Abstract

The head thrust maneuver is a simple bedside test of the higher frequency vestibulo-ocular reflex, which is based on Ewald's second law. It is performed by grasping the patient's head and applying a brief, small-amplitude, high-acceleration head turn, first to one side and then to the other. The patient fixates on the examiner's nose and the examiner watches for corrective rapid eye movements (saccades), which are a sign of decreased vestibular response. The "catch-up" saccades after a head thrust in one direction indicate a peripheral vestibular lesion on that side (in the labyrinth or the $8^{th}$ nerve including the root's entry zone in the brain stem). An individual pair of vertical semicircular canals can also be stimulated by turning the head to the right or left by $45^{\circ}$ and then by rotating the head in the pitch plane relative to the body. Recent studies have suggested that assessment of individual semicircular canal function by head thrust test may provide useful information for anatomical and functional details of a variety of peripheral vestibulopathies and for predicting the prognosis of vestibular neuritis. In central vestibulopathy, the head thrust test may also be valuable sign to determine dysfunction of the central pathways from individual semicircular canals and its role for the development of diverse central nystagmus.

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