Catch-up Saccades on Clinical Head Impulse Testing in a Man in His 60s

Clinical head impulse testing (cHIT) assesses the vestibulo-ocular reflex (VOR) by identifying compensatory eye movements during rapid head movements. Presence of catch-up saccades during cHIT is useful for identifying peripheral vestibular deficits. This slow-motion video (240 frames per second) demonstrates catch-up saccades bilaterally in a man in his 60s evaluated for vertigo with acceleration and deceleration who had normal video head impulse testing (vHIT) findings, suggesting that a negative vHIT result should be confirmed with an extended window and high-speed video if clinically indicated. The patient was diagnosed with high-frequency vestibular loss on the basis of the findings. Click the Related Multimedia link for a comparable example in a different patient and the Related Article link for complete details.