The head impulse or head thrust
test was first described by
Halmagyi and Curthoys in 1988.1
It has acquired an increasingly
important place in the clinical
examination of the vertigo patient.
It detects severe unilateral loss of
semicircular canal (SCC) function
clinically; it is more sensitive and
specific than the traditional
Romberg and similar tests; and it
is particularly important in the
emergency unit, where it can distinguish
between vestibular neuritis
and cerebellar infarction,
which can both generate similar
symptoms suggesting an initial
attack of severe acute vertigo. The
result of the head thrust test is
definitely normal in a patient with
a cerebellar infarction but abnormal
in a patient with vestibular
neuritis.