HINTS Examination
- HINTS= Head Impulse (HI), Nystagmus (N), and Test-of-Skew (TS) (Pula, Newman-Toker & Kattah, 2013).
- The 3 components of this exam include head impulse with vestibular ocular reflex function, nystagmus with primary, right and left gaze, and alternate cover test for skew deviation (Kattah et al, 2009).
- A positive exam would find abnormal head impulse, direction-fixed horizontal nystagmus and abnormal skew (Kattah et al, 2009).
- This test takes about one minute at bedside (Kattah et al, 2009).
- HINTS battery aids in distinguishing central from peripheral causes of Acute Vestibular Syndrome (AVS)(Pula, Newman-Toker & Kattah, 2013).
- Multiple Sclerosis patients fit the HINTS paradigm, although more obvious oculomotor signs (Pula, Newman-Toker & Kattah, 2013).
- Having any of the three central findings with HINTS provides good sensitivity and specificity that the lesion is central (Pula, Newman-Toker & Kattah, 2013).
- With all three positive this exam has a sensitivity of 100% and a specificity of 96% for central lesion findings (Kattah et al, 2009).