Associate Professor, Departments of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
Horizontal Head Impulse Test, Nystagmus, Test of Skew; Neurological Examination
Describes the 3-Component H.I.N.T.S. (Head Impulse, Nystagmus, Test of Skew) battery. A wide-angle view of the tests is followed by a close-up view. Please note that in the wide-angle view, the order of the tests is as would be typically conducted in practice (searching first for spontaneous nystagmus and skew deviation, prior to repeatedly rotating the patient's head for the horizontal head impulse test, which could influence the results of the prior two tests). In the close-up view, the tests are conducted in the order suggested by the acronym (purely as a memory aid). Viewers should also note that in the close-up view, the alternate cover test was not demonstrated with ideal technique, since the patient's right eye was incompletely occluded by the examiner's hand during testing (this represents an artifact resulting from suboptimal examiner positioning during videography).