Central findings

Question 1

Explain what HINTS testing is for

Answer 1

Can be used to reveal possible posterior circulation stroke in individuals with acute vestibular symptoms (acute, spontaneous, continuous vertigo)

Question 2

Explain the components of the HINTS exam

Answer 2

POSITIVE EXAM IF ONE OF THESE COMPONENTS ARE CONCERNING - imaging recommended

Head impulse test: CONCERNING if theres a NEGATIVE head impulse (normal head impulse test)

Nystagmus: CONCERNING if nystagmus changes in direction

Skew/cross cover test: CONCERNING if theres a POSITIVE skew

Question 3

Describe central oculomotor findings

Answer 3

• pure upbeating/downbeating for torsional nystagmus
• slow saccades
• rebound nystagmus (hold gaze laterally with RBN and then returning to the centre the nystagmus reverses in direction)
• pendular nystagmus (no fast phase, only slow phase)
• Opsoclonus (See it best right after a saccade. See all fast phase moving in multiple planes RIGHT AFTER a saccade
• INO
• hypermetric saccades