Clear, informative, and comprehensive explanation. You won a neuro follower. Thanks
@PeterJohns2 жыл бұрын
Thanks for the kind words! If you haven't already watch my video with detailed tips on how to perform the Head Impulse Test. kzbin.info/www/bejne/opzNiJ18iLt5fa8
@alwaleedsaud61142 жыл бұрын
@@PeterJohns already watched🙏
@leahmaschke257 Жыл бұрын
Thank you so much. I am an outpost RN in the Yukon. This has really helped my assessment skills. I am continually searching for videos with excellent teaching to improve my assessment skills. You're it!
@jxc-gz5yv3 жыл бұрын
Thank you, so much for these videos! I can see your passion for teaching and I know many would agree with me that we are extremely grateful!
@travisvlasaty87162 жыл бұрын
Best video and information with real patient exam for HINTS exam! Thanks!
@drjohnvinodkumarАй бұрын
Brilliant, really useful video Doctor , thank you
@Pindakeshi7 ай бұрын
Exellent video! Thank you for sharing your knowledge! General practitioner from the Netherlands here
@kieranmp41434 жыл бұрын
Probably the best video on this I have seen so far. Excellent work
@flavio339 Жыл бұрын
Damn, this is one high grade teaching skill! Congrats!
@ntinalondon11 ай бұрын
You're awesome!! neuro resident here from Greece. Thank you very much!
@felixbuffet1301 Жыл бұрын
As a medical student, your videos are by far one the top notch in the medical field. I dream of being as good as you in teaching others some arduous medical notions. For the sake of patients! A big thanks from France! Don't hesitate if you come by Burgundy, doors open! :)
@PeterJohns Жыл бұрын
I've been to Burgundy before, happy to be invited back!
@ranjitrajandr2 жыл бұрын
This was such a clear description. Excellent! You are a wonderful teacher!👏👏
@joelouisscilabra31389 ай бұрын
Very helpful review of such an important test. Very well done.
@patrickgomez293 жыл бұрын
Thank you so much for sharing your knowledge! 🙏 Greetings from Vienna,Austria
@ajh1955 жыл бұрын
Hello Peter your videos are simply amazing because you actually record with real patients and explain everything.... Medical school student from Denmark. Thank you very much
@PeterJohns5 жыл бұрын
Thanks so much, this is why I make these videos!
@tja42014 жыл бұрын
Nice sequence of vertigo/nystagmus videos. Just left a two day Masterclass with Kingma, van den Berg and Widdershoven. A pitty regular medical curriculum does not pay that much attention on these symptoms. Physicians could do a lot more in diagnostics and therapy. Keep up the good work!
@jamesburge397711 ай бұрын
aaaah...now I get it!! Thanks for putting in all that effort to make a great teaching video.
@obayal-raslan84032 жыл бұрын
I tried to understand the details of this test and the difference between spontaneous and gaze-evoked (cerebellar) nystagmus in many neurology books. This video is way better than anything I read about these aspects. Thank you
@manvikatiwari46464 ай бұрын
Beautifully explained. Thank you
@alfarouqelboom84654 ай бұрын
great explanation. Much appreciated sir!
@life-mm5do2 жыл бұрын
Very educational videos with explanations of different nystagmus and technique .
@Valcreee Жыл бұрын
Thank you very much for contributing to the medical community with this video. Listened to Dr. Newman-Toker podcast so this video was helpful to see some actual examples of what he was describing.
@PeterJohns Жыл бұрын
Was that on curbsiders?
@Valcreee Жыл бұрын
@@PeterJohns yes sir
@jjero15 жыл бұрын
Thank you so much. The multiple examples are especially useful.
@sunshine_prophylaxis85402 жыл бұрын
Oh my gosh, this was so helpful! Thank you so much for posting this!
@deepikaperera24192 жыл бұрын
Thank you so much, sir. The video is very informative and concise. I learn a lot from this video
@ahmedfarag13363 жыл бұрын
Great channel, great videos, I intend to finish The whole thing enshaa allah, thanks a lot prof.
@Vincee9675 жыл бұрын
Thank you for your videos Sir, you are a great teacher!
@sawsanalh28025 жыл бұрын
Thank you for this video, it's great!
@paulof20282 жыл бұрын
I im from Brazil, Pará, thank for your video !!!!
@Muhammad-gq8fs2 ай бұрын
I really enjoy your vertigo videos and infact I recommend every doctor to watch your videos on this extremely topic. Just one thing that I think is not right: I note that You are advocating impulsing the head from right or left lateral to midline instead of jerking it laterally from midline primary position. This must be your own or someone else’s modification, because I have not read this method of Head Inpulse in any neuro text including Adam and Victor’s and Blumefeld’s Neuroanatomy through Clinical cases. Professor Haymalgayi who described this test has also not described it and he is the guy here in Australia who does all the advances testing in spinning chair and much more when no one can figure out what is making the patient dizzy. And I dont conceive how test ever will or ever could be validated the way it is being suggested here. There are simple and very obvious anatomical and physiological reasons why it cant be validated this way: the premise and foundation for the head impulse testing is the anatomical and physiological fact that in primary position the gaze centring mechanisms on right and left are firing equally which is necessary to keep the gaze in primary position. This ‘centring tendency’ is the default position and action of the brain mechanisms that mediate it. Lateral head position with fixing the eye on a point straight ahead is a deviation and a departure from the default state. Once you move the head to right or left those impulses have changed in their amplitude and firing frequencies to keep the eyes fixated straight forward. Moving the head from right or left lateral to the midline is not the same as jerking the head to right or left lateral because neuronal impulses have to change to make adjustments. When you move the head away from that specifically defined primary gaze position, then you have changed the afferent impulses firing rates and amplitudes of the brain mechanisms and impulses that mediate the VOR hence and keep the eyes centred, thus altering the validity of the test. So we can not just swap the test around(even if it is with the noble intentions of making it more comfortable for the patient). The primary position for VOR and semicricular canals is the primary gaze position which is head horizontal in neutral position and looking straight forward as in anatomical postion and the eyes gazing straight forward. But I look forward to be corrected and educated by such a learned and highly esteemed colleague like yourself. If you have any clinical references I look forward to reading them and the primary references they mention. Regards A 26th year medical student.
@PeterJohns2 ай бұрын
Watch David Newman-Toker demonstrating the HIT in this video on this page. sjrhem.ca/resident-clinical-pearl-hints-exam-in-acute-vestibular-syndrome/ And watch Jorge Kattah perform it also kzbin.info/www/bejne/e4O6ZKyorceBqck Here is Dr. Kattah performing the HIT in another patient. kzbin.info/www/bejne/najUo3qMhtd5qc0&ab_channel=WangcaiGao Drs' Newman-Toker and Kattach were the principle authors of the HINTS studies. They have both observed my technique of performing the HIT. Dr. Newman-Toker in person when I attended a vestibular masterclass at Johns Hopkins, and Dr. Kattah when I sent them a video of my head impulse test. He noted "very nice technique" when he replied to me. I've met Dr. Halmagyi as well, and he is a very nice man.
@marcelamoonstruck3094 Жыл бұрын
Thank you so much teacher
@marcelorodriguesbr3 жыл бұрын
Thank's for this video, Excellent work!!!
@imo503911 ай бұрын
This is amazing! Thank you!
@Jesssunlim334 жыл бұрын
These videos are so helpful!! Amazing job :)
@nightlydreamer_3 жыл бұрын
Excellent video, learned a lot!
@latifaalmutairi88302 жыл бұрын
Thank you so much
@ejazmohdkhan3 жыл бұрын
Great video sir
@manishaent68724 жыл бұрын
Amazing videos. Thank you so much !
@Squiderrant2 жыл бұрын
Fantastic. Thank you
@ORL-HNS3 жыл бұрын
Really right ,never like dizziness
@PeterJohns3 жыл бұрын
??
@ORL-HNS3 жыл бұрын
@@PeterJohns Thanks sir , made me understand HINTS exam easily
@ahmedkhaleel10253 жыл бұрын
Thank you sir, great video.
@drash8593 Жыл бұрын
Amazing
@huhucat123 жыл бұрын
what a great video! Thank u!
@martinalazzari6182 Жыл бұрын
Me encanto ! Super practico y consizo 🫶
@muzafferbalaban3823 жыл бұрын
Described perfektly. Thank you.
@joyasamuel52132 жыл бұрын
Fantastic
@ahmedthamir95312 жыл бұрын
I cant thank you enough sir .. but thank you anyway ♥️♥️♥️♥️♥️ , your videos are all simple educational practical and funny ☺️ .. stay safe sir.
@killua99824 жыл бұрын
Thank you
@knosis2 жыл бұрын
Thanks for the video. Great entertainment value haha
@PeterJohns2 жыл бұрын
Thanks. The dog video is funny!
@hindbennis9106Ай бұрын
Love your videos! In case of using a vestibular sedative like sulpiride in the last 24h, and the patient has no nystagmus. Do you do the HINTS? And would it be affected by it?
@PeterJohnsАй бұрын
I've seen studies show that vestibular sedatives can decrease the amplitude of the nystagmus, but I've never seen a study showing that it would completely suppress it. I've remove fixation with a piece of paper if I didn't see nystagmus at rest.
@rumpledstilski93484 жыл бұрын
Thank you for your videos, they are wonderful! I have basically memorized that in vestibular neuritis the nystagmus points away from the affected side and the head impulse test is abnormal when turning head toward the affected side. But I don’t intuitively understand why this is. Can you please explain?
@PeterJohns4 жыл бұрын
It is not intuitive, but a result of the complicated anatomy and physiology and pathophysiology of vertigo. The first half of this video describes how a left vestibular neuritis will cause nystagmus to the right. kzbin.info/www/bejne/eJvbd3ieid-HnKc&
@robertocarlosdiazalvarez36284 жыл бұрын
good stuff
@Muhammad-gq8fs2 ай бұрын
19:20 are you saying that if nystagmus is left beating then in vestibular neuritis head impulse will also be when head is impulses to the left. That is opposite to what you have been saying earlier in this video (and many other videos). If his left vestibular nerve is affected, his HI test would have catchup saccade when his head is turned impulsed to the RIGHT, not left side. Or did misunderstood something? Would appreciate if you can clarify please. Thanks.
@PeterJohns2 ай бұрын
Yes, you did misunderstand something. For the case that begin at 18:24 I said his nystagmus was beating towards the RIGHT, which means his LEFT ear was affected. And that the HIT should be abnormal when the head is turned rapidly to the LEFT, which it was. And I'm pretty sure I never said in any of my videos that if the left ear is affected, that the HIT is abnormal when the head is turned to the right. Watch the video again.
@Muhammad-gq8fs2 ай бұрын
Thanks a lot for the reply and the clarification. Yes I think I have gotten it wrong for this video. I have watched all your videos many many times so don’t remember which one if at all you said what I claim here. I pribably am wrong on this but will let you know if find out I wasn’t because; addition to perpetually recommending your channel to all docs, I am watch your videos rather regularly on a recurrent basis when I want to revise and remind myself.. If at all you said anything it was in all likelihood the verbal/oral equivalent of a ‘typo’ error which all of us can make time to time.
@kchadala Жыл бұрын
Nice video. But sometimes it is imposible to do such tests with old vomiting patients with osteoporosis in the neck who dont collaborate with me. Really - I dont like vertigo :)
@PeterJohns Жыл бұрын
The only clinicians who like vertigo understand it well.
@alfredopampanga93562 жыл бұрын
Excellent teacher. Why were my teachers in med school so mediocre? There’s no substitute for intelligence. And it’s on display here like a flashing neon light. ( But not an a normal head impulse)
@doculam Жыл бұрын
is the HIT positive for other causes of peripheral vertigo? e.g BPPV and Labrynthitis
@PeterJohns Жыл бұрын
The head impulse test detects if there a problem with the vestibular nerve. So you shouldn't see an abnormal HIT in a patient with BPPV, but you should see it with labyrinthitis. Vestibular neuritis is much more common than labyrinthitis.
@lucasglatthardt5368 Жыл бұрын
Does VPPB also causes abnormal Head impulse If tested?
@PeterJohns Жыл бұрын
I assume you mean BPPV. And the answer is no.
@user-kj5lw9in7v5 жыл бұрын
What the rotatory chair test
@life-mm5do2 жыл бұрын
What about bilateral loss signs.
@PeterJohns2 жыл бұрын
My understanding is they will have bilateral abnormal HIT. I have not seen it myself.