Comment: A quick and reliable test of peripheral vestibular function—On an impulse

The head impulse test paradigm (HIMP), also known as head impulse test or video head impulse test, is a test of peripheral vestibular function based on the principle that normal vestibulo-ocular reflex function drives both eyes in a direction equal and opposite that of a rapid head movement. Hence, a quick turn of the head toward an ear with vestibular loss results in the eyes moving with the head instead of opposite the head. In this Class III, prospective, case-control study of patients with unilateral (n = 5) or bilateral (n = 5) vestibular loss, and normal participants (n = 6), MacDougall et al.¹ introduce a new complementary addition to HIMP referred to as the suppression head impulse paradigm (SHIMP). Video recordings were performed of responses to 20 random manually applied head impulse movements of between 150° and 250°/s; these were done with attention to the corrective or compensatory saccades that followed.