HINTs exam

Just a review of the HINTS exam: 


HINTS Exam: use for pts with ongoing hours/days of vertigo and nystagmus to assess for cerebellar vs peripheral cause; has 3 components  

Nystagmus

- unilateral, fatigable- likely peripheral                  

- bilateral, vertical, non fatigable-worrisome!

Test of Skew

- no skew- normal                      

- skew (eyes dart when uncovered)- worrisome! 

Head Impulse test

- no vertigo: normal (eyes stay fixed)                              

- vertigo

: abnormal (eyes correct back to midline) - vestibular neuritis peripheral                                          

: normal (eyes stay fixed) - cerebellar stroke! worrisome!             

Any worrisome findings warrant workup for cerebellar stroke.

Best video explanation I've seen so far:
https://www.youtube.com/watch?v=1q-VTKPweuk&t=17s