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neurology emergency

HINTS Exam for Stroke vs Vestibular Neuritis

Head Impulse, Nystagmus, Test of Skew (HINTS). 3-step bedside eye examination to differentiate posterior fossa stroke from peripheral vestibular disorder in acute vestibular syndrome. More sensitive than early MRI.

Rapidly turn head 10–15° to each side while patient fixes gaze on examiner's nose. Corrective saccade = normal VOR (peripheral)

Test in primary gaze and with gaze deviation left and right

Cover one eye then quickly switch to the other; observe for vertical refixation movement

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.