IMPORTANT!!! You should first screen your dizzy patients for central features that would not be expected in vestibular neuritis and may signify a central cause such as stroke. And they are: New Significant headache or neck pain Focal weakness or paresthesias Any dangerous D's - diplopia, dysarthria, dysmetria, dysphonia, dysphagia Vertical nystagmus at rest (not during the Dix-Hallpike test) Inability to walk unaided You should carefully consider a central cause if your patient has any of these central features, irregardless of their HINTS exam findings.
For my wish... I hope medical school be more like RUclips. Its ironic that it will just take a series of free video to understand concepts I paid thousands in tuition fee to learn in medical school...
Oh my goodness .. I think I just died and gone to heaven!!! Wish all med school lectures had your flair for explanation and teaching! Thank you Dr Johns.. this video have upgraded my visual understanding of the assurance of abnormal testing. As students we don't often get to see normal and abnormal side by side (like this) so on the ward our confidence in diagnosis can be affected. My utmost gratitude and aspiration to you! Charlie
One of the most useful medical videos on RUclips. Period. Thank you. Update: I still go back to this video everytime I need a refresher of this important exam!
I am just diving into the world of vestibular rehab as a physical therapist and I appreciate this video so much! Seeing actual video clips of people with abnormal findings and your explanations is invaluable! THANK YOU so much!!
Learned about this exam during the vestibular unit of my neuro dysfunction class in PT school, so grateful that my professor shared the link to this video as a recommendation for comprehension!
Amazing! Just amazing. I am speechless. I keep coming back to watch this over and over again ever now and then. Thank you so much. Very clear, simply the best.
This was one of my favourites medical video I have ever seen! My last neurology exam will be in two weeks, and you helped me a lot with this video!! I am so grateful for these excellent teaching videos like this!
EXCELLENT video. We need more videos like this. Most of them talk about topics but do not show the actual practice with the patient taking place. Thank you sincerely.
God, this is incredibly good! Im currently studying for a otorhinolaryngology test and ,at the vertigo class, my teacher just mentioned the HINTS test and didnt give too much of an importance to the matter.. Thanks for the intuitive teaching!
This is not only the best video I have seen on this subject, it has also made me realise how I need to deploy slow-motion video in our medical media workflow, and how I need to demonstrate comparative presentations in our videos. Thank you so much for all your time and effort Dr Johns.
I am currently a paramedic student doing a case study on dealing with vertigo in the pre-hospital environment. This is a brilliant video to expand on differential diagnosis and look at whether hospital admission is appropriate. Many thanks for this video. Well put together and explained so even quite a dim person like me can understand.
Great video, professor! I am from Uruguay and this video was deeply helpful. Could not imagine someone explaining it better. Congrats on the dedication and how articulate you are!
This video is fantastic, and like many others here, I could not understand this concept after reading multiple articles. After this 8 minute video I now not only understand what to expect for normal/abnormal, but how to perform the test and apply the results to differentiate between vestibular neuritis vs a stroke. Thank you very much Dr. Johns!
Fantastic video! I've never seen this so well explained in visual terms. I'am starting in neurology residency in a few weeks and that just cheered me a lot. Thank you for sharing this!
i love your channel so much im watching all your videos on a friday night. Thank you for this content, i´ve been reading about this tests but nothing is like watching someone doing and learning from them. a friend from brazil.
I am a junior doctor working in the NHS, UK. I’ve always found it difficult to perform and interpret HINTS test on patients with Vertigo. I’ve seen loads of videos, read loads of posts and I think this is best video ever on HINTS test. Thank you so much!
Great video, clear and concise, well explained. Very helpful for family physicians or general practitioners in the community who're short on time and trying to find needles in haystacks!
Glad to find this video. I had the Hints test but no clue what it actually was. Very reassuring that mine came out not worrisome. Starting PT tomorrow for the nuritius. Hopefully I can get it fixed pretty quickly.
Thank you for your video. (I cannot recall if I've commented before, I tend to be more of a silent viewer). But your video is immensely helpful, and I direct a lot of my more junior colleagues to watch it for their learning too. Thanks for sharing your knowledge and skills.
Great video explaining normal and abnormal and I was thinking about the question you posted at the end of the video before it was posted! Greetings from a Mexican Dr that just passed the step 1!
I learned the acronym INFARCT to memorize the results suggesting a vascular cause: Impulse Normal / Fast-Phase Alternating / Refixation on Cover Test. Thanks for the class!!
Yes, David Newman-Toker does like his acronyms. :) I personally think that if you need an acronym to remember how to interpret the results, you probably don't understand how to perform and interpret the tests well enough to reply on them. For instance, "Refixation on Cover Test" fits into the "INFARCT" acronym perfectly in terms of the letters "RTC" but in fact doesn't describe the vertical or slanted skew which is what you are looking for. And "Fast phase Alternating" is another example of the descriptive words being changed to fit the acronym. So it's more of a backronym than an acronym. In my opinion, it would be better to refer to a chart such as I made in my Big 3 of vertigo video.ruclips.net/video/MwbqJvMDonU/видео.html .
As a neurologist, I always was kinda worried when I had to assess the ENT origin of a vertigo ; now thanks to your video it all looks so simple ! None ever told me about the HINTS, and I only knew Dix/Hallpike or Fukuda, that are of course really harder to perform on a stretcher in emergency room (and apparently a lot less relevant...) Thanks a lot for your great work Dr Johns !
Thanks for the compliment. I find it easy to perform the Dix-Hallpike test in the emergency department. The key is to turn them around in the stretcher so that their head hangs off the foot of the stretcher. And to get a stool and sit down when doing it. And of course the most important thing is to only perform it on patients with less than 2 min episodes of vertigo and no spontaneous or gaze evoked nystagmus!
Развлечения
IMPORTANT!!! You should first screen your dizzy patients for central features that would not be expected in vestibular neuritis and may signify a central cause such as stroke. And they are:
New Significant headache or neck pain
Focal weakness or paresthesias
Any dangerous D's - diplopia, dysarthria, dysmetria, dysphonia, dysphagia
Vertical nystagmus at rest (not during the Dix-Hallpike test)
Inability to walk unaided
You should carefully consider a central cause if your patient has any of these central features, irregardless of their HINTS exam findings.
thank you for this important update on Hints exam
I wish RUclips existed when I was in medical school. What a great teaching video thanks.!
Thank you. Videos are a great way to bring the patient to the learner.
Can't agree more!!. Much better way to learn something than to read textbook and imagine how it works.
For my wish... I hope medical school be more like RUclips. Its ironic that it will just take a series of free video to understand concepts I paid thousands in tuition fee to learn in medical school...
Yes I wish the same
Thank you for the excellent video, dr. Peter.
Outstanding video. Finally, someone explains properly why and "abnormal" test is reassuring. Thanks for making this Dr. Johns. Great work.
Oh my goodness .. I think I just died and gone to heaven!!! Wish all med school lectures had your flair for explanation and teaching! Thank you Dr Johns.. this video have upgraded my visual understanding of the assurance of abnormal testing. As students we don't often get to see normal and abnormal side by side (like this) so on the ward our confidence in diagnosis can be affected. My utmost gratitude and aspiration to you! Charlie
One of the most useful medical videos on RUclips. Period. Thank you.
Update: I still go back to this video everytime I need a refresher of this important exam!
I am just diving into the world of vestibular rehab as a physical therapist and I appreciate this video so much! Seeing actual video clips of people with abnormal findings and your explanations is invaluable! THANK YOU so much!!
Learned about this exam during the vestibular unit of my neuro dysfunction class in PT school, so grateful that my professor shared the link to this video as a recommendation for comprehension!
Amazing! Just amazing. I am speechless. I keep coming back to watch this over and over again ever now and then. Thank you so much. Very clear, simply the best.
This was one of my favourites medical video I have ever seen! My last neurology exam will be in two weeks, and you helped me a lot with this video!! I am so grateful for these excellent teaching videos like this!
EXCELLENT video. We need more videos like this. Most of them talk about topics but do not show the actual practice with the patient taking place. Thank you sincerely.
This is the most clearly presented information I have ever found on the HINTS exam I love it!
By far the best explanation I have seen on the HiNTS exam, thank you!
This is by far one the best, if not the best, video on HINTS exam. Thank you, sir. Very well done! I will share with colleagues and medical students.
Best video on the HI/N/TS exam on the net.
Thanks for this Dr Johns
What a great video. I have watched it many, many times. How clearly did he explain ! I really appreciate this gentleman's effort.
Just amazing, and I will start performing these tests on my patients in ED as appropriate.
God, this is incredibly good! Im currently studying for a otorhinolaryngology test and ,at the vertigo class, my teacher just mentioned the HINTS test and didnt give too much of an importance to the matter.. Thanks for the intuitive teaching!
This is not only the best video I have seen on this subject, it has also made me realise how I need to deploy slow-motion video in our medical media workflow, and how I need to demonstrate comparative presentations in our videos. Thank you so much for all your time and effort Dr Johns.
Fantastic! I'm so impressed by all your videos. This is super clear instruction with great demonstrations. Thank you so much.
Fantastic video!! I've always struggled with tests for vertigo but finally understand it !
I am currently a paramedic student doing a case study on dealing with vertigo in the pre-hospital environment. This is a brilliant video to expand on differential diagnosis and look at whether hospital admission is appropriate. Many thanks for this video. Well put together and explained so even quite a dim person like me can understand.
I will start my residency in ENT in a few months. This video helped me a lot in my studying! Thank you, Doctor, for making things easier for us !
Great video, professor! I am from Uruguay and this video was deeply helpful. Could not imagine someone explaining it better. Congrats on the dedication and how articulate you are!
This video is fantastic, and like many others here, I could not understand this concept after reading multiple articles. After this 8 minute video I now not only understand what to expect for normal/abnormal, but how to perform the test and apply the results to differentiate between vestibular neuritis vs a stroke. Thank you very much Dr. Johns!
Fantastic video! I've never seen this so well explained in visual terms. I'am starting in neurology residency in a few weeks and that just cheered me a lot. Thank you for sharing this!
Thank you so much for this Dr Johns, my doubts on how to perform the exam steps have been cleared!
Excellent video. The most clearly presented information I've ever found on the HINTS exam.
Thank you!
best video of hints and explanation i've found so far! Thank you!!
What an excellent teaching video - so clear! Thank you very much!
This is THE BEST video of the Hints exam. Thank you so much !!!
i love your channel so much im watching all your videos on a friday night. Thank you for this content, i´ve been reading about this tests but nothing is like watching someone doing and learning from them.
a friend from brazil.
Excellent! Thank you and please thank your patients as well.
I am a junior doctor working in the NHS, UK. I’ve always found it difficult to perform and interpret HINTS test on patients with Vertigo. I’ve seen loads of videos, read loads of posts and I think this is best video ever on HINTS test. Thank you so much!
Great video, clear and concise, well explained. Very helpful for family physicians or general practitioners in the community who're short on time and trying to find needles in haystacks!
Loved the video. Cleared up everything. Keep them coming!
Love this video as a second year resident. Fantastic instructions and the actual patient videos made it extremely clear.
Thanks!
medical resident here, absolutely fantastic explanation, thank you.
This was a very well explained video! Many thanks for the details and distinctions !
Couldn't find better explanation. Great video and great job!
Awesome explanation with patients...live long and spread knowledge
What an amazing teaching video 👏 I had to perform it on a patient yesterday and I'm glad I've seen this video
Amazing video! Straight to the point explanation. 10/10
Thank you for the explanations and great demonstrations on your patients. Subscribed!
Excellent Video Dr.Johns, Thank You.
Excellent demonstration. Thanks for taking the trouble to make these videos.
Thank you so much for this video, absolute gold!
Best video on this examination I have found! Thank you.
Great video, using this as clarification on methods in my 5th year of medical school in Denmark. Thank you!
Fantastic video . A pleasure to the eyes
Glad to find this video. I had the Hints test but no clue what it actually was. Very reassuring that mine came out not worrisome. Starting PT tomorrow for the nuritius. Hopefully I can get it fixed pretty quickly.
You did an excellent job explaining this. Thank you!
Awesome vídeo. Thank you for this great class!!!
Thank you. I am a physical therapist in Florida and learned a lot from your video.
Thank you for the video, it's really informative, the examples with the patients were the highlight! Greetings from Brazil!
Most learning I've done about EM in years! Thanks!
Thank you for your kind words.
Thank you for your video. (I cannot recall if I've commented before, I tend to be more of a silent viewer). But your video is immensely helpful, and I direct a lot of my more junior colleagues to watch it for their learning too. Thanks for sharing your knowledge and skills.
The last question really helped to consolidate everything
Great series of teaching videos dealing with a tough subject! Hearty congratulations!
Thanks!
Thank you doctor for your beautiful explanations !
Great video, clearly explained and helpful. Thank you for the work
Amazing video, thanks for sharing
Lovely video! Congratulations!
excelente video, clear, no beating around the bush; directly to indispensable knowledge. Thank you
Ha! Thank you! People who know me would certainly agree that I don't beat around the bush!
You made HINTS exam so simple. Thank you.
This was god sent. Thank u, good sir!
such an amazing video. this helped me so much in my neurology-course at medschool. thank you so much
Great video explaining normal and abnormal and I was thinking about the question you posted at the end of the video before it was posted! Greetings from a Mexican Dr that just passed the step 1!
Thanks for the teaching! Cheers from Spain!
Thank you for providing an example of abnormals.
very very helpful for my ENT case presentation this week! thank you doctor
I learned the acronym INFARCT to memorize the results suggesting a vascular cause: Impulse Normal / Fast-Phase Alternating / Refixation on Cover Test. Thanks for the class!!
Yes, David Newman-Toker does like his acronyms. :)
I personally think that if you need an acronym to remember how to interpret the results, you probably don't understand how to perform and interpret the tests well enough to reply on them.
For instance, "Refixation on Cover Test" fits into the "INFARCT" acronym perfectly in terms of the letters "RTC" but in fact doesn't describe the vertical or slanted skew which is what you are looking for.
And "Fast phase Alternating" is another example of the descriptive words being changed to fit the acronym. So it's more of a backronym than an acronym.
In my opinion, it would be better to refer to a chart such as I made in my Big 3 of vertigo video.ruclips.net/video/MwbqJvMDonU/видео.html .
Exception video, loved your presentation 😊
Thanks for a great video Dr Johns!
Thank you so much Mr Peter Johns.
Amazing video! Really helpful! Thank you very much!! Wish there where more videos like this one! Greetings from Spain!
An amazing video to understand the differentiation of vertigo .
THANK YOU!
very illustrative and informative
Amazzzing. I read about it but this makes a world of difference. You sir have earned my man of the day vote. Thank you very much
Hey, glad you found it useful! Thanks so much for your remarks.
great video with excellent explanation - thanks
This is an amazing video and explained it very clearly. Keep up the great work. I will add to my presentation for the juniors.
Thank you for a wonderful explanation.
Excellent, thank you for the video!
That is very clear " bedside teaching", thank you.
Thank you, one of the most useful videos
year 3 medical student here and this helped me sooooo much thank you :)
Great explaination... Thank you for this Video
Thank you so much Professor! Awesome teaching video.
Fabulous video, thank you!!!
Best explained I have ever seen!
Thanks from Mexico, great video!
Great video!!!easy to practice and detail explanation
Thank you so much sir, that was very crisp to the point and informative at the same time
Amazing video, thank you so much for sharing
I finally understand it thanks to you. Thank U!
Fantastic video, God bless Peter Johns
As a neurologist, I always was kinda worried when I had to assess the ENT origin of a vertigo ; now thanks to your video it all looks so simple ! None ever told me about the HINTS, and I only knew Dix/Hallpike or Fukuda, that are of course really harder to perform on a stretcher in emergency room (and apparently a lot less relevant...)
Thanks a lot for your great work Dr Johns !
Thanks for the compliment. I find it easy to perform the Dix-Hallpike test in the emergency department. The key is to turn them around in the stretcher so that their head hangs off the foot of the stretcher. And to get a stool and sit down when doing it. And of course the most important thing is to only perform it on patients with less than 2 min episodes of vertigo and no spontaneous or gaze evoked nystagmus!
Definitely the best video out there on this stuff, which is poorly explained elsewhere. Videos were great. Thanks!
Thank you!
Best video ever!
Many thanks
Спасибо за видео, очень здорово и информативно! Всегда делаю этот тест пациентам с головокружением
Saludos desde Chile... muy buen video para explicar correctamente como evaluar a pacientes con este motivo de consulta tan frecuente. Muchas gracias!
Eres muy bienvenido!