Authored in-house by NeuroDash — not board-certified, and not reviewed by an outside specialist.

Clinical note · The bedside eye exam

Read the eyes.
Make the call.

Case 03

Unidirectional horizontal · abnormal head impulse · damped by fixation

Inner ear, or the brain?

Make the call — then see the reasoning. No sign-up.

The eye, live. The eye above the reading line. Each sign cites its guideline — Kattah 2009 for HINTS, Bhattacharyya 2017 for the positional beat. Stylised teaching, exaggerated for visibility; not a recording of a patient.

The dizzy patient you cannot afford to misread is the one whose inner-ear story is hiding a stroke. The eyes are what tell them apart. Make that call here first, on a new patient every time.

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Only here

Two patients. One story. One finding apart.

A video shows you one patient. It cannot show you the same patient with a normal reflex instead of an abnormal one — that patient does not exist. Ours does: generated from the physics, the answer derived from the same math that draws the eyes.

Same history · one finding apart
Counterfactual twin
Generated live · answer derived from the physics

Three days of continuous dizziness, present now at rest and worse with any head movement. It began at rest, with nothing that set it off. Hearing is unchanged. No double vision, no weakness, no slurred speech.

Two patients, the same story. Everything looks the same — until you flick the head. One eye makes a catch-up saccade; one does not. Which one is the central call — the stroke until proven otherwise?

Patient A
Patient B
Run the head impulse on both, then make your call.

Stylised teaching animation from a physics engine — not a real-patient recording, not a diagnosis.

The twin, read. An abnormal head impulse — a catch-up saccade — is the reassuring peripheral sign; a normal impulse in ongoing vertigo points central and is the one most often read as reassuring. After Kattah et al., 2009 (Stroke). Stylised teaching from a physics engine; not a real-patient recording.

The drill

Reading about the exam is not the same as making the call.

NeuroDash gives you the reps: a new dizzy patient every time, generated live. You decide inner ear or stroke, then see the reasoning — case after case, not a fixed set of clips to watch once.

  1. 01

    Gate the syndrome

    HINTS applies only to the acute vestibular syndrome — dizzy right now, continuously. The gate comes first, on the TiTrATE framework (Newman-Toker & Edlow, 2015).

  2. 02

    Read the eyes

    Head impulse, nystagmus, test of skew — rendered from parameters, not filmed. Read the finding the way you would at the bedside.

  3. 03

    Make the call

    Inner ear or stroke. You commit before the rationale — retrieval practice, cited on the trust page, not a passive re-read.

  4. 04

    See the reasoning

    The INFARCT logic, laid against the finding you just read. Then the next patient, weighted toward the signs you miss.

Why the eyes

Why this call is worth drilling.

Evidence · cited in full

In acute vestibular syndrome, a trained examiner reading the eyes at the bedside can outperform early MRI: HINTS was 100% sensitive and 96% specific, while early MRI missed about 1 in 8 strokes in the first 48 hours (Kattah et al., 2009, Stroke). Those are the ceiling, not the average — the examiners were subspecialists. A later meta-analysis put HINTS at 96.7% sensitivity and 94.8% specificity when specialists ran it, and at 83.3% and 43.8% in the one cohort that was not all subspecialists (Ohle et al., 2020, Academic Emergency Medicine). That gap is what NeuroDash drills.
The claim is scoped to a trained examiner in acute vestibular syndrome — not a promise about any one reader, and never a diagnosis.

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Disclosure

It supports your judgment. It never replaces it.

Cited, not asserted

Every answer names the guideline it comes from. Kattah 2009 for HINTS, the Bárány Society and AAO-HNS for the rest.

Stylised teaching

The animations are rendered from physics and exaggerated for visibility. Never a recording of a real patient, and never diagnostic.

Plain about what it is

Authored in-house by NeuroDash — not board-certified, and not reviewed by an outside specialist. What this is, and isn’t →

The drill

A dizzy patient is on the schedule. Be ready.

NeuroDash — HINTS exam & nystagmus training for the dizzy patient