Alternate cover testCentral · refer

Skew deviation

Vertical misalignment — specific for central.

Alternate cover testLive

On the alternate-cover test the just-uncovered eye makes a small vertical refixation. Skew is the least sensitive but most specific of the three HINTS signs — when present, refer.

Source: HINTS exam (Kattah 2009); Newman-Toker AVS literature.

Practice this in the trainerPlay today’s case

Other signs

Up-beating torsional

Dix-Hallpike

Horizontal direction-changing

Supine roll test

Horizontal apogeotropic

Supine roll test

Stylised teaching animations authored by NeuroDash. Not real-patient recordings, not board-certified, and not reviewed by an outside specialist. Educational only — not medical advice or a diagnosis.