Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2022 Jun;42(3):613-619. doi: 10.1007/s11596-022-2562-z. Epub 2022 Jun 9.
The purpose of the study was to evaluate the efficiency of the supine roll test (SRT) and alternative positional tests (APTs) including the bow and lean test (BLT), pseudo-spontaneous nystagmus (PSN), and lying down nystagmus (LDN) to identify the affected side in horizontal canal benign paroxysmal positional vertigo (HC-BPPV).
In our prospective study, we performed a testing profile (PSN, BLT, LDN, SRT) on 59 HC-BPPV patients using videonystagmography. We compared the accuracy and sensitivity of these tests in HC-BPPV lateralization. Data from 30 healthy patients were collected as the control group.
When performing positional tests, the elicited nystagmus coinciding with Ewald's second law was defined as a "positive response". In 44 patients with geotropic nystagmus, the rates of positive response in LDN, PSN, and BLT were 22/44 (50%), 19/44 (43%), and 18/44 (41%), respectively, while in 15 patients with apogeotropic nystagmus, the positive response rates of these three tests were 10/15 (66.7%), 9/15 (60%), and 4/15 (27.00%), respectively. The sensitivity of LDN (54.38%) was higher than that of PSN (47.37%) and BLT (38.60%) but lower than that of SRT (89.47%). Notably, the accuracy rate of PSN (71.8%) was higher than that of the other APTs. In 6 patients with symmetrical nysgtamus during the roll test, 5 patients showed a positive response in both LDN and BLT (83.34%), whereas 4 patients showed a positive response in PSN (66.67%).
All positional tests are helpful for determining the affected side of HC-BPPV, but SRT carries the highest accuracy of lateralization followed by PSN.
本研究旨在评估仰卧滚转试验（SRT）和替代位置试验（APTs），包括弓背倾斜试验（BLT）、假性自发性眼震（PSN）和卧位眼震（LDN），在水平半规管良性阵发性位置性眩晕（HC-BPPV）中确定患侧的效率。
在我们的前瞻性研究中，我们使用视频眼震图对 59 例 HC-BPPV 患者进行了 PSN、BLT、LDN 和 SRT 测试。我们比较了这些测试在 HC-BPPV 侧别定位中的准确性和敏感性。收集 30 例健康患者的数据作为对照组。
在进行位置性试验时，与 Ewald 第二定律相符的诱发眼震被定义为“阳性反应”。在 44 例向地性眼震患者中，LDN、PSN 和 BLT 的阳性反应率分别为 22/44（50%）、19/44（43%）和 18/44（41%），而在 15 例背地性眼震患者中，这三种测试的阳性反应率分别为 10/15（66.7%）、9/15（60%）和 4/15（27.00%）。LDN 的敏感性（54.38%）高于 PSN（47.37%）和 BLT（38.60%），但低于 SRT（89.47%）。值得注意的是，PSN 的准确率（71.8%）高于其他 APTs。在 6 例滚转试验中出现对称眼震的患者中，5 例 LDN 和 BLT 均出现阳性反应（83.34%），而 4 例 PSN 出现阳性反应（66.67%）。
所有位置性试验都有助于确定 HC-BPPV 的患侧，但 SRT 的定位准确性最高，其次是 PSN。
