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Updated: Jun 28, 2025

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm
Published on: April 28, 2020
A new roll test to diagnose posterior semicircular canal benign paroxysmal positional vertigo
Hiroaki Ichijo1, Hisako Ichijo1
1Ichijo Ear, Nose and Throat Clinic, 3-2-1, Ekimae, Hirosaki 036-8002, Japan.
Background:
The Dix-Hallpike (DH) test is a gold standard for diagnosing benign paroxysmal positional vertigo (BPPV). However, lateral semicircular canal BPPV is not rare. We have been performing the new roll test that begins from the sitting position and contains a head-hanging position, in order not to overlook lateral canal BPPV. We noticed that transient vertical/torsional nystagmus sometimes occurs during the new roll test.
Objective:
To clarify the value of the new roll test in diagnosing posterior canal BPPV and elucidate the position that elicits nystagmus.
Materials And Methods:
The subjects were 100 consecutive patients (79 were female, 21 were male) with posterior canal BPPV. We classified the patients into four types based on a position that induced nystagmus.
Results:
The patient's position that elicited nystagmus varied. The supine type accounted for 24 %, the lateral type accounted for 62 %, the head-hanging type accounted for 9 %, and the DH type accounted for 5 %.
Conclusion:
The new roll test is valuable for diagnosing posterior canalolithiasis cases. Most patients reveal vertical/torsional nystagmus in the supine or lateral position. Therefore, performing the new roll test first is efficient at the initial visit.

