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Published on: April 28, 2020
Diagnostic Efficacy of the Body Roll Test for Lateral Canal Benign Paroxysmal Positional Vertigo: A Randomized
Hyun Jin Lee1, Yun-Jung Yang2, Sung Goo Yoo3
1Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Objectives:
Lateral canal benign paroxysmal positional vertigo (LC-BPPV) is diagnosed using the head roll test (HRT), which involves rotating the head to mobilize particles within the lateral canal, inducing nystagmus. The body roll test (BRT) is conducted by rolling both the body and head simultaneously, offering the advantage of safely achieving the correct rotational angle in both directions. This study evaluates the diagnostic utility of the BRT.
Methods:
A randomized controlled study was conducted. In total, 43 patients with LC-BPPV symptoms were enrolled and randomly divided into two groups. In group A (n=21), the HRT was administered first, followed by the BRT after a 5-minute interval. In contrast, group B (n=22) received the BRT first, followed by the HRT after 5 minutes. Participants wore Fresnel glasses, which allowed for the observation of nystagmus in sitting, bowing, and lying down positions. We recorded the direction, latency, and duration of the nystagmus.
Results:
The distribution of nystagmus types was 18:25 (geotropic: apogeotropic). There was no significant difference in age, sex, or type of nystagmus between the two groups. The findings from the HRT aligned with those from the BRT for 32 (74.4%) of the participants. No statistical differences were noted in the diagnosis of the affected side or in the type of nystagmus (geotropic vs. apogeotropic) between the HRT (n=32) and BRT (n=32) (P>0.05). The diagnostic rates in the first (n=31) and second tests (n=33) were similar, showing no significant difference and consistent results regarding the type of LC-BPPV. Additionally, there were no significant differences in postural discomfort and pain scores between these groups.
Conclusion:
BRT and HRT demonstrate comparable diagnostic efficacy for LC-BPPV. BRT offers a viable alternative, especially for patients whose conditions preclude the use of HRT, and may improve diagnostic accuracy when combined with HRT.
