Re-evaluating the lying-down test: a step-saving and well-tolerated diagnostic adjunct for horizontal canal benign...

Area of Science:

• Neurology
• Otolaryngology
• Vestibular System Disorders

Background:

• The supine roll test (SRT) is the standard for diagnosing horizontal canal benign paroxysmal positional vertigo (HC-BPPV).
• Clinical use of SRT is limited by variable nystagmus and patient discomfort.
• The lying-down test (LDT) offers a simpler, more tolerable alternative, but its diagnostic performance needs consistent reporting.

Purpose of the Study:

• To systematically evaluate the diagnostic value of the LDT for HC-BPPV.
• To compare the diagnostic efficiency of LDT with established methods.
• To identify factors influencing LDT results in HC-BPPV patients.

Main Methods:

• Retrospective analysis of 209 patients diagnosed with HC-BPPV.
• Comprehensive recording of nystagmus characteristics during positional testing.
• Stratification into fLDT-positive and fLDT-negative groups for comparative analysis.

Main Results:

• LDT showed an overall positive rate of 60.3% with 96.7% side-determination accuracy.
• fLDT-positive patients exhibited superior diagnostic efficiency, greater nystagmus intensity, and shorter latency.
• Older age (≥60 years) independently predicted positive LDN in canalithiasis HC-BPPV.

Conclusions:

• LDT is a reliable and well-tolerated diagnostic tool for HC-BPPV.
• Routine integration of LDT as an adjunct to SRT is recommended.
• Advanced age is a predictor of positive LDT response in canalithiasis HC-BPPV.