Lateralization of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) with the latency test: a pilot study

Abstract

Background: The treatments of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) have low remission rates ranging between 60% and 90%, connected to the difficulty in correctly identifying the affected side of HSC-BPPV.

Objective: To propose and compare the efficacy of the latency test (LT) in identifying the affected ear in patients with HSC-BPPV.

Materials and methods: Twenty-one subjects diagnosed with HSC-BPPV, as ascertained by head rolling test (HRT), were prospectively identified. Lateralization was assessed with pseudo-spontaneous nystagmus, lying-down nystagmus, bow and lean (BLT), HRT and LT tests. LT is a novel technique involving a 180° movement of the head and the analysis of the time required to reverse the nystagmus.

Results: About 57% of patients were diagnosed with geotropic, and 43% with apogeotropic type HSC-BPPV. LT achieved a correct side diagnosis in 86%. Efficacy analysis of the tests compared to HRT revealed a substantial fair level of agreement for lying-down test (κ = 0.32, p < .05), a slight level of agreement for BLT (κ = 0.19, p < .05) and a substantial level of agreement for LT (κ = 0.071, p < .001).

Conclusions and significance: LT was proven to show a substantial level of agreement compared to HRT in identifying the affected ear in patients with HSC-BPPV in this pilot study.

背景：水平半规管良性阵发性位置性眩晕（HSC-BPPV）的治疗具有60％至90％的低缓解率, 这与正确鉴别HSC-BPPV患侧的难度有关。

目的：提出并比较潜伏期测试（LT）对鉴别HSC-BPPV患者受累耳的效果。

材料和方法：前瞻性鉴定了通过头部滚动试验（HRT）确定的21名被诊断患有HSC-BPPV的受试者。用假性自发性眼球震颤、卧位眼球震颤、弓身和后倾（BLT）、HRT和LT测试评估侧向化。 LT是一种新技术, 涉及头部的180°运动和分析眼球震颤反转所需的时间。

结果：约57％的患者被诊断为向地性, 43％的患者被诊断为非地向型HSC-BPPV。 LT在86％的情况下获得了正确的患侧诊断。与HRT相比, 测试的疗效分析显示, 对于平躺测试, 一致性水平相当高（κ= 0.32, p <.05）；对于BLT测试, 一致性水平低（κ= 0.19, p <.05）；对于LT测试, 一致程度较高（κ= 0.071, p <.001）。

结论和意义：在这项试点研究中, 与HRT相比, LT被证明在鉴定HSC-BPPV患者的病耳方面显示出相当高的一致性。

Keywords:

• Benign paroxysmal positional vertigo
• latency test
• bow and lean test
• head rolling test
• lying-down nystagmus
• treatment
• diagnosis
• horizontal semicircular canal

Acknowledgements

The authors would like to thank Johanna Chester for her editorial assistance and critical appraisal of the manuscript. All the Authors have made substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; they all have been involved in drafting the manuscript or revising it critically and have given final approval of the version to be published.

Disclosure statement

No potential conflict of interest was reported by the authors.