Luigi Califano, Salvatore Martellucci, Maria Grazia Melillo
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引用次数: 0
Abstract
Objectives: Lateral semicircular canal BPPV (LSC-BPPV) is diagnosed with the Head Yaw Test (HYT) by observing nystagmus direction and comparing the nystagmus intensity on both sides according to Ewald's laws. Head Pitching Test (HPT) is a diagnostic maneuver performed in the upright position by bending the patient's head forward (bowing) and backward (leaning) and observing the evoked nystagmus. We aimed to assess the sensitivity of HPT in correctly diagnosing LSC-BPPV through the quantitative measurement of Bowing and Leaning nystagmus slow-phase velocity (SPV).
Methods: One hundred cases of LSC-BPPV were prospectively enrolled. HPT was performed, looking for pseudospontaneous, bowing, and leaning nystagmus. HYT was considered for the "final diagnosis." HPT was defined as "diagnostic" if the nystagmus was present in at least one position, "undiagnostic" if no nystagmus was detectable. The direction and the SPV of nystagmus in all positions were analyzed and compared to determine the degree of agreement between HPT and HYT.
Outcomes: Sixty-four geotropic and 36 apogeotropic forms were diagnosed. HPT was diagnostic in 80 cases, with no difference between the two forms. According to Ewald's laws, the direction of stronger nystagmus evoked by HPT agreed with the HYT results in 39/52 (75%) cases in geotropic forms and 21/28 (75%) cases in apogeotropic forms. The agreement between HPT and HYT was "substantial" considering all the cases and "almost complete" considering only the patients with diagnostic HPT.
Conclusion: Quantitative HPT is a valid test in diagnosing the affected side and form of LSC-BPPV, even if less reliable than HYT.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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