Diagnostic efficacy of body roll test for lateral canal BPPV: A randomized controlled study.

Abstract

Background: Lateral semicircular canal BPPV (LC-BPPV) is diagnosed by the head roll test (HRT), in which the head is rotated to move particles in the lateral canal, causing nystagmus. The body roll test (BRT) is performed in a rolling position with the body and head together, which has the advantage of safely rotating the head at the correct angle in both directions. This study aims to assess the diagnostic utility of the body roll test (BRT).

Methods: A randomized controlled study was conducted. A total of 43 enrolled patients with LCBPPV symptoms were randomly divided into two groups. In group A (n=21), the HRT was performed first followed by the BRT after 5 minutes. Conversely, the BRT was performed first in group B followed by the HRT after 5 minutes (n=22). Participants were fitted with Freznel glasses and observed for nystagmus in the sitting, bow, and lying down position. The direction, latency, and duration of nystagmus were recorded.

Results: The type of nystagmus was 18:25 (geotropic: apogeotropic). No significant difference was found in age, sex, and nystagmus type between the two groups. The results of the HRT were consistent with those of the BRT for 32 (74.4%) participants. No statistical differences were observed in the diagnosis of the affected side and nystagmus type (geotropic vs. apogeotropic) between the HRT (n=32) and BRT (n=32) (P>0.05). The diagnosis rate in the first (n=31) and second tests (n=33) showed no significant difference and yielded similar results including the type of LC-BPPV. Moreover, no significant difference was found in postural discomfort and pain scores between these groups.

Conclusion: BRT and HRT show similar diagnostic efficacy for LC-BPPV. BRT provides a practical alternative, particularly for patients with limitations that prevent HRT, and may enhance diagnostic accuracy when used together with HRT.