09-13, 08:30–10:00 (Europe/Istanbul), Equlibirium 1
BPPV - Is completely clarified?
Introduction and objectives: The diagnostic accuracy and reliability of the head pitch test in differentiating between different types of BPPV require further investigation. Studying the diagnostic accuracy of the head pitch test in BPPV diagnosis can aid in the development of targeted management strategies for patients presenting with BPPV.
Methods: All patients who complained of positional vertigo for seconds underwent complete videonystagmography test using ICS Chartr 200 VNG/ENG system (Otometrics, Denmark) including : spontaneous nystagmus, complete occulomotor test battery, then the head pitch test was performed in two positions: first the patient's head was bent 90 degrees forwards, then 60 degrees backwards for approximately 1 min each. If nystagmus was observed, its direction was recorded.<sup>1</sup>All patients then underwent gold standard tests for positional vertigo including both Dix-Hallpike maneuver and the supine roll tests.
Results: The sensitivity (true positive cases) was defined as the head pitch (HPT) test being positive and showing the correct nystagmus for different categories of BPPV. The sensitivity of the experimental HPT was compared to the gold standard tests (100% sensitive) for diagnosis of different categories of vertical canal and lateral canal BPPV. It was highest (100%) for Lateral Cupulolithiasis patients (n = 12) and Anterior canal Canalithiasis (n = 3) and lowest (68%) for Typical Posterior Canalithiasis patients (n = 68).
Conclusion: This study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.
our study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.
Konrad P. Weber is a Senior Physician at the Department of Neurology, Department of Ophthalmology and works for the Interdisciplinary Center for Vertigo and Neurological Visual Disorders at the University Hospital Zurich. He has been a lecturer in neuro-ophthalmology and neuro-otology since 2014. His research focus is on the development of diagnostic tests for patients with ocular motor and balance disorders based on eye movement measurements with state-of-the-art technology. Together with Prof. MacDougall he pioneered the clinical application of the video head impulse test for comprehensive testing of vestibular function in patients with vertigo and dizziness. His clinical education includes employment as an Internal Medicine Resident (1999-2001) and a Neurology Resident (2002-2010). Since 2010 he has been a Senior Physician at the Department of Neurology and since 2014 also at the Department of Ophthalmology (University Hospital Zurich). Since 2015 he has served as a Senior Physician at the Interdisciplinary Center for Vertigo and Neurology Visual Disorders (University Hospital Zurich). Konrad P. Weber has undergone research training in the groups of Dominik Straumann (2001-2002) and Michael Halmagyi (2006-2008) and worked with Klara Landau (2009-2018). Konrad P. Weber has exceptional expertise in clinical neuro-otology and neuro-ophthalmology.
Mayada Abdel Salam ElSherif is Associate Professor of Audio-vestibular medicine, Otorhinolaryngology department, Fculty of medicine, Alexandria university of Egypt ,with over a decade of specialized experience in Audio-vestibular science. Her expertise is grounded in both rigorous academic training, including a Doctorate in Audiology from Alexandria University, and hands-on clinical experience.
She has made significant contributions to the field through her extensive research and clinical practice, with a focus on diagnosing and managing vestibular disorders. Her work has been published in numerous peer-reviewed journals, covering topics such as the Video Head Impulse Test (vHIT) in vestibular migraine, benign paroxysmal positional vertigo, and the clinical significance of vestibular reflex testing. Her international training as an observer at the Cleveland Clinic with Dr. Judith White further underscores her specialized knowledge. Recognized for her research, she received the Best Research Award at the EROC 2020 Congress.