Zhonghua Yi Xue Za Zhi. 2026 Jun 30;106(24):2500-2506. doi: 10.3760/cma.j.cn112137-20260205-00402.
ABSTRACT
Objective: To explore the consistency of lateralization of the head-shaking test (HST), lying-down test (LDT), and rapid axial roll test (RART) with the supine roll test (SRT), and to investigate their relationship with repositioning efficacy in patients with horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV). Methods: Patients diagnosed with primary HC-BPPV using SRT and Dix-Hallpike test at the First Affiliated Hospital of Xi’an Jiaotong University between December 1, 2021 and June 30, 2024 were prospectively enrolled. Based on the order of their visits, all patients were semi-randomly assigned to subgroups to undergo the HST, LDT, or RART as auxiliary provocative tests. The nystagmus elicitation rates of the three tests and their consistency with SRT-based lateralization were compared, and the relationship between lateralization consistency and repositioning efficacy was analyzed. Results: A total of 585 patients with HC-BPPV were included in the study: 199 cases in the HST group, 190 cases in the LDT group, and 196 cases in the RART group. There were no statistically significant differences in sex, age, body mass index, disease duration, and lesion side among the three groups (all P>0.05). The nystagmus elicitation rate of RART (99.0%, 194/196) was higher than that of HST (31.7%, 63/199) and LDT (56.8%, 108/190), with statistically significant differences (both P<0.017). The consistency rate of lateralization between RART and SRT (86.7%, 170/196) was higher than that of HST (17.6%, 35/199) and LDT (44.2%, 84/190), and there were statistically significant differences (both P<0.017). The impact of lateralization distribution between auxiliary provocation tests and SRT on repositioning efficacy in HC-BPPV was analyzed. The results showed that the cure rate of the consistent lateralization group (92.4%, 267/289) was higher than that of the inconsistent lateralization group (55.3%, 30/76) and the nystagmus non-elicitation group (63.2%, 139/220), with statistically significant differences (both P<0.017). In addition, the cure rate of the RART and SRT lateralization consistent group (98.2%, 167/170) was higher than that of the LDT group (88.1%, 74/84) and the HST group (74.3%, 26/35), with statistically significant differences (both P<0.017). Conclusion: RART can serve as an effective auxiliary provocation test for the SRT, enhancing the accuracy of determining the affected side in HC-BPPV through a «dual verification» approach and providing valuable reference for clinical assessment.
PMID:42373471 | DOI:10.3760/cma.j.cn112137-20260205-00402
