Predictors for benign paroxysmal positional vertigo with positive Dix–Hallpike test
نویسندگان
چکیده
OBJECTIVE Patient medical history is important for making a diagnosis of causes of dizziness, but there have been no studies on the diagnostic value of individual items in the history. This study was performed to identify and validate useful questions for suspecting a diagnosis of benign paroxysmal positional vertigo (BPPV). METHODS Construction and validation of a disease prediction model was performed at the outpatient clinic in the Department of General Medicine of Chiba University Hospital. Patients with dizziness were enrolled (145 patients for construction of the disease prediction model and 61 patients for its validation). This study targeted BPPV of the posterior semicircular canals only with a positive Dix-Hallpike test (DHT + BPPV) to avoid diagnostic ambiguity. Binomial logistic regression analysis was performed to identify the items that were useful for diagnosis or exclusion of DHT + BPPV. RESULTS Twelve patients from the derivation set and six patients from the validation set had DHT + BPPV. Binomial logistic regression analysis selected a "duration of dizziness ≤15 seconds" and "onset when turning over in bed" as independent predictors of DHT + BPPV with an odds ratio (95% confidence interval) of 4.36 (1.18-16.19) and 10.17 (2.49-41.63), respectively. Affirmative answers to both questions yielded a likelihood ratio of 6.81 (5.11-9.10) for diagnosis of DHT + BPPV, while negative answers to both had a likelihood ratio of 0.19 (0.08-0.47). CONCLUSION A "duration of dizziness ≤15 seconds" and "onset when turning over in bed" were the two most important questions among various historical features of BPPV.
منابع مشابه
Number of maneuvers need to get a negative Dix-Hallpike test.
UNLABELLED Benign Paroxysmal Positional Vertigo is one of the most common causes of dizziness. Its characteristic clinical profile is dizziness at head movements. The main diagnostic maneuver of posterior canal Benign Paroxysmal Positional Vertigo is the Dix-Hallpike test. If the maneuver is positive (vertigo and/or nystagmus), the physician can perform the Epley maneuver on the injured side. ...
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متن کاملThe Dix-Hallpike test and the canalith repositioning maneuver.
The Dix-Hallpike test and the canalith repositioning maneuver (CRM) are used to diagnose and treat benign positional vertigo (BPV). Dix-Hallpike is the standard procedure for diagnosis of BPV, but if the horizontal canal is not tested for BPV and the Dix-Hallpike is only carried out once, the condition may not be diagnosed and appropriately treated. We describe our method of testing for BPV and...
متن کاملThe Efficacy of Repositioning Maneuver in the Management of Benign Paroxysmal Positional Vertigo
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متن کامل[Meta-analysis on the efficacy of Epley's manoeuvre in benign paroxysmal positional vertigo].
INTRODUCTION Benign paroxysmal positional vertigo (BPPV) is one of the most common conditions that cause the physiognomy of peripheral vertigo. OBJECTIVE To evaluate the effectiveness of Epley's manoeuvre (EM) in the treatment of BPPV using a critical review of the medical literature and a meta-analysis. METHODS Searches were made in the databases of MEDLINE (PubMed), in the Cochrane collec...
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عنوان ژورنال:
دوره 4 شماره
صفحات -
تاریخ انتشار 2011