New scoring system of an interview for the diagnosis of benign paroxysmal positional vertigo

Imai, Toshio; Higashi-Shingai, Kayoko; Takimoto, Yasumitsu; Masumura, Chisako; Hattori, Kenji; Inohara, Hidenori

doi:10.3109/00016489.2015.1121547

Cited by 15 publications

(6 citation statements)

References 12 publications

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“…Thus, the description, temporal pattern, and aggravating factors of the symptoms, 16,17,53,121 as depicted in the TABLE, can be useful to determine the need for additional tests, such as the head thrust or head impulse test, and head shaking nystagmus, dynamic visual acuity for peripheral vestibular pathology, or the Dix-Hallpike or head-roll maneuvers for benign paroxysmal positional vertigo. 49 Spontaneous and gaze-evoked nystagmus, as well as other oculomotor tests such as eye tracking, skew deviation, and saccades, may be required if central vestibular pathology or brain injury is suspected.…”

Section: Differential Diagnosismentioning

confidence: 99%

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Treleaven¹

2017

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis There is considerable evidence to support the importance of cervical afferent dysfunction in the development of dizziness, unsteadiness, visual disturbances, altered balance, and altered eye and head movement control following neck trauma, especially in those with persistent symptoms. However, there are other possible causes for these symptoms, and secondary adaptive changes should also be considered in differential diagnosis. Understanding the nature of these symptoms and differential diagnosis of their potential origin is important for rehabilitation. In addition to symptoms, the evaluation of potential impairments (altered cervical joint position and movement sense, static and dynamic balance, and ocular mobility and coordination) should become an essential part of the routine assessment of those with traumatic neck pain, including those with concomitant injuries such as concussion and vestibular or visual pathology or deficits. Once adequately assessed, appropriate tailored management should be implemented. Research to further assist differential diagnosis and to understand the most important contributing factors associated with abnormal cervical afferent input and subsequent disturbances to the sensorimotor control system, as well as the most efficacious management of such symptoms and impairments, is important for the future. J Orthop Sports Phys Ther 2017;47(7):492–502. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7052

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Section: Differential Diagnosismentioning

confidence: 99%

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Treleaven¹

2017

Journal of Orthopaedic & Sports Physical Therapy

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“…We previously developed a new scoring system for the diagnosis of BPPV via patient interview, which we described as the “BPPV score (B score)” (10). The details of this scoring system are provided in Appendix 1.…”

Section: Methodsmentioning

confidence: 99%

Effects of Interval Time of the Epley Maneuver on Immediate Reduction of Positional Nystagmus: A Randomized, Controlled, Non-blinded Clinical Trial

et al. 2019

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Objective: The Epley maneuver (EM) has an immediate effect: rapid reduction of positional nystagmus. Benign paroxysmal positional vertigo (BPPV) causes BPPV fatigue, which constitutes fatigability of positional nystagmus and vertigo with repeated performance of the Dix-Hallpike test; notably, BPPV fatigability becomes ineffective over time. We hypothesized that the immediate effect of the EM is caused by BPPV fatigue. Therefore, we suspected that performance of the EM with intervals between head positions would worsen the immediate reduction of positional nystagmus in patients with BPPV, because BPPV fatigability would become ineffective during performance of this therapy. Methods: Forty patients with newly diagnosed BPPV were randomly assigned to the following two groups; one group performed the EM without intervals between positions (group A), and the other group performed the EM with 3 min intervals between positions (group B). The primary outcome measure was the ratio of maximum slow-phase eye velocity (MSPEV) of positional nystagmus soon after the EM, compared with that measured before the EM. Secondary outcome included whether a 30 min interval after the EM enabled recovery of MSPEV of positional nystagmus to the original value. This study followed the CONSORT 2010 reporting standards. Results: In both groups A and B, the immediate effect of the EM could be observed, because MSPEV during the second Dix-Hallpike test was significantly smaller than MSPEV during the first Dix-Hallpike test ( p < 0.0001 in group A, p < 0.0001 in group B). The primary outcome measure was larger in group B than in group A ( p = 0.0029). The immediate effect faded 30 min later (secondary outcome). Conclusions: This study showed that the EM had an immediate effect both with and without interval time in each head position of the EM. Because setting interval time in each head position of the EM reduced the immediate effect of the EM, interval time during the EM adds less benefit. This finding can reduce the effort exerted by doctors, as well as the discomfort experienced by patients with pc-BPPV, during EM. However, this immediate effect may be caused by BPPV fatigue, and may fade rapidly. Classification of Evidence: 1b

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“…There are a large number of scores for diagnosis also. For example, these have been developed for the diagnosis of benign paroxysmal positional vertigo,[ 16 ] for necrotizing soft-tissue infections,[ 17 ] for chronic lymphocytic leukemia,[ 18 ] and for acute appendicitis. [ 19 ] All such scoring systems are statistical tools, and now increasingly used for diagnosis of diseases and for prognosis assessment, lending credence to our plea that statistical medicine is an appropriate candidate to be considered a medical specialty.…”

Section: Statistical Medicine In Clinicsmentioning

confidence: 99%

Statistical medicine

Indrayan

2017

Journal of Postgraduate Medicine

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A large number of statistical tools are now used for medical decision in the core activities of diagnosis, treatment and prognosis. These tools provide undeniable help in improving medical outcomes. Prominent among them are uncertainty measurement by probability, medical indicators and indexes, reference ranges, and scoring systems. In addition are tools such as odds ratio, sensitivity, specificity and predictivities, area under the ROC curve, likelihood ratios, and cost-benefit analysis that are commonly applied in medical research but have implications for day-to-day clinical activities. These tools have so completely integrated into medical practice that statistical medicine by itself can stand alone as a medical specialty. Time has arrived to recognize statistical medicine as a medical specialty.

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New scoring system of an interview for the diagnosis of benign paroxysmal positional vertigo

Cited by 15 publications

References 12 publications

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Effects of Interval Time of the Epley Maneuver on Immediate Reduction of Positional Nystagmus: A Randomized, Controlled, Non-blinded Clinical Trial

Statistical medicine

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