Back to Browse Journals » International Journal of General Medicine » Volume 4

Predictors for benign paroxysmal positional vertigo with positive Dix–Hallpike test

Authors Noda K, Ikusaka M, Ohira Y, Takada T, Tsukamoto T

Published Date December 2011 Volume 2011:4 Pages 809—814


Published 2 December 2011

Kazutaka Noda, Masatomi Ikusaka, Yoshiyuki Ohira, Toshihiko Takada, Tomoko Tsukamoto
Department of General Medicine, Chiba University Hospital, Chiba, Japan

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.

Keywords: benign paroxysmal positional vertigo, likelihood ratio, diagnosis, screening, prediction rules

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:

Readers of this article also read:

Influence of PEGylation and RGD loading on the targeting properties of radiolabeled liposomal nanoparticles

Rangger C, Helbok A, von Guggenberg E, Sosabowski J, Radolf T, Prassl R, Andreae F, Thurner GC, Haubner R, Decristoforo C

International Journal of Nanomedicine 2012, 7:5889-5900

Published Date: 27 November 2012

Risk factors for primary open-angle glaucoma in Japanese subjects attending community health screenings

Ishikawa M, Sawada Y, Sato N, Yoshitomi T

Clinical Ophthalmology 2011, 5:1531-1537

Published Date: 20 October 2011

A novel cell-based 384-well, label-free assay for discovery of inhibitors of influenza A virus

Fuli Jia, Clinton Maddox, Alice Gao, et al

International Journal of High Throughput Screening 2010, 1:57-67

Published Date: 12 May 2010

Cause for controversy? Infliximab in the treatment of ulcerative colitis: an update

Garrett Lawlor, Alan C Moss

Clinical and Experimental Gastroenterology 2009, 2:149-161

Published Date: 10 December 2009

Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate) in adult males with epilepsy

Ghaydaa A Shehata, Abd El-aziz M Bateh, Sherifa A Hamed, et al

Neuropsychiatric Disease and Treatment 2009, 5:527-533

Published Date: 15 October 2009

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors

Eduardo Pimenta, Suzanne Oparil

Vascular Health and Risk Management 2009, 5:453-463

Published Date: 19 May 2009

ATP8A1 activity and phosphatidylserine transbilayer movement

Eric Soupene, Dwi Utami Kemaladewi, Frans A Kuypers

Journal of Receptor, Ligand and Channel Research 2008, 1:1-10

Published Date: 22 September 2008