Diagnosing Lateral Canal BPPV with the "Bow and Lean" Test This recent study suggests that the Head Pitching Test (HPT), or "Bow and Lean Test", is effective for diagnosing Lateral Semicircular Canal BPPV. It demonstrated 75% agreement with the Head Yaw Test (HYT), or Supine Roll Test, the current gold standard. The HPT: - detected nystagmus in 80 of 100 cases, effective for both geotropic and apogeotropic forms. - helps measure slow-phase velocity (SPV) to identify the affected side. While HYT remains more reliable, HPT provides a useful alternative for clinicians. 📄 Reference: Califano L, et al. Otol Neurotol. 2024 Sep;45(8) . doi: 10.1097/MAO.0000000000004256. Note: abstract only https://lnkd.in/gSfjxKtw #vestibularhealth #BPPV #BowAndLeanTest #SupineRollTest #vesticam #altiusgruppen
Very good test. To determine the side, which is the big question with a lateral CSC, it all depends on whether the amalgam is stuck against the cup (cupulolithasis) or if it is free in the large arm of the canal (canalolithiasis). I rarely perform the supine roll test, because cervical torsion, according to some authors, can create cervicogenic vertigo.
Have you utilized the "Bow and Lean" test in your evaluation of Lateral Canal BPPV patients? Any unexpected findings? https://lnkd.in/ghrd-r3R
B&L test appears as an elegant and less-stressing vs Supine Roll test , but appears to be less sensitive for hsc-bppv and for psc-asc variants too ( respect to lateral head hanging position )
Intéressant
Disclaimer: All posts are solely my own thoughts and do not represent those of my company - FYZICAL. They are based only on my understanding and may not be entirely accurate.
2moI need clarification on whether you need to add a head tilt right or left to differentiate sides. The BOW or LEAN will produce mirrored nystagmus.