Seo-Young Choi1, Se-Won Oh2, Hyo-Jung Kim3, Ji-Soo Kim4,5,6. 1. Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, Pusan, Korea. 2. Dizziness Center, Seoul National University Bundang Hospital, Seongnam, South Korea. 3. Research Administration Team, Seoul National University Bundang Hospital, Seongnam, South Korea. 4. Dizziness Center, Seoul National University Bundang Hospital, Seongnam, South Korea. jisookim@snu.ac.kr. 5. Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea. jisookim@snu.ac.kr. 6. Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea. jisookim@snu.ac.kr.
Abstract
OBJECTIVES: This study aimed to define the factors affecting accuracy of bedside determination of the involved side in HC-BPPV. INTERVENTIONS: We developed 44 video clips including the nystagmus induced during supine head-roll test from patients with apogeotropic (n = 23) or geotropic (n = 21) HC-BPPV. The intensity of nystagmus was also quantified using video-oculography. Each video clip was presented twice to 25 participants, 14 medical students, and 11 medical personnel trained in neurology or neurotology, and the participants reported the lesion side using an evaluation sheet after each presentation. From the quantified video-oculographic data, absolute difference and asymmetry (absolute difference divided by the sum) of nystagmus intensity were calculated. MAIN OUTCOMES AND MEASURES: The accuracy of bedside lateralization of HC-BPPV was 83.5% after the first presentation, and 86.0% after the second presentation, and was not different between the medical students and trained personnel after the second presentation. The accuracy was more closely correlated with the asymmetry than the absolute difference (Spearman's ρ = 0.627, p < 0.001). With a cut-off for the asymmetry at 30.8%, the accuracy was estimated at 93.8% with a sensitivity of 92.9%, and the area under the ROC curve of 0.779. CONCLUSIONS AND RELEVANCE: The accuracy of bedside lateralization of the affected side is acceptable in HC-BPPV when the nystagmus asymmetry is more than 30%.
OBJECTIVES: This study aimed to define the factors affecting accuracy of bedside determination of the involved side in HC-BPPV. INTERVENTIONS: We developed 44 video clips including the nystagmus induced during supine head-roll test from patients with apogeotropic (n = 23) or geotropic (n = 21) HC-BPPV. The intensity of nystagmus was also quantified using video-oculography. Each video clip was presented twice to 25 participants, 14 medical students, and 11 medical personnel trained in neurology or neurotology, and the participants reported the lesion side using an evaluation sheet after each presentation. From the quantified video-oculographic data, absolute difference and asymmetry (absolute difference divided by the sum) of nystagmus intensity were calculated. MAIN OUTCOMES AND MEASURES: The accuracy of bedside lateralization of HC-BPPV was 83.5% after the first presentation, and 86.0% after the second presentation, and was not different between the medical students and trained personnel after the second presentation. The accuracy was more closely correlated with the asymmetry than the absolute difference (Spearman's ρ = 0.627, p < 0.001). With a cut-off for the asymmetry at 30.8%, the accuracy was estimated at 93.8% with a sensitivity of 92.9%, and the area under the ROC curve of 0.779. CONCLUSIONS AND RELEVANCE: The accuracy of bedside lateralization of the affected side is acceptable in HC-BPPV when the nystagmus asymmetry is more than 30%.
Authors: Ji Soo Kim; Sun-Young Oh; Seung-Han Lee; Ji Hoon Kang; Dong Uk Kim; Seong-Hae Jeong; Kwang-Dong Choi; In Soo Moon; Byung Kun Kim; Hyo Jung Kim Journal: Neurology Date: 2012-08-01 Impact factor: 9.910
Authors: Salvatore Martellucci; Pasquale Malara; Andrea Castellucci; Rudi Pecci; Beatrice Giannoni; Vincenzo Marcelli; Alfonso Scarpa; Ettore Cassandro; Silvia Quaglieri; Marco Lucio Manfrin; Elisabetta Rebecchi; Enrico Armato; Francesco Comacchio; Marta Mion; Giuseppe Attanasio; Massimo Ralli; Antonio Greco; Marco de Vincentiis; Cecilia Botti; Luisa Savoldi; Luigi Califano; Angelo Ghidini; Giulio Pagliuca; Veronica Clemenzi; Andrea Stolfa; Andrea Gallo; Giacinto Asprella Libonati Journal: Front Neurol Date: 2020-11-19 Impact factor: 4.003