ArticleFrontiers in neurology
Kinetic classification of posterior semicircular canal canalithiasis based on quantitative nystagmus parameters and its predictive value for the need of a second Epley maneuver: a retrospective quantitative analysis of 60 patients.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To classify the kinetic state of otoconia in canalithiasis according to the slow phase velocity (SPV) of nystagmus during the Dix‑Hallpike test in patients with posterior semicircular canal benign paroxysmal positional vertigo (PSC‑BPPV), and to evaluate the association between different subtypes and the need for a second Epley maneuver, thereby establishing a prognostic model based on kinetic classification. Methods: Clinical data of 60 patients with unilateral PSC canalithiasis were retrospectively analyzed. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold of diagnostic vertical SPV for predicting the need for a second repositioning. Patients were subsequently divided into a high‑SPV aggregated type and a low‑SPV dispersed type based on better prognostic discrimination in clinical grouping (threshold = 20%). The direction and SPV of nystagmus during each step of the Epley maneuver were recorded. The primary outcome was a positive Dix‑Hallpike test 24-48 hours after the initial maneuver, indicating the need for a second repositioning. The rates of second repositioning and the characteristics of inhibitory nystagmus during the maneuver were compared between the two types. Logistic regression was used to analyze the independent predictive value of the classification. Results and discussion: ROC curve analysis showed that the area under the curve (AUC) of diagnostic vertical SPV for predicting a second repositioning was 0.85 (95% CI 0.76-0.94,
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