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March 03, 2020; 94 (9) Article
Questionnaire-based diagnosis of benign paroxysmal positional vertigo
View ORCID ProfileHyo-Jung Kim, Jeong-Mi Song, Liqun Zhong, Xu Yang, View ORCID ProfileJi-Soo Kim
First published December 30, 2019, DOI: https://doi.org/10.1212/WNL.0000000000008876
Hyo-Jung Kim
From the Research Administration Team (H.-J.K.) and Department of Neurology (J.-M.S., J.-S.K.), Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Neurology (L.Z.), Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine; Department of Neurology (X.Y.), Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China; and Department of Neurology (J.-S.K.), College of Medicine, Seoul National University, Korea.
ORCID record for Hyo-Jung Kim
Jeong-Mi Song
Liqun Zhong
Xu Yang
Ji-Soo Kim
ORCID record for Ji-Soo Kim
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Hyo-Jung Kim, Jeong-Mi Song, Liqun Zhong, Xu Yang, Ji-Soo Kim
Neurology Mar 2020, 94 (9) e942-e949; DOI: 10.1212/WNL.0000000000008876
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Objectives To develop a simple questionnaire for self-diagnosis of benign paroxysmal positional vertigo (BPPV).
Methods We developed a questionnaire that consisted of 6 questions, the first 3 to diagnose BPPV and the next 3 to determine the involved canal and type of BPPV. From 2016 to 2017, 578 patients with dizziness completed the questionnaire before the positional tests, a gold standard for diagnosis of BPPV, at the Dizziness Clinic of Seoul National University Bundang Hospital.
Results Of the 578 patients, 200 were screened to have BPPV and 378 were screened to have dizziness/vertigo due to disorders other than BPPV. Of the 200 patients with a questionnaire-based diagnosis of BPPV, 160 (80%) were confirmed to have BPPV with positional tests. Of the 378 patients with a questionnaire-based diagnosis of non-BPPV, 24 (6.3%) were found to have BPPV with positional tests. Thus, the sensitivity, specificity, and precision of the questionnaires for the diagnosis of BPPV were 87.0%, 89.8%, and 80.0% (121 of 161, 95% confidence interval 74.5%–85.5%). Of the 200 patients with a questionnaire-based diagnosis of BPPV, 30 failed to respond to the questions 4 through 6 to determine the involved canal and type of BPPV. The questionnaire and positional tests showed the same results for the subtype and affected side of BPPV in 121 patients (121 of 170, 71.2%).
Conclusion The accuracy of questionnaire-based diagnosis of BPPV is acceptable.
Classification of evidence This study provides Class III evidence that, in patients with dizziness, a questionnaire can diagnose BPPV with a sensitivity of 87.0% and a specificity of 89.8%.
AC=
anterior canal;
BPPV=
benign paroxysmal positional vertigo;
CRP=
canalith repositioning procedure;
HC=
horizontal canal;
PC=
posterior canal;
STARD=
Standards for Reporting Diagnostic Accuracy Studies;
VOG=
video-oculography
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Class of Evidence: NPub.org/coe
CME Course: NPub.org/cmelist
Received May 12, 2019.
Accepted in final form August 29, 2019.
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Disputes & Debates: Rapid online correspondence
Author response: Questionnaire-based diagnosis of benign paroxysmal positional vertigo
Hyo-Jung Kim, PhD, Research Administration Team, Seoul National University Bundang Hospital (Seongnam, Korea)
Ji-Soo Kim, MD, PhD, Department of Neurology, College of Medicine, Seoul National University (Seoul, Korea)
Submitted May 02, 2020
Reader response: Questionnaire-based diagnosis of benign paroxysmal positional vertigo
Douglas J. Lanska, Neurologist, Epidemiologist, I.M. Sechenov First Moscow State University, Moscow, Russia; University of Wisconsin School of Medicine (Madison, Wisconsin)
Hyo-Jung Kim, Research Professor, Seoul National University Bundang Hospital
Ji-Soo Kim, Professor, Seoul National University Bundang Hospital
Submitted December 30, 2019
Daniel R. Gold, DO, Associate Professor of Neurology, Ophthalmology, Neurosurgery, Otolaryngology, Emergency Medicine, and Medicine, The Johns Hopkins University School of Medicine (Baltimore, MD)
David E. Newman-Toker, MD, PhD, Professor of Neurology, Ophthalmology, & Otolaryngology, The Johns Hopkins University School of Medicine (Baltimore, MD)
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Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X