Objective: To ascertain the value of different positioning tests in diagnosis of benign paroxysmal positional vertigo (BPPV).

Method: Seventy-two patients who had determined the diagnosis of the posterior semicircular canal BPPV (PC-BPPV) in our department from Feb. 2000 to Apr. 2004 was tested with different positioning maneuvers. All cases were randomly divided into 2 groups with cross-over design. Group A with 36 subjects was tested with the Dix-Hallpike maneuver followed up by side-lying maneuver; Group B was tested in reverse order. Then, the Roll test was performed.

Result: The results had association (P > 0.01) between the Dix-Hallpike maneuver and side-lying maneuver, and the positive rate had no significant difference (P < 0.01). The features of vertigo and nystagmus provoked by the tests were the same. One patient was found combining with BPPV of horizontal semicircular canal (HC-BPPV) by the Roll test.

Conclusion: As the Dix-Hallpike maneuver, the side-lying test has the same diagnostic value in determine the PC-BPPV. Because it is safer and easier to perform in the condition of range-of-motion limitations such as spondylosis, it can alter the Dix-Hallpike maneuver. If the horizontal nystagmus provoked in above tests, the Roll test should be perform also to determine whether combining with HC- BPPV or not.

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