Benign paroxysmal positional vertigo and clinical test of sensory interaction and balance in ankylosing spondylitis.

Objective: To assess the frequency and characteristics of benign paroxysmal positional vertigo (BPPV) and clinical test of sensory interaction and balance (CTSIB) abnormalities in patients with ankylosing spondylitis (AS).

Study Design: A series of consecutive patients that fulfilled the modified New York diagnostic criteria for AS and matched controls were studied.

Setting: The study was performed at the Otolaryngology Division of a tertiary reference center.

Patients: Fifty-nine patients with AS (47 men [79.6%]) attending hospital outpatient rheumatology clinics between March and October 2008, and 46 controls (34 men [73.9%]) were studied.

Intervention: Dix-Hallpike and cephalic rotational tests and CTSIB were performed in AS patients and age-, sex-, and ethnically frequency-matched controls.

Main Outcome Measure: Type and frequency of BPPV and CTSIB conditions were assessed.

Results: BPPV was diagnosed in 6 patients (10.1%) with AS and in 2 (4.3%) of the controls (p = 0.24). Abnormal caloric test was more commonly observed in patients with AS (n = 15 [25.4%]) than the controls (n = 0) (p < 0.001). Increased frequency of abnormal CTSIB also was observed in patients (19/59 [32%]) compared with the controls (3 [6.5%]) (odds ratio, 6.81 [95% confidence interval, 1.77-38.0]; p = 0.001). Among the abnormal CTSIB patterns, the vestibular loss was the most commonly observed in patients with AS (15/59 [25.4%]).

Conclusion: The present study shows an increased frequency of abnormal postural control in CTSIB test of vestibular origin in patients with AS.