Re-evaluating the lying-down test: a step-saving and well-tolerated diagnostic adjunct for horizontal canal benign paroxysmal positional vertigo
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By
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Kai Xia
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Rui Gao
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Xiaodi Zhang
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Xiaoxiao Yan
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Dandan He
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May 25, 2026
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Objective:
To systematically evaluate the diagnostic value of the lying-down test (LDT) for horizontal canal benign paroxysmal positional vertigo (HC-BPPV).
Key Findings:
- Overall positive rate of LDT was 60.3%, with a side-determination accuracy of 96.7%.
- The first LDT (fLDT) positive rate was 44.5%.
- fLDT-positive group required fewer diagnostic steps and exhibited greater intensity and shorter latency of nystagmus compared to fLDT-negative group.
- Older age (≥60 years) was identified as an independent predictor of positive LDT response in canalithiasis HC-BPPV.
Interpretation:
Limitations:
- The study is retrospective and may have inherent biases.
- Variability in nystagmus patterns and patient discomfort during testing may affect results.
Conclusion:
