Benign Paroxysmal Positional Vertigo and Clinical Test of Sensory Interaction and Balance in Systemic Sclerosis

Abstract

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 systemic sclerosis (SSc). A series of consecutive patients diagnosed with SSc according to well-established classification criteria and matched controls were studied. The study was performed at the otolaryngology division of a tertiary reference center. Forty-two patients (35 with limited SSc [lSSc] and 7 with diffuse SSc [dSSc]) and 74 controls were studied between January and May 2007. Dix-Hallpike and cephalic rotational tests and CTSIB were performed in SSc patients and age-, sex-, and ethnically frequency-matched controls. Type and frequency of BPPV and CTSIB conditions were assessed. Seven patients (17%) fulfilled the diagnostic criteria for BPPV compared with none of the controls (p < 0.001). It was related to the involvement of the posterior semicircular canal in two lSSc patients and the horizontal semicircular canal in another three patients with lSSc and two with dSSc. A significantly increased frequency of abnormal CTSIB was also observed in SSc patients (20 [48%]) compared to controls (7 [10%]; p < 0.0001; odds ratio, 8.70; 95% confidence interval, 2.97-27.2). It was caused by a vestibular pattern in most patients (p < 0.0001). The present study shows an increased frequency of BPPV and a vestibular pattern in CTSIB in SSc patients.