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

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 systemic sclerosis (SSc).

Study Design: A series of consecutive patients diagnosed with SSc according to well-established classification criteria and matched controls were studied.

Setting: The study was performed at the otolaryngology division of a tertiary reference center.

Patients: Forty-two patients (35 with limited SSc [lSSc] and 7 with diffuse SSc [dSSc]) and 74 controls were studied between January and May 2007.

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

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

Results: 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).

Conclusion: The present study shows an increased frequency of BPPV and a vestibular pattern in CTSIB in SSc patients.