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

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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.


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.

Main Outcome Measure:

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.

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