CLINICAL UTILITY OF LATERAL HEAD TILT POSTUROGRAPHY

The Sensory Organization Test (SOT) of dynamic posturography, a functi onal test of balance, has a low sensitivity for compensated unilateral peripheral vestibular lesions. Tilting the head 45 degrees laterally during SOT [i.e. lateral head tilt (LHT) SOT] may better detect such l esions. Normal subjects and vestibular clinic patients were studied us ing SOT and LHT SOT. Caloric, rotational chair, and oculomotor testing were also performed for patients, in either a double-blind or non-dou ble-blind manner. The results for both patient groups were similar and thus were collapsed. Normative LHT SOT performance ranges were establ ished to be slightly lower than corresponding SOT scores, for subjects aged 20-59 years. Subjects in older age groups performed with similar equilibrium scores in both SOT and LHT SOT. Normal subjects aged 20-5 9 and 60-69 years performed similarly, whereas those aged 70-79 perfor med significantly worse. Sensitivity of LHT SOT to unilateral peripher al vestibular lesions was poor (24%). Specificity of LHT SOT from pati ents having balance-system disorders without indication of peripheral vestibular system weakness was 90%. The results of this study indicate that LHT posturography does not facilitate significant discrimination of patients with compensated unilateral peripheral weakness from thos e without such lesions.