It is known that abnormality in the autonomic nervous system often induces dizziness, and standing position tests including the Schellong test (ST) and head up tilt test (HUT) have been used for diagnosis. HUT is often used for the diagnosis of vasovagal reflex (VVR), a dizziness disease caused by the abnormality in autonomic nervous system, but there are few reports that compared the results of ST and HUT in VVR patients. We conducted ST and HUT in 6 patients with VVR-related dizziness, and compared the results.
Six patients were studied including 3 males and 3 females with a mean age of 25.5 years of age who visited the otolaryngology department of Juntendo Izu-Nagaoka Hospital and Juntendo Urayasu Hospital and were diagnosed with dizziness caused by VVR.
These 6 patients with dizziness underwent ST and HUT tests in the standing position, to compare their test results. The assessment variables were cardiac rate, systolic blood pressure, and diastolic blood pressure.
The results of ST were negative in all 6 patients, however, those of HUT were positive in 5 patients. In comparison of cardiac rates at rest, mean cardiac rate in ST was 72.6±9.6 beats/min without statistically significant difference compared with 67.8±13.9 beats/min in HUT. On the other hand, in comparison of cardiac rates at rest and immediately after head up, mean cardiac rate immediately after head up in ST was 82.7±10.7 beats/min with significant difference, while mean cardiac rate after head up in HUT was 87.3±10.8 beats/min and increased with significant difference compared with the baseline at rest.
Increase in cardiac rates in one of the factors that induces vasovagal reflex. Head up tilt test might easily induce vasovagal reflex, as cardiac rate promptly increases immediately after head up.
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