What role for theophylline?

Objective: To evaluate the predictive value of the Quix test in identifying a vestibular abnormality in the non-vertiginous dizzy patient. Background: The evaluation of the dizzy patient poses a major challenge for physicians. Previously, we reported the Quix test’s usefulness in determining the involved side in BPPV; however, properly performed, the Quix test may also uncover a vestibular component in patients with multiple comorbidities. Methods: Two-hundred patients were evaluated at a Balance Disorders Clinic with chief complaints of dizziness, vertigo, or imbalance. We administered the Quix test (patient’s eyes closed, feet opposed, arms extended toward target, 2.5 cm deviation considered positive) prior to standard testing videonystagmography (VNG) and dynamic platform posturography (DPP). Eighty-four patients were classified by Drachmann’s criteria as type II (syncope), III (upright instability), or IV (anxiolytic). The study focused on patients with dizziness; the remaining 116 patients categorized as Drachmann I (vertigo) were excluded. Patients were determined to have a vestibular abnormality if VNG revealed canal paresis, visually suppressed nystagmus, or failure to maintain balance in vestibular derived conditions on DPP. Results: A logistic regression was performed to ascertain the effect of a positive Quix test in predicting the likelihood of vestibular involvement in the patient’s dizziness. The Quix test was a statistically significant predictor variable of vestibular abnormality, (p < .0005). The model explained 29[percnt] (Nagelkerke R2) of the variance and correctly classified 73.8[percnt] of cases. The sensitivity was 70.8[percnt] and specificity was 77.8[percnt]. Conclusions: A positive Quix test helps identify a vestibular abnormality in patients with generic dizziness. A negative test raises the likelihood of an alternative diagnosis. As a complementary tool, it provides valuable insight in patient evaluation. Absent of proven clinical examination techniques that identify vestibular abnormalities, the Quix test proves to be a critical tool in the evaluation of the dizzy patient. Disclosure: Dr. Reese has nothing to disclose. Dr. Zuchowski has nothing to disclose. Dr. Barr has nothing to disclose. Dr. Evan has nothing to disclose. Dr. Maitland has nothing to disclose.