McClure-Pagnini Test

Aka: McClure-Pagnini Test, Supine roll test

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II. Indications

  1. Vestibular Testing for Benign Paroxysmal Positional Vertigo affecting the lateral canal (horizontal canal)
    1. Vertigo evoked by position change (triggered Vertigo)
    2. No symptoms at rest

III. Contraindications

  1. Elderly with significant carotid vascular disease
  2. Unstable spinal disorder
  3. Acute vesitibular syndrome (non-triggered Vertigo)

IV. Mechanism

  1. Tests in horizontal plane for lateral canal (horizontal canal) BPPV

V. Technique

  1. Positioning
    1. Patient lies supine on exam table
    2. Clinician stands at patient's head
  2. Maneuver
    1. Patient's head is turned 90 degrees first to one side and then to the other
    2. Observe for Nystagmus AND its direction for one minute after each head turn

VI. Interpretation: Positive Test for Horizontal Canal (Lateral Canal) BPPV

  1. Nystagmus beats TOWARD the direction of the head turn (down toward ground) on the affected side
  2. Nystagmus beats AWAY from the direction of the head turn (up toward ceiling) on the opposite side

VII. Resources

  1. McClure-Pagnini Test (Youtube)
    1. https://www.youtube.com/watch?v=1uJ2R1ZuW_U

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