Supine Roll Test (Right Horizontal Semicircular Cupulolithiasis)

A 4-inch thick pillow is placed at the head end of the examination table. From the long-sitting on the examination table, the patient is positioned supine flexing the head 30-degrees. The patient remains in the supine position with the head straight ahead for 37 seconds. At 38th second, the head is rolled left lateral. At 46th second an apogeotropic horizontal positional nystagmus is elicited (latency 8 seconds), which lasts for about 2 minutes and 49 seconds. The lateral head roll to right elicits after a latency of 4 seconds an apogeotropic horizontal positional nystagmus lasting about 45 seconds. The apogeotropic horizontal positional nystagmus is stronger on the lateral head roll to left compared to the right, implying a diagnosis of Right Horizontal Semicircular Cupulolithiasis.

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