Smooth Pursuit Neck Torsion Test (SPNT) | Cervicogenic Dizziness

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The smooth pursuit neck torsional test abbreviated as SPNT helps to determine the presence of disturbances in eye movement and postural stability. It is thought to test proprioceptive function, particularly for controlling static and dynamic head and neck position.

Teo et al from the year 1998 found a sensitivity of 90% and a specificity of 91% in a group of traumatic neck pain patients with dizziness compared to a mixed group of patients with vertigo, central nervous system findings, Meniere's disease, and healthy subjects.

Although it seems to have a high accuracy to diagnose cervicogenic dizziness, it is the only study evaluating this test so far. For this reason, we give it a moderate clinical value in practice.

To conduct the SPNT, the patient is in a sitting position on a swivel chair. The patient's head is kept in a horizontal position and head rotation is introduced to a maximum of 45 degrees by turning the patient's chair.

The therapist instructs the patient to trace a slowly moving target with his eyes in right or left horizontal direction while the patient's head is kept steady.

This test is done in neutral torso position, torso turned to the right, and torso turned to the left side.

This test is positive in a clinical setting in case dizziness is reproduced in the torsion position compared to neutral.

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