Roll test for BPPV

When assessing dizziness, if Dix-Hallpike testing is negative you should consider performing the Roll test to help rule in BPPV affecting the lateral canal. The Dix-Hallpike is useful for assessing BPPV affecting the posterior canal and 85-95% of the time BPPV affects the posterior canal. 5-15% of the time it, however, affects the lateral (horizontal) canal and the Roll test can be a useful assessment technique to determine if there is BPPV affecting the lateral canal.