The bucket test reinterpreted: a study on benign paroxysmal positional vertigo and Ménière’s disease patients

Background The bucket test is a simple and practical instrument to evaluate vestibular diseases; additionally, it could be a useful tool in the evaluation of the vertigo patient. Unfortunately, the bucket test still lacks standardization. The objective of this study was to evaluate and to interpret the subjective visual vertical (SVV) using the bucket test in benign paroxysmal positional vertigo (BPPV) and Ménière’s disease patients. We performed a cross-sectional study in a secondary care center. All patients with diagnosis of unilateral posterior canal BPPV or Ménière’s disease underwent complete neuro-otological physical examination and the bucket test. Normal bucket test was 0° to 3° according to previous study. Results We included seventy-eight subjects. Benign paroxysmal positional vertigo cases (n = 51) showed a mean 2.62° of SVV prior to the Epley maneuver and 1.7° of SVV after the maneuver (p = < 0.001), 57% of patients with BPPV were categorized as abnormal. Inactive Ménière’s disease patients (n = 22) had mean SVV of 2.74° and Ménière’s disease with active crisis (n = 5) had 5.06° of SVV (p = 0.002). Conclusion The bucket test is a simple and useful test for the evaluation of SVV, and it has a role in the evaluation of patients with active vestibular diseases such as Ménière’s disease and BPPV.