Tightness of the lateral retinacular structures was assessed with the patellar tilt test [ 44].
Other tests included in the initial evaluation were orthostatic blood pressure movements (48%), carotid sinus massage (36%), tilt test (35%), and external loop recording (12%).
The most frequent double diagnosis was the presence of orthostatic hypotension and tilt test positivity for vasovagal syncope in 89 patients (15.8% of the diagnoses).
Our study yielded better reliability for the patellar tilt test than that reported by Watson et al [ 24] Watson et al's study included mainly asymptomatic individuals (19 symptomatic and 76 asymptomatic) as subjects and students as testers.
There were, however, simple diagnostic tests that could have been used more widely and would have been included in the initial phase of evaluation, e.g. tilt test, carotid sinus massage, and orthostatic blood pressure measurements.
17 In our study, 129 patients showed a double diagnosis after neuroautonomic evaluation (ie, positivity in two of the three tests conducted), in 10% of these cases it was tilt test + CSM in patients older than 65yearss.
We analyzed a database of 727 consecutive cases of tilt test.
All the studies, except the tilt test were performed in the supine position.
Interestingly, no changes of systolic or diastolic blood pressure were found in migraineurs treated with the tilt test.
However, no practical system is currently used in the clinical setting for the early prediction of the tilt test outcome.
Even an optimized tilt test has shown limited utility in detecting mild to moderate intravascular fluid loss (<10%) [4 6].
