scholarly journals Intractable Persistent Direction-Changing Geotropic Nystagmus Improved by Lateral Semicircular Canal Plugging

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Toru Seo ◽  
Kazuya Saito ◽  
Katsumi Doi
Keyword(s):  
Hearing Loss ◽  
Supine Position ◽  
Semicircular Canal ◽  
Sudden Hearing Loss ◽  
Neutral Point ◽  
Positional Nystagmus ◽  
Lateral Semicircular Canal ◽  
Positional Vertigo ◽  
Light Cupula ◽  
The Right

Antigravitational deviation of the cupula of the lateral semicircular canal, which is also called light cupula, evokes persistent direction-changing geotropic nystagmus with a neutral point. No intractable cases of this condition have been reported. In our case, a 67-year-old man complained of positional vertigo 3 months after developing idiopathic sudden hearing loss in the right ear with vertigo. He showed a persistent direction-changing geotropic nystagmus with a leftward beating nystagmus in the supine position. The nystagmus resolved when his head was turned approximately 30° to the right. He was diagnosed with light cupula of the right lateral semicircular canal and was subsequently treated with an antivertiginous agent. However, his symptoms and positional nystagmus did not improve, so the right lateral semicircular canal was plugged by surgery. One month after surgery, his positional vertigo and nystagmus were completely resolved. We speculated that the cause of the patient’s intractable light cupula was an enlarged cupula caused by his idiopathic sudden hearing loss.

scholarly journals About Nystagmus Transformation in a Case of Apogeotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Paolo Vannucchi ◽  
Rudi Pecci
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Pathophysiological Mechanism ◽  
Positional Nystagmus ◽  
Lateral Semicircular Canal ◽  
Posterior Aspect ◽  
Positional Vertigo ◽  
The Right ◽  
Head Rotations ◽  
Paroxysmal Positional Vertigo

There are two forms of lateral semicircular canal benign paroxysmal positional vertigo: geotropic and apogeotropic. When the pathophysiological mechanism of the apogeotropic form is that of canalolithiasis, we can observe a transformation from an apogeotropic nystagmus into a geotropic one. Usually, this phenomenon happens simultaneously on both sides, thus enabling us to observe a right-beating paroxysmal positional nystagmus when the patient lies on the right side and a left-beating paroxysmal positional nystagmus on the left side. We describe a case in which the transformation occurred gradually, so that, after three head rotations from side to side in supine position, there was a right nystagmus beating toward the ground (geotropic) with the patient on the right side and a right nystagmus beating away from the ground (apogeotropic) on the left side. However, after further rotations we observed the nystagmus transformation also on the left side, with a geotropic nystagmus on both sides. The phenomenon of gradual transformation could happen because initially only a part of the debris moved from the anterior to the posterior aspect of the canal during head rotations.

scholarly journals Persistent Down-Beating Torsional Positional Nystagmus: Posterior Semicircular Canal Light Cupula?

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Akihide Ichimura ◽  
Koji Otsuka
Keyword(s):  
Supine Position ◽  
Semicircular Canal ◽  
Sitting Position ◽  
Positional Nystagmus ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Light Cupula ◽  
Lying Down

A 16-year-old boy with rotatory positional vertigo and nausea, particularly when lying down, visited our clinic. Initially, we observed vertical/torsional (downward/leftward) nystagmus in the supine position, and it did not diminish. In the sitting position, nystagmus was not provoked. Neurological examinations were normal. We speculated that persistent torsional down-beating nystagmus was caused by the light cupula of the posterior semicircular canal. This case provides novel insights into the light cupula pathophysiology.

Diagnosis and Management of Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

2005 ◽  
Vol 133 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Judith A. White ◽  
Kathleen D. Coale ◽  
Peter J. Catalano ◽  
John G. Oas
Keyword(s):  
Treatment Outcomes ◽  
Study Design ◽  
Retrospective Review ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Diagnostic Testing ◽  
Positional Nystagmus ◽  
Lateral Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Objective: Describe the diagnosis, treatment, and outcome of a group of 20 patients with lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). Study Design and Setting: Retrospective review of 20 patients with LSC-BPPV (10 with geotropic and 10 with apogeotropic nystagmus) presenting to a tertiary balance center. Diagnosis was confirmed with infrared nystagmography in Dix-Hallpike positioning tests and supine positional tests. Patients were treated with one or more particle repositioning maneuvers. Results: Addition of supine positional nystagmus tests to Dix-Hallpike positioning testing improves sensitivity in the diagnosis of LSC-BPPV. Treatment outcomes in the apogeotropic LSC-BPPV group were poorer than the geotropic LSC-BPPV group. Significance: Adding supine positional testing to routine vestibular diagnostic testing will increase the identification of LSC-BPPV. Apogeotropic LSC-BPPV is more challenging to treat.

scholarly journals Zuma Modified Maneuver as a Treatment to Geotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

2020 ◽  
Author(s):  
Bernardo Faria Ramos ◽  
Renato Cal ◽  
Camila Martins Brock ◽  
Pedro Luiz Mangabeira Albernaz ◽  
Francisco Zuma e Maia
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Positional Nystagmus ◽  
Vestibular Disorder ◽  
Lateral Semicircular Canal ◽  
Positional Vertigo ◽  
Floating Particles ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Abstract Introduction Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder, resulting from detached otoliths that migrate to one of the semicircular canals – canalolithiasis – or one of the cupulas – cupulolithiasis. The present study is related to lateral canal BPPVs, which may be either geotropic or apogeotropic. The geotropic variant of lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV) is attributed to free floating particles in the posterior arm of the lateral semicircular canal. Objectives To verify the possibility of employing the Zuma repositioning maneuver, with a brief modification, as an alternative treatment for geotropic LC-BPPV. Methods Seven patients with geotropic LC-BPPV were enrolled and treated with the Zuma modified maneuver. Patients were reevaluated 1 hour after a single maneuver, to confirm the resolution of vertigo and positional nystagmus. Results All seven patients achieved immediate resolution of vertigo and positional nystagmus as measured 1 hour after the application of the maneuver. Conclusion The Zuma modified maneuver was effective for geotropic LC-BPPV after a single application. The use of the Zuma maneuver for both apogeotropic and geotropic LC-BPPV may simplify the treatment of these patients.

scholarly journals Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akihide Ichimura ◽  
Shigeto Itani
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Head Roll ◽  
The Right ◽  
Upbeat Nystagmus ◽  
Torsional Nystagmus ◽  
Paroxysmal Positional Vertigo

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix–Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.

Sleep position and laterality of benign paroxysmal positional vertigo

2008 ◽  
Vol 122 (12) ◽  
pp. 1295-1298 ◽  
Author(s):  
S G Korres ◽  
C E Papadakis ◽  
M G Riga ◽  
D G Balatsouras ◽  
D G Dikeos ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Sleep Onset ◽  
The Elderly ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Subjective Preference ◽  
The Right ◽  
A Prospective Study ◽  
Paroxysmal Positional Vertigo

AbstractObjective:The aim of this study was to investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo in each ear, and to assess the association between the ear affected by benign paroxysmal positional vertigo and the head-lying side during sleep onset. Based on a previous study which used objective methods to prove the preference of the elderly for the right head-lying side during sleep, we hypothesised that a predominance of the same head-lying side in benign paroxysmal positional vertigo patients may affect the pathophysiology of otoconia displacement.Study design:We conducted a prospective study of out-patients with posterior semicircular canal benign paroxysmal positional vertigo, confirmed by a positive Dix–Hallpike test.Methods:One hundred and forty-two patients with posterior semicircular canal benign paroxysmal positional vertigo were interviewed about their past medical history, focusing on factors predisposing to benign paroxysmal positional vertigo. All patients included in the study were able to define a predominant, favourite head-lying side, right or left, during sleep onset.Results:The Dix–Hallpike test was found to be positive on the right side in 82 patients and positive on the left side in 54; six patients were found to be positive bilaterally. During sleep onset, 97 patients habitually laid their head on the right side and the remaining 45 laid their head on the left. The association between the affected ear and the head-lying side during sleep onset was statistically significant (p < 0.001).Conclusions:Our study found a predominance of right-sided benign paroxysmal positional vertigo, a subjective preference amongst patients for a right head-lying position during sleep onset, and an association between the ear affected by benign paroxysmal positional vertigo and the preferred head-lying side during sleep onset. The clinical and therapeutical implications of this observation are discussed.

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