Canalith repositioning procedure improves gait and static balance in people with posterior semicircular canal benign paroxysmal positional vertigo

2020 ◽  
Vol 30 (5) ◽  
pp. 335-343
Author(s):  
Yafit Cohen-Shwartz ◽  
Yael Nechemya ◽  
Alon Kalron
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Signs And Symptoms ◽  
Healthy Controls ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Balance Tests ◽  
Canalith Repositioning Procedure ◽  
The Impact ◽  
Paroxysmal Positional Vertigo

BACKGROUND: Investigations measuring gait tests have rarely been studied in the benign paroxysmal positional vertigo (BPPV) population. OBJECTIVE: Examine instrumented mobility metrics in people with posterior semicircular canal BPPV. We examined the impact of a canalith repositioning procedure (CRP), prior to and after treatment on instrumented mobility measures, comparing the scores to those of healthy controls. METHODS: At baseline, the subject performed a series of instrumented gait and balance tests and then, the CRP was performed. At re-evaluation (1-week later), identical gait and balance tests were assessed. In addition, the Hallpike-Dix test identified patients who had improved or had not improved in their BPPV signs and symptoms. RESULTS: Thirty-two people with BPPV (25 women) and 15 healthy subjects participated in the study. At baseline (pre-CRP), people with BPPV demonstrated an increased vestibular ratio, and walked more slowly compared with the healthy controls. The CRP resolved the vertigo in 90.6% of the BPPV subjects. Compared with the pre-CRP scores, the BPPV subjects demonstrated a decreased vestibular ratio and faster walking at the post-CRP evaluation. Out of the five parameters that were significantly different from the healthy values pre-CRP, only one remained different post-CRP. CONCLUSIONS: Besides vertigo and balance difficulties, people with BPPV demonstrate walking modifications. Furthermore, the CRP has a high success rate in improving not only vertigo but also in restoring gait and balance in persons with BPPV.

scholarly journals Behavior of the posterior semicircular canal after Dix-Hallpike maneuver

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Francisco Carlos Zuma e Maia ◽  
Pedro Luiz Mangabeira Albernaz ◽  
Renato Valério Cal
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Biomechanical Model ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix- Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients’ age.

scholarly journals The efficacy of Epley and Semont maneuvers in posterior semicircular canal benign paroxysmal positional vertigo treatment: A short-term comparative study

2021 ◽  
Vol 9 (3) ◽  
pp. 75-80
Author(s):  
Mustafa Caner Kesimli
Keyword(s):  
Comparative Study ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Short Term ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
The One ◽  
Paroxysmal Positional Vertigo

OBJECTIVE: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. METHODS: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. RESULTS: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and one-month follow-ups (p=0.002, p<0.001, p=0.001, respectively). CONCLUSION: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigo.

Evolution of Treatment Maneuvers for Benign Paroxysmal Positional Vertigo

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
21St Century ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Initial Examination ◽  
Positional Vertigo ◽  
Anterior Semicircular Canal ◽  
Paroxysmal Positional Vertigo

Near the turn of the 21st century, as more physicians began performing the Epley and Semont maneuvers for treatment of benign paroxysmal positional vertigo (BPPV), it became apparent that the procedures could be done at the time of initial examination without the need for sedation or vibration. Furthermore, modified versions of the maneuvers evolved that were more effective and easier to perform. There are clear similarities in these modified repositioning maneuvers. BPPV nearly always results from otoconial debris within the posterior semicircular canal because this is the canal in which it is most easily trapped. Although less common, there are horizontal and anterior semicircular canal variants of BPPV, and otolithic debris can become attached to the cupula, producing a true cupulolithiasis. The nystagmus is in the plane of the affected canal; the nystagmus is transient when the debris is freely floating and persistent when debris is attached to the cupula.

Schuknecht and His Breakthrough on Benign Paroxysmal Positional Vertigo

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Temporal Bone ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Assistant Professor ◽  
Clinical Instructor ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Patient Reported ◽  
The University ◽  
Paroxysmal Positional Vertigo

In 1949, Harold Schuknecht completed his residency in John Lindsay’s Otolaryngology Department at the University of Chicago and stayed first as a clinical instructor and then as an assistant professor. Schuknecht reviewed the temporal bone specimens from the patient reported by his mentor, John Lindsay, and from patients reported by Charles Hallpike and colleagues and was struck by the similarity in the pathologic changes. He concluded that in each case damage to the labyrinth resulted from occlusion of the anterior vestibular artery. Schuknecht believed that the delayed positional vertigo that occurred in these cases must have originated from the posterior semicircular canal. He reasoned that with degeneration of the superior vestibular labyrinth, otoconia would be released from the otolithic membrane of the utricular macule and that, in certain positions of the head, the otoconia would respond to gravity and thereby activate the cupula of the posterior semicircular canal.

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.

Sign in / Sign up

Export Citation Format

Share Document