scholarly journals Lateral semicircular canal benign paroxysmal positional vertigo and direction changing positional nystagmus, with the ultimate objective to know whether or not central nervous system lesions could be diagnosed based on these findings

2015 ◽  
Vol 74 (3) ◽  
pp. 238-243
Author(s):  
Tomoyuki Okada ◽  
Izumi Koizuka
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Lateral Semicircular Canal ◽  
Positional Vertigo ◽  
Ultimate Objective ◽  
Paroxysmal Positional Vertigo

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.

Down-Beating Nystagmus in Anterior Canal Benign Paroxysmal Positional Vertigo

2008 ◽  
Vol 19 (03) ◽  
pp. 257-266 ◽  
Author(s):  
David A. Zapala
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Benign Paroxysmal Positional Vertigo ◽  
Signs And Symptoms ◽  
Central Nervous System Disease ◽  
Positional Nystagmus ◽  
Central Nervous System Dysfunction ◽  
Positional Vertigo ◽  
Anterior Canal ◽  
Paroxysmal Positional Vertigo

Down-beating positional nystagmus is typically associated with central nervous system disease. Anterior canal benign paroxysmal positional vertigo (AC-BPPV) can mimic down-beating positional nystagmus of central origin, particularly when it is bilateral. Factors that increase the probability of bilateral AC-BPPV include a history of bilateral multicanal BPPV, transient down-beating and torsional nystagmus that follows the plane of the provoked canal, and the absence of co-occurring neurologic signs and symptoms of central nervous system dysfunction. With neurologic clearance for canalith repositioning, exploration for AC-BPPV and canalith repositioning trials may alleviate symptoms even when the nystagmus does not appear to fatigue. In the case presented, the use of a side-lying maneuver with the nose down to provoke AC-BPPV symptoms and the use of a reversed Epley to clear AC-BPPV symptoms are highlighted. This approach is helpful when the diagnosis is unclear and neck hyperextension is to be avoided. El nistagmo posicional de batida hacia abajo está típicamente asociado con enfermedades del sistema nervioso central. El vértigo posicional paroxístico benigno del canal anterior (AC-BPPV) puede simular un nistagmo posicional de batida hacia abajo de origen central, particularmente cuando es bilateral. Los factores que influyen sobre la probabilidad de un AC-BPPV bilateral incluyen una historia de BPPV multicanal bilateral, de nistagmo transitorio de batida hacia abajo o de nistagmo de torsión, que sigue el plano del canal provocado, y la ausencia de signos y síntomas neurológicos concurrentes por una disfunción del sistema nervioso central. Con una depuración neurológica de reposición canalicular, la exploración buscando AC-BPPV y los intentos de reposicionamiento canalicular pueden aliviar los síntomas aún cuando el nistagmo no parezca fatigarse. En el caso presentado, se destaca el uso de la maniobra de decúbito lateral con descenso de la nariz para provocar los síntomas del AC-BPPV. Este enfoque es útil cuando el diagnóstico no es claro y se debe evitar la hiperextensión del cuello.

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 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 Benign Paroxysmal Positional Vertigo and Positional Vertigo Variants

2012 ◽  
Vol 4 (1) ◽  
pp. 25-40 ◽  
Author(s):  
Giacinto Asprella Libonati
Keyword(s):  
Differential Diagnosis ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Posterior Semicircular Canal ◽  
Diagnosis And Therapy ◽  
Positional Vertigo ◽  
Peripheral Origin ◽  
Paroxysmal Positional Vertigo

ABSTRACT This article reviews the causes of positional vertigo and positional nystagmus of peripheral origin. Benign paroxysmal positional vertigo is described in all its variants, its diagnosis and therapy are highlighted. In addition, nonparoxysmal positional vertigo and nystagmus due to light/heavy cupula of lateral and posterior semicircular canal is focused on. The differential diagnosis between positional vertigo due to otolithic and nonotolithic causes is discussed. How to cite this article Asprella Libonati G. Benign Paroxysmal Positional Vertigo and Positional Vertigo Variants. Int J Otorhinolaryngol Clin 2012;4(1):25-40.

scholarly journals Pseudo-spontaneous nystagmus in lateral semicircular canal benign paroxysmal positional vertigo: Correlation with bow and lean test in a pitch plane

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242580
Author(s):  
Hyun-Jin Lee ◽  
Seong Ki Ahn ◽  
Chae Dong Yim ◽  
Dae Hwan Kim ◽  
Dong Gu Hur
Keyword(s):  
Treatment Outcome ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Spontaneous Nystagmus ◽  
Sitting Position ◽  
Lateral Semicircular Canal ◽  
Video Oculography ◽  
Positional Vertigo ◽  
End Of Treatment ◽  
Paroxysmal Positional Vertigo

Objectives We investigated the incidence and characteristics of pseudo-spontaneous nystagmus (PSN) in benign paroxysmal positional vertigo involving the lateral semicircular canal (LC-BPPV) and evaluated the correlation between PSN and the bow and lean test. Methods We examined nystagmus in the sitting position using video-oculography goggles in 131 LC-BPPV patients. The positioning test and bow and lean test were also performed. Patients were divided into canalolithiasis and cupulolithiasis groups according to the character of nystagmus. In each group, the incidence and direction of PSN, correlation with the bow and lean test, and treatment outcome were analyzed. Results PSN was observed in 25 cases (19.1%) in LC-BPPV patients, 7 of which were canalolithiasis and 18 of which were cupulolithiasis (p = 0.098). Of the 25 patients with PSN, 21 (84%) exhibited nystagmus consistent with the lean test whereas 4 (16%) exhibited nystagmus consistent with the bow test. In patients with PSN, nystagmus was observed in the bow and lean test in all cases (23/23), but in patients without PSN, no nystagmus was observed in 13 cases (13/87) in the bow and lean test (p = 0.048). The number of barbecue maneuvers performed until the end of treatment was 1.4 ± 0.7 in patients with PSN and 1.4 ± 0.9 in those without PSN (p = 0.976). Conclusion We identified PSN in patients with LC-BPPV irrelevant of subtype. Moreover, all patients with PSN showed nystagmus in the bow and lean test. The direction of PSN was mostly consistent with that of the lean test (21/25, 84%). The presence of PSN was not related to the treatment outcome in this study.

Use of Vestibular Rehabilitation in the Treatment of Benign Paroxysmal Positional Vertigo

2020 ◽  
Vol 5 (4) ◽  
pp. 917-939
Author(s):  
Richard A. Clendaniel
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Signs And Symptoms ◽  
Positional Nystagmus ◽  
Test Procedures ◽  
Horizontal Semicircular Canal ◽  
Treatment Techniques ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Purpose The purposes of this article are (a) to describe the different test procedures for benign paroxysmal positional vertigo (BPPV) and (b) to provide guidance for the treatment of the various forms of BPPV and to discuss the efficacy of the different interventions. Conclusions While BPPV primarily occurs in the posterior semicircular canal, it is also seen in the anterior and horizontal semicircular canals. There are distinctive patterns of nystagmus that help identify the affected semicircular canal and to differentiate between cupulolithiasis and canalithiasis forms of BPPV. There is reasonable evidence to support the different treatments for both posterior and horizontal semicircular canal BPPV. Anterior semicircular canal BPPV is rare, and as a consequence, there is little evidence to support the various treatment techniques. Finally, while BPPV is generally easy to identify, there are central causes of positional nystagmus with and without vertigo, which can complicate the diagnosis of BPPV. The signs and symptoms of BPPV are contrasted with those of the central causes of positional nystagmus.

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