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.

Reversible Canalith Jam of the Horizontal Semicircular Canal Mimicking Cupulolithiasis

2021 ◽  
pp. 000348942110072
Author(s):  
Olivia A. Kalmanson ◽  
Davis M. Aasen ◽  
Samuel P. Gubbels ◽  
Carol A. Foster
Keyword(s):  
Literature Review ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Positional Nystagmus ◽  
Horizontal Semicircular Canal ◽  
Horizontal Canal ◽  
Positional Vertigo ◽  
Horizontal Head ◽  
Paroxysmal Positional Vertigo

Objective: To describe a case of benign paroxysmal positional vertigo (BPPV) resulting in reversible horizontal semicircular canalith jam successfully treated with horizontal canal occlusion. A brief literature review of similar cases was performed. Methods: Case report and literature review. Results: A 68-year-old female presented with apogeotropic positional nystagmus, attributed to reversible horizontal canalith jam mimicking cupulolithiasis that was refractory to tailored repositioning maneuvers across months. She was unable to work due to the severity of her symptoms. She underwent surgical occlusion of the affected canal with immediate resolution of her symptoms. A literature review revealed similar cases of canalith jam mimicking cupulolithiasis. Conclusions: Reversible canalith jam, in which particles moving with horizontal head position alternate between obstructing the semicircular canal and resting on the cupula, can mimic signs of cupulolithiasis. This variant of BPPV can be effectively managed with surgical canal occlusion should symptoms fail to resolve after tailored repositioning maneuvers.

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 Unveiling Positioning Nystagmus in Patients of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo by Diagnostic Head-Shaking in the Yaw Plane

2019 ◽  
Vol 2 (02) ◽  
pp. 85-88
Author(s):  
Ajay Kumar Vats
Keyword(s):  
Successful Treatment ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Sitting Position ◽  
Precise Localization ◽  
Positional Nystagmus ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Abstract Introduction The diagnosis of benign paroxysmal positional vertigo (BPPV) is largely dependent on elicitation of positioning nystagmus on the diagnostic positional tests, namely Dix-Hallpike and supine roll tests (DHT and SRT, respectively), in patients complaining of vertigo, which occurs when patient’s head moves relative to the gravity. The pattern of elicited positioning nystagmus localizes as well as lateralizes the diseased canal, and the therapeutic positioning maneuver is accordingly undertaken. Objective The diagnostic positional tests, at times fail to elicit positional nystagmus, leaving clinician in a state of dilemma, when examining a patient who is currently experiencing paroxysms of vertigo triggered by positional change. In two patients with history consistent with BPPV but with negative positional tests initially, head shaking for 10 seconds in the yaw axis was done, and Dix-Hallpike and supine roll tests were repeated. The aim of head shaking for 10 seconds was to unveil positional nystagmus, to precisely localize and lateralize the diseased semicircular canal. Results and Discussion In the two cases of horizontal semicircular canal BPPV (HSC-BPPV) reported here, the DHT and/or SRT initially failed to elicit positional nystagmus but head shaking for 10 seconds in the left Dix–Hallpike position in case one and with the head anteflexed 30-degrees in the sitting position in the case two, unveiled horizontal positional nystagmus on ensuing SRT. The use of head-shaking in the yaw plane to unveil a horizontal positioning nystagmus in cases where a conventional positional test (DHT and SRT) has failed to elicit the PN, has not been reported in the literature hitherto. Conclusion After precise localization and lateralization of the diseased canal, both patients successfully underwent successful treatment with Gufoni maneuver. A verifying SRT done at 1 hour and/or at 24 hours follow-up was negative. In patients, who are currently experiencing paroxysms of vertigo triggered by the change of position of head relative to the gravity; head-shaking for few seconds just prior to the positioning test, can unveil positional nystagmus not elucidated with the conventionally performed positional tests.

scholarly journals A Show of Ewald's Law: I Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo

2021 ◽  
Vol 12 ◽  
Author(s):  
Xueqing Zhang ◽  
Yanru Bai ◽  
Taisheng Chen ◽  
Wei Wang ◽  
Xi Han ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Healthy Subjects ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Head Turning ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Latency Duration ◽  
Paroxysmal Positional Vertigo

Objective: To evaluate horizontal semicircular canal (HSC) effects according to Ewald's law and nystagmus characteristics of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) in the supine roll test.Methods: Patients with HSC-BPPV (n = 72) and healthy subjects (n = 38) were enrolled. Latency, duration, and intensity of nystagmus elicited by supine roll test were recorded using video nystagmography.Results: In patients with HSC-BPPV, horizontal nystagmus could be elicited by right/left head position (positional nystagmus) and during head-turning (head-turning nystagmus), and nystagmus direction was the same as that of head turning. Mean intensity values of head-turning nystagmus in HSC-BPPV patients were (44.70 ± 18.24)°/s and (44.65 ± 19.27)°/s on the affected and unaffected sides, respectively, which was not a significant difference (p = 0.980), while those for positional nystagmus were (40.81 ± 25.56)°/s and (17.69 ± 9.31)°/s (ratio, 2.59 ± 1.98:1), respectively, representing a significant difference (p < 0.0001). There was no positional nystagmus in 49 HSC-BPPV patients after repositioning treatment, nor in the 38 healthy subjects. No significant difference in head-turning nystagmus was detected in HSC-BPPV patients with or without repositioning.Conclusions: The direction and intensity of nystagmus elicited by supine roll test in patients with HSC-BPPV, was broadly consistent with the physiological nystagmus associated with a same HSC with single factor stimulus. Our findings suggest that HSC-BPPV can be a show of Ewald's law in human body.

scholarly journals Serum levels of superoxide dismutases in patients with benign paroxysmal positional vertigo

2020 ◽  
Vol 40 (5) ◽  
Author(s):  
Jing Li ◽  
Rui Wu ◽  
Bin Xia ◽  
Xinhua Wang ◽  
Mengzhou Xue
Keyword(s):  
Serum Level ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Serum Levels ◽  
Superoxide Dismutases ◽  
Binary Logistic Regression Analysis ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Abstract Objective: To investigate the possible role of superoxide dismutases (SODs) in the development of benign paroxysmal positional vertigo (BPPV) and recurrence events in a 1-year follow-up study. Methods: This was a prospective one-center study. A total of 204 patients with BPPV and 120 age-and sex matched healthy subjects were included. The levels of SOD between patients and control cases were compared. The levels of SOD between posterior semicircular canal (PSC) and horizontal semicircular canal (HSC) were also compared. In the 1-year follow-up, recurrence events were confirmed. The influence of SOD levels on BPPV and recurrent BPPV were performed by binary logistic regression analysis. Results: The serum levels of SOD in patients with BPPV were lower than in those control cases (P<0.001). Levels of SOD did not differ in patients with PSC and HSC (P=0.42). As a categorical variable, for per interquartile range (IQR) increment of serum level of SOD, the unadjusted and adjusted risks of BPPV would be decreased by 72% (with the odds ratio [OR] of 0.28 [95% confidence interval (CI): 0.21–0.37], P<0.001) and 43% (0.57 [0.42–0.69], P<0.001), respectively. Recurrent attacks of BPPV were reported in 50 patients (24.5%). Patients with recurrent BPPV had lower levels of SOD than in patients without (P<0.001). For per IQR increment of serum level of SOD, the unadjusted and adjusted risks of BPPV would be decreased by 51% (with the OR of 0.49 [95% CI: 0.36–0.68], P<0.001) and 24% (0.76 [0.60–0.83], P<0.001), respectively. Conclusion: Reduced serum levels of SOD were associated with higher risk of BPPV and BPPV recurrence events.

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.

BENIGN PAROXYSMAL POSITIONAL VERTIGO OF HORIZONTAL SEMICIRCULAR CANAL: DIAGNOSTICS AND TREATMENT

2017 ◽  
Vol 86 (1) ◽  
pp. 60-67
Author(s):  
N. L. Kunel’skaya ◽  
◽  
E. V. Baybakova ◽  
M. A. Chugunova ◽  
E. S. Yanyushkina ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo
Sign in / Sign up

Export Citation Format

Share Document