scholarly journals Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Aly M. Nagy El-Makhzangy

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC) follows the posterior semicircular canal (PSCC) as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1–24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic). Level Ia evidence (systematic review of RCTs) shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

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

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.


2005 ◽  
Vol 133 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Judith A. White ◽  
Kathleen D. Coale ◽  
Peter J. Catalano ◽  
John G. Oas

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.


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