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.

Argon laser irradiation of the semicircular canal in two patients with benign paroxysmal positional vertigo

2002 ◽  
Vol 116 (9) ◽  
pp. 723-725 ◽  
Author(s):  
Yasuya Nomura
Keyword(s):  
Laser Irradiation ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Argon Laser ◽  
Laser Device ◽  
Positional Vertigo ◽  
Long Term Follow Up ◽  
Paroxysmal Positional Vertigo

The results of long-term follow-up after surgical treatment of two patients with intractable benign paroxysmal positional vertigo are reported. Argon laser irradiation of the blue-lined posterior and lateral semicircular canals in one patient, and of only the posterior canal in the other was performed seven and six years ago, respectively. Argon laser irradiation was carried out 10 times in succession three mm along the canal to occlude it. The power applied each time was 1.5.W on the dial of the laser device for 0.5.sec. Relief of vertigo was noted on the second post-irradiation day. There has been no recurrence of vertigo in these patients.

scholarly journals Diagnosis of benign paroxysmal positional vertigo in Emergency Department: Our experience

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elisabetta Cristiano ◽  
Vincenzo Marcelli ◽  
Antonio Giannone ◽  
Stefania De Luca ◽  
Flavia Oliva ◽  
...  
Keyword(s):  
Emergency Department ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Medical Personnel ◽  
Head Movements ◽  
Positional Vertigo ◽  
Training Activities ◽  
Peripheral Vertigo ◽  
Observation Period ◽  
Paroxysmal Positional Vertigo

The Benign Paroxysmal Positional Vertigo (BPPV) represents the first cause of peripheral vertigo in populations and it is determined by a displacement of otoconial fragments within the semicircular canals. Following the patient’s head movements, these fragments, moving by inertia, incorrectly stimulate the canals generating vertigo. The BPPV is diagnosable by observing the nystagmus that is generated in the patient following the Dix-Hallpike maneuver used for BPPV diagnosis of vertical semi-circular canal, and, following the supine head yaw test used for lateral semi-circular canal. Correctly identifying the origin of this specific peripheral vertigo, would mean to obtain a faster diagnosis and an immediate resolution of the problem for the patient. In this context, this study aims to identify precise training activities, aimed at the application of specific diagnostic maneuverers for algorithm decisions in support of medical personnel. The evaluations reported in this study refer to the data collected in the Emergency Department of the Cardarelli Hospital of Naples. The results obtained, over a six-month observation period, highlighted the advantages of the proposed procedures in terms of costs, time and number of BPPV diagnoses.

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.

scholarly journals Diagnosis dan Tatalaksana Benign Paroxysmal Positional Vertigo (BPPV) Horizontal Berdasarkan Head Roll Test

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Yan Edward ◽  
Yelvita Roza
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Position Change ◽  
Horizontal Canal ◽  
Positional Vertigo ◽  
Head Roll ◽  
Paroxysmal Positional Vertigo

AbstrakLatar belakang: Benign Paroxysmal Positional Vertigo (BPPV) merupakan vertigo yang dicetuskan oleh perubahan posisi kepala atau badan terhadap gaya gravitasi. Diagnosis BPPV ditegakkan berdasarkan anamnesis dan manuver provokasi. Sering kali terjadi kesalahan dalam menegakkan diagnosis BPPV yang berakibat terhadap penatalaksanaan vertigo yang tidak adekuat. Tujuan: Untuk menjelaskan bagaimana diagnosis dan tatalaksana BPPV Kanalis Horizontal. Kasus: Seorang laki-laki berusia 56 tahun yang didiagnosis sebagai BPPV Kanalis Horizontal kiri tipe kanalolithiasis apogeotropik. Penatalaksanaan: Dilakukan barbeque maneuver terapi reposisi kanalith. Kesimpulan: Penatalaksanaan BPPV adalah berdasarkan lokasi kanal yang terlibat dengan terapi reposisi kanalith.Kata kunci: BPPV, kanalis horizontal, kanalolithiasis apogeotropik.AbstractBackground: Benign Paroxysmal Positional Vertigo (BPPV) is vertigo that provoked by a position change of the head or body to the gravitation. The diagnosis of BPPV can be established by anamnesis and provocation maneuver. However, because BPPV frequently is misdiagnosed, it will implicate to an adequate therapeutic. Purposes: Explaining how to diagnose and manage a Horizontal Canal BPPV. Case : a man, 56 ages which diagnosed as a Left Horizontal Canal BPPV apogeotropic canalolithiasis type. Management: A barbeque maneuver was performed as canalith reposition treatment. Conclution: The management of BPPV is based on the involved canal with canalith repositioning treatment.Keywords: BPPV, horizontal canal, apogeotropic canalolithiasis.

scholarly journals Effect of vitamin D levels in benign paroxysmal positional vertigo

2021 ◽  
Author(s):  
Shweta Sawant ◽  
Taranath Nandini ◽  
Rajashree Partabad
Keyword(s):  
Vitamin D ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Vitamin D Supplementation ◽  
High Rate ◽  
Common Cause ◽  
Rehabilitation Therapy ◽  
Positional Vertigo ◽  
Vitamin D Levels ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is a common cause of disabling vertigo with a high rate of recurrence. BPPV is the most common cause of neurotological disorder. It is caused by dislodged otoconia which fall from the utricular macula and float into the semicircular canals there by making them sensitive to gravity. It has been shown that elderly people may suffer from unrecognized, chronic BPPV. Patients with unrecognized BPPV were more likely to have reduced activity of daily living scores, to have sustained a fall in the previous 3 months and to have depression.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 100 patients with clinical diagnosis of BPPV visiting Navodaya medical college and hospital between June 2019 to May 2020 were included in the study.</p><p class="abstract"><strong>Results:</strong> Patients taking both vitamin D supplementation and rehabilitation therapy improved better than patients taking rehabilitation therapy alone.</p><p class="abstract"><strong>Conclusions:</strong> Both rehabilitation therapy and supplementation of vitamin D is helpful in patients with vitamin D deficient BPPV patients.</p>

scholarly journals Case Report: Bow Hunter Syndrome—One Reason to Add Non-gravity Dependent Positional Nystagmus Testing to Your Clinical Neuro-Otologic Exam

2021 ◽  
Vol 12 ◽  
Author(s):  
Michael C. Schubert ◽  
Nathaniel Carter ◽  
Sheng-fu Larry Lo
Keyword(s):  
Computed Tomography ◽  
Benign Paroxysmal Positional Vertigo ◽  
Hunter Syndrome ◽  
Downbeat Nystagmus ◽  
Positional Nystagmus ◽  
Imaging Studies ◽  
Positional Vertigo ◽  
Dependent Position ◽  
Paroxysmal Positional Vertigo

This case study describes transient downbeat nystagmus with vertigo due to a bilateral Bow Hunters Syndrome that was initially treated for 7 months as a peripheral benign paroxysmal positional vertigo. Normal static angiography and imaging studies (magnetic resonance, computed tomography) contributed to the mis-diagnosis. However, not until positional testing with the patient in upright (non-gravity dependent) was a transient downbeat nystagmus revealed with vertigo. The patient was referred for neurosurgical consult. Unfortunately, surgery was delayed due to suicidal ideation and hospitalization. Eventually, vertigo symptoms resolved following a C4-5 anterior cervical dissection and fusion. This case highlights the critical inclusion of non-gravity dependent position testing as an augment to the positional testing component of the clinical examination as well as the extreme duress that prolonged positional vertigo can cause.

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.

Prolonged Positional Downbeat Nystagmus in Benign Paroxysmal Positional Vertigo: A Case Report and Literature Review

2021 ◽  
pp. 1-6
Author(s):  
Hyun-Jin Lee ◽  
Seong Ki Ahn ◽  
Chae Dong Yim ◽  
Seong Dong Kim ◽  
Dong Gu Hur
Keyword(s):  
Medical Records ◽  
Unusual Case ◽  
Benign Paroxysmal Positional Vertigo ◽  
Clinical Manifestations ◽  
Careful Consideration ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Torsional Component ◽  
Anterior Canal ◽  
Paroxysmal Positional Vertigo

Purpose This study aimed to report an unusual case of benign paroxysmal positional vertigo (BPPV), who showed prolonged positional downbeat nystagmus without latency and was diagnosed with cupulolithiasis of the anterior canal (AC). We compared this case with one of typical AC-BPPV, and possible mechanisms underlying the atypical characteristics were discussed. Method Two patients diagnosed with AC-BPPV were reported. Positional testing using video-oculography goggles was performed, and outcomes were measured via medical records and analysis of videos of the nystagmus. Results Downbeat nystagmus was observed in the contralateral Dix–Hallpike test in both cases. The torsional component was subtle or absent, but motion was induced toward the affected ear. The two cases differed in latency and duration of vertigo, as well as habituation. The patient with atypical nystagmus showed little or no latency and longer duration. Moreover, there was no habituation on repeated tests. The nystagmus showed several differences from that of typical AC-BPPV. Conclusions Based on our case, AC-BPPV may induce various unusual clinical manifestations of nystagmus. Accurate diagnosis requires careful consideration of the patient's symptoms and the characteristics of the nystagmus. Supplemental Material https://doi.org/10.23641/asha.14265356

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