scholarly journals The History of Research in Vestibular Organ and Benign Paroxysmal Positional Vertigo

2021 ◽  
Vol 64 (7) ◽  
pp. 457-466
Author(s):  
Kee Hyun Park
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
18Th Century ◽  
Test Methods ◽  
Vestibular Organ ◽  
History Of Research ◽  
Positional Vertigo ◽  
History Of ◽  
The 19Th Century ◽  
Vestibular Organs ◽  
Paroxysmal Positional Vertigo

Since B.C., vertigo had been described as a condition closely related to migraines or epilepsy. This perception remained during the 14th-16th century and vertigo was considered to be a symptom of brain disease. Until the 18th century, the perception remained that the vestibular organ would be in charge of hearing. However, during the 19th century, it was understood that the sense of equilibrium and vertigo might have been related to vestibular organs. Barany first mentioned positional vertigo and otolithic disease in 1921, and Dix and Hallpike defined their clinical characteristics in 1952. After studies from numerous otologists and neurologists, including Schuknecht and Epley, which identified benign paroxysmal positional vertigo (BPPV) has emerged as one of today’s most common diseases. The development of various test methods enabled more detailed diagnosis of BPPV. The treatment performance also improved significantly as various canalith repositioning procedures were introduced.

Management of Bilateral Benign Paroxysmal Positional Vertigo

2005 ◽  
Vol 133 (5) ◽  
pp. 769-773 ◽  
Author(s):  
Daniel M. Kaplan ◽  
Michel Nash ◽  
Alexander Niv ◽  
Mordechai Kraus
Keyword(s):  
American Academy ◽  
Benign Paroxysmal Positional Vertigo ◽  
Neck Surgery ◽  
Positive History ◽  
Positional Vertigo ◽  
History Of ◽  
The Mean ◽  
Symptomatic Side ◽  
Paroxysmal Positional Vertigo

Objective To describe a series of patients with bilateral benign paroxysmal positional vertigo (BiBPPV), with respect to demographics, management, and outcome. Methods All patients who were identified and treated for BiBPPV in a previous 36-month period with a minimal follow-up period of 6 months were included. Patients were treated with Epley's maneuver (EM) on the side that was more symptomatic and that had a greater velocity and amplitude of tortional nystagmus. Patients were re-treated according to symptoms and findings on follow-up visits. Results Ten patients were identified with BiBPPV. Most patients complained of nonlocalized positional vertigo and unsteadiness. Four were males and 6 were females, and the mean age was 54 years. There was a positive history of recent head trauma in 4 of the patients. All patients recovered after performing a mean of 2.6 EMs during a 3-month period. One patient experienced unilateral recurrence and was re-treated successfully. Conclusion BiBPPV has typical characteristics and can be managed successfully with EM, performed on the more symptomatic side, followed by repeated treatments as needed. Ebm Rating: C © 2005 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.

scholarly journals A Young Patient with Horizontal Semicircular Cupulolithiasis with Immediate Response to the Therapeutic Head-Shaking Maneuver (HSM)

2021 ◽  
Author(s):  
Ajay Kumar Vats
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Treatment Options ◽  
Positional Nystagmus ◽  
Short Term ◽  
Horizontal Semicircular Canal ◽  
Positional Vertigo ◽  
History Of ◽  
The Right ◽  
Rotational Vertigo ◽  
Paroxysmal Positional Vertigo

AbstractThe apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo is attributed to either short anterior ampullary arm canalolithiasis or to the cupulolithiasis with the otoconial debris adhering to the cupula on utricular (Cup-U) or canal side (Cup-C), rendering it heavy and gravity sensitive. The treatment options for horizontal semicircular cupulolithiasis are not very well defined. A 25-year-old female patient with 8 days history of vertigo on rolling to either of the lateral recumbent position presented in the first week of November 2019. The supine roll test (SRT) on yawing head maximally to the right as well as to the left elicited an apogeotropic horizontal positional nystagmus lasting more than 1 minute, which was stronger on the right side and indicated a diagnosis of left horizontal semicircular cupulolithiasis. Two short-term follow-ups at 1 and 24 hours after head-shaking maneuver (HSM), with verifying SRT, were undertaken. During either of the two follow-ups, neither the previously elicited horizontal positional nystagmus was observed, nor did the patient have vertigo on rolling to lateral recumbent positions. She was telephonically questioned weekly regarding the recurrence of rotational vertigo for the next 4 weeks, and it was confirmed that she remained symptom free till then. The therapeutic HSM, owing to the inertial forces generated, can detach the otoconial debris from the cupula that renders it heavy and gravity sensitive. Successful offloading of cupula by HSM brings immediate cure in the Cup-U variant of the horizontal semicircular cupulolithiasis.

Hallpike Defines the Syndrome of Benign Paroxysmal Positional Vertigo

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Clinical Features ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Positional Vertigo ◽  
Common Causes ◽  
History Of ◽  
Clinical Description ◽  
Vestibular Neuronitis ◽  
Temporal Bones ◽  
Paroxysmal Positional Vertigo

In 1952, Charles Hallpike and Margaret Dix published a paper in which they described the clinical profile of three of the most common causes of vertigo—Ménière’s disease, vestibular neuronitis, and benign paroxysmal positional vertigo (BPPV). Their strategy was simple: First, identify the symptoms and natural history of the disease, then document the physical signs associated with the disease, and finally, when possible, correlate the clinical features with histological studies of the temporal bones. They provided the first clear clinical description and the first pathology associated with the syndrome of BPPV. They described the clinical features of a large number of cases they had seen in the Queen Square clinic. They concluded that positional nystagmus of the benign paroxysmal type, first described by Robert Bárány in 1921, was due, as Bárány believed, to otolith disease.

scholarly journals A Case of Right Apogeotropic Posterior Semicircular Canal BPPV that Initially Emulated as Left Anterior Semicircular Canal BPPV

2020 ◽  
Author(s):  
Ajay Kumar Vats ◽  
Sudhir Kothari ◽  
Anirban Biswas
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
History Of ◽  
Anterior Semicircular Canal ◽  
The Right ◽  
Paroxysmal Positional Vertigo

AbstractIn any patient with a history of rotational vertigo triggered by changes in the position of head relative to the gravity, whose oculomotor patterns elicit a positional downbeating nystagmus (p-DBN), the localization could be either central in the brainstem, midline cerebellum, or at the craniocerebral junction; or else peripheral due to one of the rare variants of benign paroxysmal positional vertigo of vertical semicircular canals. Most serious causes of central vertigo in patients with p-DBN can be diagnosed by magnetic resonance imaging of the posterior fossa and craniovertebral junction. However, the peripheral p-DBN could be either due to anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV) or a recently described apogeotropic variant of posterior semicircular canal BPPV (apo-PSC-BPPV) and the two are almost impossible to differentiate initially. The usual clinical scenario in apo-PSC-BPPV is diagnosing it initially as ASC-BPPV. However, following diagnostic or therapeutic positioning maneuvers for the purported ASC-BPPV, the positional oculomotor pattern changes to an upbeating nystagmus with the reversal in the direction of the torsion as well, localizing it to the contralateral PSC with respect to the ASC initially diagnosed. The initial oculomotor pattern observed on the right Dix–Hallpike test in this patient, of a short latency downbeating left torsional (from the patient’s perspective) positional nystagmus suggested a diagnosis of left ASC-BPPV, which was accordingly treated with multiple sessions of reverse Epley maneuvers daily for a week. At the end of the week, a verifying right Dix–Hallpike test elicited an upbeating right torsional (from the patient’s perspective) positional nystagmus. It is extremely unlikely that this patient had resolution of her initial left ASC-BPPV with the daily sessions of reverse Epley maneuvers carried over a week and immediately suffered from commoner geotropic variant of the right PSC-BPPV (geo-PSC-BPPV). It is plausible to interpret that this patient suffered from the right apo-PSC-BPPV from the very outset, and the reverse Epley maneuver performed for the ostensive left ASC-BPPV led to an intracanal shift of otoconial debris from its nonampullary to the ampullary arm resulting in right geo-PSC-BPPV. The reasons why situations like this outwit the clinician resulting in inaccurate localization as well as lateralization is discussed. The patient was successfully treated with right Epley maneuver after transformation to geo-PSC-BPPV and was asymptomatic at follow-up for 4 weeks. A peripheral p-DBN with torsional component in any patient with a history of positionally triggered vertigo can be either ASC-BPPV or apo-PSC-BPPV. A very close follow-up at a short interval of time with meticulously executed positional tests is the only definitive way to differentiate the two conditions.

RELATIONSHIP BETWEEN MIGRAINE AND THE OCCURANCE OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)

2020 ◽  
Vol 7 (8) ◽  
pp. 70-74
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Control Group ◽  
Case Group ◽  
Vestibular Disorder ◽  
Inconsistent Result ◽  
Positional Vertigo ◽  
History Of ◽  
And Control ◽  
The Relationship ◽  
Paroxysmal Positional Vertigo

Introduction: Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder. Migren also common in general population. Several studies have shown inconsistent result for the relationship between migraine and BPPV.This study aims to determine relationship between migraine and the occurance of BPPV Methode: This case control study selected subjects with consecutive sampling techniques. Sampling was conducted at H. Adam Malik General Hospital Medan and network hospital. Thirty two patients with BPPV were selected as case group and matched with thirty two patients without BPPV as control group. Migraine history was taken in medical record. This study began in March until June 2020. Result: The majority of case and control group were female with eighteen subjects (56.2%) and median age about 60.5 (27-78) years old. We found eight patients (25.0%) with history of migraine in case group and in control group four patients (12,5%) with history of migraine. There is no significance relationship in migraine and the occurance of BPPV with p= 0.33 and OR=2.33 (95% CI = 0.62-8.71) Conclusion: There is no relationship between migraine and the occurance of BPPV.

scholarly journals Benign Paroxysmal Positional Vertigo and the Increased Risk of Ischemic Stroke: A Nested Case-Control Study Using a National Cohort Sample

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hyo Geun Choi ◽  
So Young Kim
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Benign Paroxysmal Positional Vertigo ◽  
National Sample ◽  
Positional Vertigo ◽  
History Of ◽  
Korean National Health Insurance ◽  
Nested Case Control ◽  
Control Study ◽  
Paroxysmal Positional Vertigo

A recent population cohort study reported that benign paroxysmal positional vertigo (BPPV) was a risk factor for ischemic stroke. This study investigated the risk of ischemic and hemorrhagic strokes in patients with BPPV. A nested case-control study used the data from the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2013. We used data of patients aged ≥50 years obtained from the Korean National Health Insurance Service-National Sample Cohort between 2002 and 2013. A total of 15,610 patients with ischemic stroke and 4,923 patients with hemorrhagic stroke were matched for age, sex, income, residential location, hypertension, diabetes, and dyslipidemia with 62,440 and 19,692 controls, respectively. History of BPPV was evaluated in the stroke and control groups. Crude and adjusted odds ratios (ORs) for stroke in patients with BPPV were analyzed using stratified logistic regression analysis. Subgroup analyses were performed for age and sex. Notably, 3.7% (572/15,610) of patients with ischemic stroke and 2.7% (1,702/62,440) of the control subjects reported a history of BPPV ( P < 0.001 ). The adjusted OR for BPPV in patients with ischemic stroke was 1.35 (95% confidence interval (CI) 1.22–1.49, P < 0.001 ). Patients with ischemic stroke showed higher ORs for BPPV in the subgroup of women. Patients with hemorrhagic stroke did not show a high OR for BPPV. Ischemic stroke patients demonstrated the increased OR for BPPV in subjects aged ≥50 years old.

Natural History of Benign Paroxysmal Positional Vertigo and Efficacy of Epley and Lempert Maneuvers

2006 ◽  
Vol 135 (4) ◽  
pp. 529-533 ◽  
Author(s):  
Kazunori Sekine ◽  
Takao Imai ◽  
Go Sato ◽  
Mahito Ito ◽  
Noriaki Takeda
Keyword(s):  
Natural History ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Vertigo ◽  
History Of ◽  
Paroxysmal Positional Vertigo

Natural history of horizontal canal benign paroxysmal positional vertigo is truly short

2014 ◽  
Vol 262 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Dae Bo Shim ◽  
Kyung Min Ko ◽  
Joon Hee Lee ◽  
Hong Ju Park ◽  
Mee Hyun Song
Keyword(s):  
Natural History ◽  
Benign Paroxysmal Positional Vertigo ◽  
Horizontal Canal ◽  
Positional Vertigo ◽  
History Of ◽  
Paroxysmal Positional Vertigo

Pain and other symptoms in patients with chronic benign paroxysmal positional vertigo (BPPV)

2013 ◽  
Vol 4 (4) ◽  
pp. 233-240 ◽  
Author(s):  
Wenche Iglebekk ◽  
Carsten Tjell ◽  
Peter Borenstein
Keyword(s):  
Observational Study ◽  
Neck Pain ◽  
Musculoskeletal Pain ◽  
Benign Paroxysmal Positional Vertigo ◽  
Widespread Pain ◽  
Dizziness Handicap Inventory ◽  
Positional Vertigo ◽  
History Of ◽  
Visual Disturbances ◽  
Paroxysmal Positional Vertigo

AbstractBackground and aimA diagnosis of chronic benign paroxysmal positional vertigo (BPPV) is based on brief attacks of rotatory vertigo and concomitant nystagmus elicited by rapid changes in head position relative to gravity. However, the clinical course of BPPV may vary considerably from a self-limiting to a persisting and/or recurrent disabling problem. The authors’ experience is that the most common complaints of patients with chronic BPPV are nautical vertigo or dizziness with other symptoms including neck pain, headache, widespread musculoskeletal pain, fatigue, and visual disturbances. Trauma is believed to be the major cause of BPPV in individuals younger than fifty years. Chronic BPPV is associated with high morbidity. Since these patients often suffer from pain and do not have rotatory vertigo, their symptoms are often attributed to other conditions. The aim of this study was to investigate possible associations between these symptoms and chronic BPPV.MethodsDuring 2010 a consecutive prospective cohort observational study was performed. Diagnostic criteria: (A) BPPV diagnosis confirmed by the following: (1) a specific history of vertigo/dizziness evoked by acceleration/deceleration, (2) nystagmus in the first position of otolith repositioning maneuvers, and (3) appearing and disappearing nystagmus during the repositioning maneuvers; (B) the disorder has persisted for at least six months. (C) Normal MRI of the cerebrum. Exclusion criteria: (A) Any disorder of the central nervous system (CNS), (B) migraine, (C) active Ménière’s disease, and (D) severe eye disorders. Symptom questionnaire (‘yes or no’ answers during a personal interview) and Dizziness Handicap Inventory (DHI) were used.ResultsWe included 69 patients (20 males and 49 females) with a median age of 45 years (range 21-68 years). The median duration of the disease was five years and three months. The video-oculography confirmed BPPV in more than one semicircular canal in all patients. In 15% there was a latency of more than 1 min before nystagmus occurred. The Dizziness Handicap Inventory (DHI) median score was 55.5 (score >60 indicates a risk of fall). Seventy-five percent were on 50-100% sick leave. Eighty-one percent had a history of head or neck trauma. Nineteen percent could not recall any history of trauma. In our cohort, nautical vertigo and dizziness (81%) was far more common than rotatory vertigo (20%). The majority of patients (87%) reported pain as a major symptom: neck pain (87%), headache (75%) and widespread pain (40%). Fatigue (85%), visual disturbances (84%), and decreased concentration ability (81%) were the most frequently reported symptoms. In addition, unexpected findings such as involuntary movements of the extremities, face, neck or torso were found during otolith repositioning maneuvers (12%). We describe one case, as an example, how treatment of his BPPV also resolved his chronic, severe pain condition.ConclusionThis observational study demonstrates a likely connection between chronic BPPV and the following symptoms: nautical vertigo/dizziness, neck pain, headache, widespread pain, fatigue, visual disturbances, cognitive dysfunctions, nausea, and tinnitus.ImplicationsPatients with complex pain conditions associated with nautical vertigo and dizziness should be evaluated with the Dizziness Handicap Inventory (DHI)-questionnaire which can identify treatable balance disorders in patients with chronic musculoskeletal pain.

Sign in / Sign up

Export Citation Format

Share Document