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 Effect of the Epley Maneuver and Brandt-Daroff Exercise on Benign Paroxysmal Positional Vertigo Involving the Posterior Semicircular Canal Cupulolithiasis: A Randomized Clinical Trial

2020 ◽  
Vol 11 ◽  
Author(s):  
Seo-Young Choi ◽  
Jae Wook Cho ◽  
Jae-Hwan Choi ◽  
Eun Hye Oh ◽  
Kwang-Dong Choi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Therapeutic Effect ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Paroxysmal Positional Vertigo

Objective: To investigate the therapeutic efficacies of the Epley maneuver and Brandt-Daroff (BD) exercise in patients with benign paroxysmal positional vertigo involving the posterior semicircular canal cupulolithiasis (PC-BPPV-cu).Methods: We conducted a randomized clinical trial to evaluate the therapeutic effect of the Epley maneuver and BD exercise in patients with PC-BPPV-cu. Patients were randomly assigned to undergo the Epley maneuver (n = 29) or BD exercise (n = 33). The primary outcome was an immediate resolution of positional nystagmus within 1 h after a single treatment of each maneuver on the visit day. Secondary outcomes included the resolution of positional nystagmus at 1 week, the change of maximal slow phase velocity (mSPV) of positional nystagmus, and dizziness handicap inventory (DHI) immediately and at 1 week.Results: Immediate resolution occurred in none of 29 patients in the Epley maneuver group and only 1 of 33 patients in the BD exercise group. The Epley maneuver and BD exercise had an equivalent effect at 1 week in treating PC-BPPV-cu in terms of resolving positional nystagmus (48 vs. 36%, p = 0.436) and the decrease of mSPV and DHI.Conclusion: Neither the Epley maneuver nor BD exercise has an immediate therapeutic effect in treating PC-BPPV-cu. Clear classification of PC-BPPV should be required at the time of different pathology and different treatment response.

scholarly journals Behavior of the posterior semicircular canal after Dix-Hallpike maneuver

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Francisco Carlos Zuma e Maia ◽  
Pedro Luiz Mangabeira Albernaz ◽  
Renato Valério Cal
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Biomechanical Model ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

The objective of the present study is to analyze the quantitative vestibulo-ocular responses in a group of patients with benign paroxysmal positional vertigo (BPPV) canalolithiasis and compare these data with the data of the tridimensional biomechanical model. This study was conducted on 70 patients that presented idiopathic posterior semicircular canal canalolithiasis. The diagnosis was obtained by Dix- Hallpike maneuvers recorded by videonystagmograph. The present study demonstrates that there is a significant correlation between the intensity of the nystagmus and its latency in cases of BPPV-idiopathic posterior semicircular canal canalolithiasis type. These findings are in agreement with those obtained in a tridimensional biomechanical model and are not related to the patients’ age.

scholarly journals The efficacy of Epley and Semont maneuvers in posterior semicircular canal benign paroxysmal positional vertigo treatment: A short-term comparative study

2021 ◽  
Vol 9 (3) ◽  
pp. 75-80
Author(s):  
Mustafa Caner Kesimli
Keyword(s):  
Comparative Study ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Short Term ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
The One ◽  
Paroxysmal Positional Vertigo

OBJECTIVE: This study aimed to compare the effectiveness of the Epley maneuver with the Semont maneuver in the treatment of posterior semicircular canal benign paroxysmal positional vertigo and observe differences in the resolution time of symptoms in the short-term follow-up. METHODS: Sixty patients with posterior semicircular canal benign paroxysmal positional vertigo (23 males, 37 females; median age: 44.9 years; range, 14 to 80 years) were included in the prospective randomized comparative study conducted in our clinic between April 2019 and October 2019. Diagnosis and treatment maneuvers were performed under videonystagmography examination. Participants were randomly selected after the diagnostic tests for the Epley maneuver and the Semont maneuver treatment groups. RESULTS: In the evaluation of vertigo with videonystagmography, 25 (83.3%) patients in the Epley maneuver group and 20 (66.6%) patients in the Semont maneuver group recovered in the one-week follow-up, and 28 (93.3%) patients in the Epley maneuver group and 24 (80%) patients in the Semont maneuver group recovered in the two-week follow-up. All patients in the Epley maneuver group recovered at the end of one month; four patients in the Semont maneuver group still had vertiginous symptoms (100% vs. 86.6%, p=0.04). There was a statistically significant difference between the Epley and Semont groups regarding visual analog scores at the one-week, two-week, and one-month follow-ups (p=0.002, p<0.001, p=0.001, respectively). CONCLUSION: The Epley maneuver was significantly more effective than the Semont maneuver in resolving vertigo in the short-term treatment of posterior semicircular canal benign paroxysmal positional vertigo.

Evolution of Treatment Maneuvers for Benign Paroxysmal Positional Vertigo

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
21St Century ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Initial Examination ◽  
Positional Vertigo ◽  
Anterior Semicircular Canal ◽  
Paroxysmal Positional Vertigo

Near the turn of the 21st century, as more physicians began performing the Epley and Semont maneuvers for treatment of benign paroxysmal positional vertigo (BPPV), it became apparent that the procedures could be done at the time of initial examination without the need for sedation or vibration. Furthermore, modified versions of the maneuvers evolved that were more effective and easier to perform. There are clear similarities in these modified repositioning maneuvers. BPPV nearly always results from otoconial debris within the posterior semicircular canal because this is the canal in which it is most easily trapped. Although less common, there are horizontal and anterior semicircular canal variants of BPPV, and otolithic debris can become attached to the cupula, producing a true cupulolithiasis. The nystagmus is in the plane of the affected canal; the nystagmus is transient when the debris is freely floating and persistent when debris is attached to the cupula.

Schuknecht and His Breakthrough on Benign Paroxysmal Positional Vertigo

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Temporal Bone ◽  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Assistant Professor ◽  
Clinical Instructor ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Patient Reported ◽  
The University ◽  
Paroxysmal Positional Vertigo

In 1949, Harold Schuknecht completed his residency in John Lindsay’s Otolaryngology Department at the University of Chicago and stayed first as a clinical instructor and then as an assistant professor. Schuknecht reviewed the temporal bone specimens from the patient reported by his mentor, John Lindsay, and from patients reported by Charles Hallpike and colleagues and was struck by the similarity in the pathologic changes. He concluded that in each case damage to the labyrinth resulted from occlusion of the anterior vestibular artery. Schuknecht believed that the delayed positional vertigo that occurred in these cases must have originated from the posterior semicircular canal. He reasoned that with degeneration of the superior vestibular labyrinth, otoconia would be released from the otolithic membrane of the utricular macule and that, in certain positions of the head, the otoconia would respond to gravity and thereby activate the cupula of the posterior semicircular canal.

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