Analyses with the Video Head Impulse Test During the Canalith Repositioning Maneuver in Patients with Isolated Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is a common, most often self-limited, vestibular end organ disorder that in some cases may be quite disabling. Recent evidence suggests that some, if not most, cases result from free-floating posterior semicircular canal endolymph particles. We postulate that the particle repositioning maneuver displaces these particles from the posterior canal through the common crus into the utricle, where they no longer induce pathologic responses. Our report focuses on 38 consecutive patients treated with this simple bedside technique during a 10-month period. On follow-up, 26 patients (68.4%) were free of disease, 4 (10.5%) were significantly improved, 4 (10.5%) remained unchanged, and 4 (10.5%) were lost to follow-up. Of the 4 patients who remained unchanged, 2 underwent successful posterior semicircular canal occlusions. The direction of the nystagmus during the second stage of the maneuver appears important in predicting the efficacy, with reversal of nystagmus denoting a poor response. These findings provide additional insight into the pathophysiology of this disorder.

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Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal

Vojnosanitetski pregled ◽

10.2298/vsp1208669b ◽

2012 ◽

Vol 69 (8) ◽

pp. 669-674 ◽

Cited By ~ 3

Author(s):

Snezana Babac ◽

Nenad Arsovic

Keyword(s):

Success Rate ◽

Semicircular Canal ◽

Benign Paroxysmal Positional Vertigo ◽

Spontaneous Nystagmus ◽

Posterior Semicircular Canal ◽

Duration Of Symptoms ◽

Positional Vertigo ◽

Epley Maneuver ◽

Repositioning Maneuver ◽

Paroxysmal Positional Vertigo

Background/Aim. Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders. The aim of this study was to examine the efficacy of the Epley maneuver in treating benign paroxysmal positional vertigo of the posterior semicircular canal (p- BPPV) and to discover possible causes of failure. Methods. This prospective study included 75 patients. In all the cases medical history showed and the positioning Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed clinical ENT examination, searching for spontaneous nystagmus, vestibulospinal tests, caloric test, and audiometry. All the patients were treated by the modified Epley canalith repositioning maneuver. The patients were followed up at the intervals of seven and, fourteen days, and one, tree, and six months and one year. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. Results. After the initial Epley maneuver the recovery rate was 90.7%, and after the second 96%. In three (4%) patients with secondary p-BPPV, symptoms did not cease even after the second repositioning maneuver. The etiology of p-BPPV had a significant effect on the maneuver?s success rate (p < 0.01), whereas duration of symptoms, age and gender had no effect (p > 0.05). After a successful treatment 11 (14.66%) patients had recurrent attack of BPPV during the first year. Conclusion. The Epley maneuver is very successful repositioning procedure in treating p- BPPV. The patients with idiopathic form p-BPPV showed higher success rate with Epley maneuver than those with secondary p-BPPV.

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The Video Head Impulse Test in the acute stage of posterior canal benign paroxysmal positional vertigo

Acta Otorhinolaryngologica Italica ◽

10.14639/0392-100x-n1033 ◽

2021 ◽

Vol 41 (1) ◽

pp. 69-76

Author(s):

Luigi Califano ◽

Raffaella Iannella ◽

Salvatore Mazzone ◽

Francesca Salafia ◽

Maria Grazia Melillo

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Acute Stage ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Head Impulse ◽

Posterior Canal ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

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Feasibility of Using the Video-Head Impulse Test to Detect the Involved Canal in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus

Frontiers in Neurology ◽

10.3389/fneur.2020.578588 ◽

2020 ◽

Vol 11 ◽

Author(s):

Andrea Castellucci ◽

Pasquale Malara ◽

Salvatore Martellucci ◽

Cecilia Botti ◽

Silvia Delmonte ◽

...

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Head Impulse Test ◽

Downbeat Nystagmus ◽

Video Head Impulse Test ◽

Head Impulse ◽

Positional Vertigo ◽

Paroxysmal Positional Vertigo

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Comparision of Video Head Impulse Test Findings Before and After Therapy Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo

10.22541/au.162830507.78469930/v1 ◽

2021 ◽

Author(s):

ERCAN KARABABA ◽

Hacı Hüseyin DERE ◽

Banu MÜJDECİ ◽

Erkan KARATAŞ

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Head Impulse Test ◽

Control Group ◽

Study Group ◽

Video Head Impulse Test ◽

Head Impulse ◽

Positional Vertigo ◽

Significant Difference ◽

Before And After ◽

Paroxysmal Positional Vertigo

Purpose: Vestibuloocular reflex (VOR) may be helpful in the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV). Video Head Impulse Test (vHIT) can effectively diagnose VOR deficits in vestibular disorders. Aims: The aim of this study is to investigate the significance of vHIT in determining the efficacy of therapeutic maneuvers in individuals with posterior semicircular canal BPPV. Materials and Methods: The study included 25 patients with posterior SCC BPPV (Study Group) between the ages of 19-65 years, 30 healthy individuals (Control Group). All individuals underwent otorhinolaryngologic examination, audiological evaluation with, videonystagmography and vHIT. The Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) were administered to the individuals with posterior SCC BPPV for the intensity of dizziness and Modified Epley maneuver was performed 3 times at an interval of 3 days. The vHIT, DHI and VAS were re-administered to these individuals 1 week after improvement was detected in positional nystagmus. Results: There was no significant difference between the study and control groups in terms of vHIT gains for all bilateral SCCs before therapeutic maneuver (p>0.05). In the study group, there was no significant difference between vHIT gains of all bilateral SSCs before and after therapeutic maneuvers (p>0.05). No asymmetry or refixation saccades (overt and covert) were observed in any of the individuals in both groups during all measurements. Compared to before therapeutic maneuvers, there was a significant decrease in dizziness-related disability level assessed by DHI and intensity of dizziness assessed by VAS in the study group after the improvement (p<0.001). Conclusion: It was found that vHIT was not a diagnostic test in BPPV and in terms of evaluating the efficacy of therapeutic maneuvers. Subjective evaluations determining the intensity of dizziness and level of dizziness-related disability in BPPV provided supportive information in diagnosis and in determining the efficacy of therapeutic maneuvers.

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