A cupulolith repositioning maneuver in the treatment of horizontal canal cupulolithiasis

Immediate efficacy of Gufoni maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV): a meta-analysis

“…Treatment of HC-BPPV relies on some physical maneuvers. Many physical treatments include the barbecue rotation (the patient's head is rotated in three 90-degree increments, for a total of 270 , from affected ear down, to supine, to unaffected ear down, to prone) [5], Vannucchi's forced prolonged position (the patient lies with the unaffected ear down for approximately 12 h) [6], head-shaking in the horizontal plane (the patient's head is shaken from side to side at approximately two cycles per second for 15 s) [7], mastoid oscillation(it was applied on the suprameatal triangle in the posterior superior area of the lesion side auricle with a 60-Hz hand-held vibrator for 30 s) [8] and Gufoni methods have been proposed [9]. The Gufoni maneuver was first described by Gufoni in 1998 [9].…”

The bedside examination of the vestibulo-ocular reflex (VOR): An update

“…The head is rotated within a comfortable range at a frequency of about three cycles per second for about ten seconds and an induced nystagmus is looked for after the head has stopped moving. With a unilateral loss of vestibular function, a vigorous nystagmus with slow phases directed initially toward the affected side usually appears, sometimes followed by a reversal phase with slow phases directed toward the intact side (Kim et al, 2012a, b; Lee et al, 2012). In patients with unilateral labyrinthine loss, there is an asymmetry of peripheral inputs during high-velocity head rotations (Ewald’s second law), which leads to an unequal accumulation of activity in the central velocity-storage mechanism within the vestibular nuclei.…”

“…LC BPPV may occur as a transient complication of treatment of PC BPPV. There are many maneuvers to treat LC BPPV (Kim et al, 2012b; Oh et al, 2009; Korres et al, 2011). Rarely an isolated direction changing horizontal nystagmus can be the sole sign of an acute focal cerebellar (nodulus) lesion (Kim et al, 2011b).…”

Update of Treatment for Horizontal Canal Benign Paroxysmal Positional Vertigo: Evidence-Based Approach

“…This review article focused on the evidences of the efficacy of various maneuvers in the treatment of HC-BPPV published after the BPPV clinical practice guidelines of 2008. Lempert (barbecue) maneuver [19] Forced prolonged maneuver [16] Forced prolonged maneuver [16,20,26] Gufoni maneuver [15,21,22] Cupulolith repositioning maneuver [18] Therapeutic head shaking [16,23] Appiani maneuver [17] Gufoni maneuver [21,[23][24][25]…”