Diagnosis strategy and Yacovino maneuver for anterior canal-benign paroxysmal positional vertigo

Yang, Xu; Xia, Ling; Shen, Bo; Hong, Yuan; Li, Kangzhi; Si, Lihong; Kim, Ji Soo

doi:10.1007/s00415-019-09312-1

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…In the remaining one patient, left-beating geotropic nystagmus was only induced when lying on the left side during the supine roll test, and right-beating geotropic nystagmus was induced during right Dix-Hallpike test, the nystagmus disappeared after particle repositioning therapy, which may be related to the uncertainty of the movement of otoliths. (6) In the present study, three patients showed downbeat nystagmus lasting > 1 min during Dix-Hallpike, the nystagmus had no latency period and did not fatigue, and the reversal of the nystagmus occurred when sitting up, those patients had a history of transient episodes of vertigo triggered by changes in body posture. Yacovino maneuver was effective in those patients; the nystagmus disappeared or was significantly weakened after treatment, therefore, those patients were diagnosed as possible AC-BPPV-cu (6).…”

Section: Discussionsupporting

confidence: 46%

“…(6) In the present study, three patients showed downbeat nystagmus lasting > 1 min during Dix-Hallpike, the nystagmus had no latency period and did not fatigue, and the reversal of the nystagmus occurred when sitting up, those patients had a history of transient episodes of vertigo triggered by changes in body posture. Yacovino maneuver was effective in those patients; the nystagmus disappeared or was significantly weakened after treatment, therefore, those patients were diagnosed as possible AC-BPPV-cu ( 6 ). At present, there are relatively few studies investigating AC-BPPV-cu, and there is still controversy about the existence of AC-BPPV-cu.…”

Section: Discussionmentioning

confidence: 99%

“…If all the nystagmus and vertigo disappeared, then a complete cure was achieved. Particle repositioning therapy was also considered effective if the nystagmus and vertigo was weaker without completely disappearing, whereas it was deemed to be non-effective if the nystagmus was unchanged or became further aggravated (6).…”

Section: Diagnostic Methodsmentioning

confidence: 99%

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Clinical Characteristics of Patients With Benign Paroxysmal Positional Vertigo Diagnosed Based on the Diagnostic Criteria of the Bárány Society

et al. 2020

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Objectives: To analyze the clinical characteristics of patients with benign paroxysmal positional vertigo (BPPV) diagnosed based on the diagnostic criteria of Bárány Society, verify the clinical application value of the diagnostic criteria, and further explore the clinical problems associated with the diagnosis of possible BPPV. Conclusions: PC-BPPV-ca is the most common among patients with BPPV, followed by HC-BPPV-ca. In emerging and controversial BPPV, MC-BPPV, and Pos-BPPV were more common. For the diagnosis of Pos-BPPV, a combination of the history of typical BPPV, particle repositioning therapy and follow-up outcome is helpful to clarify the diagnosis.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Patients With Benign Paroxysmal Positional Vertigo Diagnosed Based on the Diagnostic Criteria of the Bárány Society

et al. 2020

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“…Even though SHH was already incorporated into the maneuvers to induce positional nystagmus by Nylén, 20 its role in diagnosing PC-BPPV remains to be delineated. Instead, its role has mostly been confined to diagnosing central positional nystagmus or BPPV involving the anterior or horizontal semicircular canals, 21 22 23 24 even though a study conducted in China found positional nystagmus typical of PC-BPPV in 22 (78.6%) of 28 patients with PC-BPPV during SHH, which is similar to the findings of the present study. 15…”

Section: Discussionsupporting

confidence: 88%

Diagnostic Value of Straight Head Hanging in Posterior Canal Benign Paroxysmal Positional Vertigo

et al. 2021

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Background and Purpose To determine the diagnostic value of straight head hanging (SHH) in benign paroxysmal positional vertigo involving the posterior semicircular canal (PC-BPPV). Methods We retrospectively included 62 patients (age=56.2±15.0 years, 47 female) with unilateral PC-BPPV who underwent both the Dix-Hallpike maneuver and SHH before receiving canalith repositioning therapy (CRT) between September 2017 and July 2020 at the Dizziness Center of Seoul National University Bundang Hospital in South Korea (16 patients, 25.8%) or the Neurology Outpatient Clinic of Aerospace Central Hospital in China (46 patients, 74.2%). SHH was performed before ( n =29, group A) or after ( n =33, group B) the Dix-Hallpike maneuver. Results Torsional upbeat nystagmus typical of PC-BPPV was induced during SHH in 52 (83.9%) patients, and the incidence of this type of positional nystagmus did not differ between the groups A and B (79.3% vs. 87.9%, p =0.569). The maximum slow-phase velocity of the induced upbeat nystagmus was higher during SHH than during the Dix-Hallpike maneuver toward the lesion side [range=2.0–60.0°/s (median=18.5°/s) vs. range=2.7–40.0°/s (median=13.4°/s), p <0.001]. Reversal of the positional nystagmus was observed upon resuming the sitting position after SHH in 47 (75.8%) patients and after the Dix-Hallpike maneuver in 54 (87.7%) patients, with no significant difference between the groups ( p =0.082). Conclusions SHH is effective for diagnosing PC-BPPV. Given its simplicity, SHH may be performed before the Dix-Hallpike maneuver, and CRT may be attempted thereafter when the typical positional nystagmus for unilateral PC-BPPV is induced during SHH.

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“…Therefore, for the patients with BPPV, Yacovino maneuver that does not require determination of the affected side should be performed. 28 Similarly, the diagnosis of bilateral HC-BPPV is also very difficult, if patients had canalolithiasis or cupulolithiasis of the bilateral HC, the Roll Test can cause canal excitement on one side and inhibition on the other side when turning the head to either side. For the horizontal tube BPPV, the nystagmus produced by Roll test is more symmetrical in bilateral HC-BPPV as compared to unilateral HC-BPPV.…”

Section: Discussionmentioning

confidence: 99%

Objective findings in patients with multi-canal benign paroxysmal positional vertigo

Zhu

et al. 2021

Ear Nose Throat J

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Objective The study aimed to investigate the clinical characteristics of patients with multi-canal benign paroxysmal positional vertigo (MC-BPPV). Methods We performed a retrospective analysis of 927 patients with BPPV who were admitted to our hospital between January 1, 2016 and December 31, 2019. The clinical data of all patients were collected. The Dix-Hallpike, straight head-hanging, and supine Roll tests were performed in all patients. The nystagmus was recorded using videonystagmography. The clinical characteristics of patients with MC-BPPV and single canal BPPV (SC-BPPV) was analyzed and compared. Results Among 927 patients included, 49 (5.29%) patients had MC-BPPV, 878 (94.71%) patients had SC-BPPV. There were significant differences in the male to female ratio (1:3.90 vs 1:1.81, P < .05), mean age (62.47±12.51 vs 59.04±13.72, P < .05), as well as the ratio of cupulolithiasis to canalithiasis (1:1.45 vs 1:4.78, P < .01) between patients with MC-BPPV and SC-BPPV. The frequency of involvement of PC, HC, and AC were involved for 66 (67.35%), 23 (23.47%), and 9 (9.18%) times, respectively, in patients with MC-BPPV, which were involved in 581 (66.17%), 281 (32.0%), and 16 (1.82%) patients, respectively, in patients with SC-BPPV. No significant difference was found in the frequency of involvement of PC and HC between patients with MC-BPPV and SC-BPPV, while there was significant difference in the frequency of AC involvement between 2 groups ( P < .01). Ipsilateral PC-HC-BPPV (n = 18) and bilateral PC-BPPV (n=19) were the most common among patients with MC-BPPV. Twenty-six (53.06%) patients had ipsilateral MC-BPPV, 23 (46.94%) had bilateral MC-BPPV. Of the 26 patients with ipsilateral MC-BPPV, 7 patients combined with unilateral peripheral vestibular disorder. Conclusion Patients with MC-BPPV had a significantly older mean age at disease onset and a higher proportion of females compared with patients with SC-BPPV. Cupulolithiasis was more common in MC-BPPV. AC involvement was also much more common in MC-BPPV than in SC-BPPV.

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Diagnosis strategy and Yacovino maneuver for anterior canal-benign paroxysmal positional vertigo

Cited by 13 publications

References 29 publications

Clinical Characteristics of Patients With Benign Paroxysmal Positional Vertigo Diagnosed Based on the Diagnostic Criteria of the Bárány Society

Clinical Characteristics of Patients With Benign Paroxysmal Positional Vertigo Diagnosed Based on the Diagnostic Criteria of the Bárány Society

Diagnostic Value of Straight Head Hanging in Posterior Canal Benign Paroxysmal Positional Vertigo

Objective findings in patients with multi-canal benign paroxysmal positional vertigo

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