Horizontal canal benign paroxysmal positioning vertigo (h‐BPPV): Transition of canalolithiasis to cupulolithiasis

Steddin, Sven; D, Ing; Brandt, Th.

doi:10.1002/ana.410400615

Cited by 97 publications

(58 citation statements)

References 13 publications

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“…With brisk positional maneuvers the latency is typically 1 or 2 seconds. Likewise, the intensity of nystagmus depends on the angle of head rotation: the intensity of nystagmus tends to be higher with larger head rotations in the head roll test [69]. 9.…”

Section: Canalolithiasis Of the Horizontal Canal (Hc-bppv)mentioning

confidence: 99%

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Benign paroxysmal positional vertigo: Diagnostic criteria

Brevern

Bertholon

Brandt

et al. 2015

VES

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561

502

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Abstract. This article presents operational diagnostic criteria for benign paroxysmal positional vertigo (BPPV), formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society. The classification reflects current knowledge of clinical aspects and pathomechanisms of BPPV and includes both established and emerging syndromes of BPPV. It is anticipated that growing understanding of the disease will lead to further development of this classification.

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Section: Canalolithiasis Of the Horizontal Canal (Hc-bppv)mentioning

confidence: 99%

“…when the patient bends over from the sitting to the "head-on-knees" position [69]. Transition of canalolithiasis from the posterior canal to the horizontal canal may occur as a result of therapeutic positional maneuvers [36].…”

Section: Commentsmentioning

confidence: 99%

Benign paroxysmal positional vertigo: Diagnostic criteria

Brevern

Bertholon

Brandt

et al. 2015

VES

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561

502

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“…The clinically more frequent type with geotropic nystagmus is supposedly caused by canalolithiasis of the long SCC arm, whereas the less frequent hBPPV, characterized by apogeotropic horizontal nystagmus during the PagniniMcClure maneuver, is thought to be caused either by canalolithiasis of the SCC short arm or by cupulolithiasis. Both types can convert into the other (2). Patients usually have a history of transient or persistent positional vertigo, but can present with spontaneous vertigo and spontaneous nystagmus (SN) (3,4) due to cupulolithiasis or spontaneous canal plugging.…”

mentioning

confidence: 99%

Spontaneous Plugging of the Horizontal Semicircular Canal With Reversible Canal Dysfunction and Recovery of Vestibular Evoked Myogenic Potentials

Luis

Costa²,

Garcia³

et al. 2013

Otology &Amp; Neurotology

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Objective: To evaluate the clinical pathophysiology of oculomotor changes in a patient presenting with a spontaneous semicircular horizontal canal plug. Patient: A 42-year-old man with acute spontaneous vertigo with spinning and persistent left-horizontal nystagmus, intensity but not direction dependent on head orientation with respect to gravity, indicating a benign paroxysmal positional vertigo due to otoconia causing a plug in the horizontal semicircular canal. Intervention: Electrophysiological and video-oculographic testing; vestibular rehabilitation. Main Outcome Measures: Cervical and ocular vestibular evoked myogenic potentials (VEMPs); video head impulse testing. Results: The video head-impulse test revealed an eye velocity cutoff at 80-/s in the time interval from 40 to 90 ms after initiation of head impulses to the right. This normalized within 2 days after liberatory maneuvers, documenting for the first time a reversible deficiency of the cupular-endolymph highfrequency system dynamics. Cervical and ocular vestibular myogenic potentials were absent during stimulation of the affected side before the liberatory maneuvers but normalized within 30 to 80 days. Conclusion: This case is special in 4 respects: 1) nystagmus intensity, but not direction, was dependent on head orientation with respect to gravity, indicating a horizontal canal plug; 2) VEMPs were asymmetrical before liberatory maneuvers; 3) VEMPs recovered after Day 30; and 4) video head-impulse test asymmetry recovered. These observations challenge the common belief that VEMPs are evoked by otolith stimulation only. Instead, the assumption of a reversible canal dysfunction by a plug offers a more plausible explanation for all effects.

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“…Although our series is a small one based on our own findings and on reports of others [Agus et al, 1995;Steddin et al, 1996], the treatment and prognosis are the same for classical PC-BPPV as well as for PC-BPPV with ageotropic nystagmus. It is important to recognize this clinical phenomenon and to differentiate it from a central vestibular disease.…”

Section: Discussionmentioning

confidence: 72%

“…Two patients, aged 49 and 69 years were reported [Steddin et al, 1996] who both had left-and right-sided BPPV of the HC, respectively. After vigorous head positioning (head-on-knees) the direction of the horizontal nystagmus changed from geotropic to ageotropic when the patients rolled the head from side to side in the supine position.…”

Section: Discussionmentioning

confidence: 99%

Posterior Semicircular Canal Type Benign Paroxysmal Positioning Vertigo with Ageotropic Paroxysmal Positioning Nystagmus

Rapoport¹,

Sadeh²

2001

Audiol Neurotol

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We report on 3 patients with typical benign paroxysmal positioning vertigo (BPPV) and atypical, paroxysmal positioning nystagmus. When the Dix-Hallpike test was performed, the patients exhibited an ageotropic nystagmus, different from that classically described in posterior semicircular canal BPPV. It was torsional-vertical with the vertical component beating downwards, and the torsional component was beating away from the lowermost ear. In both left and right Dix-Hallpike positions, the upper poles of the eyes were turning away from the lowermost ear. The atypical ageotropic paroxysmal positional nystagmus of the posterior semicircular canal was observed in the evolution of the BPPV in 2 patients and on the first examination in the third. Two patients had changing patterns of paroxysmal positioning nystagmus.

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Horizontal canal benign paroxysmal positioning vertigo (h‐BPPV): Transition of canalolithiasis to cupulolithiasis

Cited by 97 publications

References 13 publications

Benign paroxysmal positional vertigo: Diagnostic criteria

Benign paroxysmal positional vertigo: Diagnostic criteria

Spontaneous Plugging of the Horizontal Semicircular Canal With Reversible Canal Dysfunction and Recovery of Vestibular Evoked Myogenic Potentials

Posterior Semicircular Canal Type Benign Paroxysmal Positioning Vertigo with Ageotropic Paroxysmal Positioning Nystagmus

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