Human Experience with Canalith Repositioning Maneuvers

Abstract

Three distinct pathological conditions, related to different means by which dense intralabyrinthine particles interfere with the function of a semicircular canal and cause nystagmus and vertigo, are amenable to treatment with repositioning maneuvers. Known as benign paroxysmal positional vertigo and variants, these conditions are better designated collectively by the term “vestibular lithiasis.” Each form requires a different treatment strategy of head maneuvers and application of other modalities to restore normal semicircular function and thereby eliminate the positional nystagmus and vertigo. Real‐time observation of the nystagmus induced by the particles during the maneuvers can greatly facilitate the repositioning process.

Manobras para o tratamento da vertigem posicional paroxística benigna: revisão sistemática da literatura

“…Although the exact mechanism by which these debris cause BPPV and nystagmus is still unknown 1 , it is broadly accepted that a canal lithiasis phenomenon be responsible for this condition 6 . Each free debris point require a different treatment strategy, through maneuvers comprised of head movements, in order to restore normal semicircular canal function and thus eliminate vertigo and positional nystagmus 7 . This therapy involves head position changes in a series of repetitions, as proposed by Brandt and Daroff 8 , Semont´s releasing maneuver, Epley`s canalicular repositioning 1,9 , among others [10][11][12][13] .…”

Purely vertical upbeat nystagmus in bilateral posterior canal benign paroxysmal positional vertigo: A case report

“…5,6 The straight back head hanging position caused movement of free-floating endolymph debris in both PC. This led to ampullofugal cupular deflection, and an excitatory response in both PC.…”

A Comprehensive Insight into the Rehabilitative Treatment of Persistent Benign Paroxysmal Positional Vertigo

“…Mastoid vibration disperses particles that form the canalith, helping the complete maneuver resolve the BPPV. However, dispersion itself can make particles temporarily incompetent to promote a positive Dix-Hallpike test result [8] . This may explain recurrence after completing the applied treatment in the series by Alessandrini et al [3] In summary, our study and the one by Alessandrini et al [3] show different approaches to the treatment of persistent BPPV; however, both may be useful and do not invalidate each other.…”