Intractable Benign Paroxysmal Positioning Vertigo

Horii, Arata; Kitahara, Tadashi; Osaki, Yasuhiro; Imai, Toshio; Fukuda, Kentarou; Sakagami, Masafumi; Inohara, Hidenori

doi:10.1097/mao.0b013e3181cabd77

Cited by 46 publications

(9 citation statements)

References 13 publications

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“…Accordingly, the innate stenosis of the canal could induce an otoconial debris jam in the narrow portion, although a giant otoconial plug could occur in a normal canal. Horii et al [5] recently suggested that patients with intractable BPPV had more abnormal appearing canals compared with normal controls based on 3-dimensional reconstruction of inner ear MR images.…”

Section: Discussionmentioning

confidence: 99%

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

Chang

Choi²,

Chung

2014

Clin Exp Otorhinolaryngol

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The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam.

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Section: Discussionmentioning

confidence: 99%

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

Chang

Choi²,

Chung

2014

Clin Exp Otorhinolaryngol

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“…В то же время отсутствие эффекта от маневров должно насторожить врача в плане правильности диагноза. В некоторых случаях низкая эффективность маневров связана с аномалией развития полукружных каналов, для диагностики которой используется магнитно-резонансная томография (МРТ) [51]. Низкая эффективность лечебных маневров может быть связана с адгезией отоконий в канале или купуле.…”

Section: атипичные варианты дппгunclassified

Benign paroxysmal positional vertigo

Kutlubaev¹

2016

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Benign paroxysmal positional vertigo (BPPV) is the most common cause of vestibular vertigo. It is caused by dislodged otoconia that enters the semicircular canals. Its main symptom is relapsing positional vertigo. The provocative tests, in particular the Dix-Hallpike maneuver, are used to confirm the diagnosis. In case of positive result of the test, one of the maneuvers is peformed depending on the affected semicircular canal, for instance the Epley maneuver. It is important to differentiate BPPV from the vertigo of central origin.

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“…Encouraging advances in imaging may eventually enable in vivo correlation. Three-dimensional T2-weighted 3-dimensional fast MRI imaging with steady-state acquisition sequences can now show some reliable detail of semicircular structure such as narrowed areas and “filling defects” [82]. In patients with “intractable” BPPV 89% had abnormal canals compared with healthy controls, but there was no correlation between the affected canal and nystagmus type.…”

Section: Future Directionsmentioning

confidence: 99%

Benign Paroxysmal Positional Vertigo (BPPV): History, Pathophysiology, Office Treatment and Future Directions

Hornibrook

2011

International Journal of Otolaryngology

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BPPV is the most common cause of vertigo. It most often occurs spontaneously in the 50 to 70 year age group. In younger individuals it is the commonest cause of vertigo following head injury. There is a wide spectrum of severity from inconsistent positional vertigo to continuous vertigo provoked by any head movement. It is likely to be a cause of falls and other morbidity in the elderly. Misdiagnosis can result in unnecessary tests. The cardinal features and a diagnostic test were clarified in 1952 by Dix and Hallpike. Subsequently, it has been established that the symptoms are attributable to detached otoconia in any of the semicircular canals. BPPV symptoms can resolve spontaneously but can last for days, weeks, months, and years. Unusual patterns of nystagmus and nonrepsonse to treatment may suggest central pathology. Diagnostic strategies and the simplest “office” treatment techniques are described. Future directions for research are discussed.

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Intractable Benign Paroxysmal Positioning Vertigo

Cited by 46 publications

References 13 publications

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam

Benign paroxysmal positional vertigo

Benign Paroxysmal Positional Vertigo (BPPV): History, Pathophysiology, Office Treatment and Future Directions

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