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V Marcelli
The objective was to evaluate nystagmus intensity and direction (NID) during bow and lean test (BLT) in subjects suffering from idiopathic lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV), in order to differentiate between the geotropic and the apogeotropic form and to determine the affected ear before using classic diagnostic procedures. The BLT was performed in 32 subjects affected by LSC-BPPV. "Nystagmus intensity" evaluation allows distinguishing the geotropic variant from the apogeotropic one, while the "nystagmus direction" allows identification of the side...
December 2016: Acta Otorhinolaryngologica Italica
Francisco Zuma e Maia
The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to canalithiasis of the anterior arm or cupulolithiasis. Despite some therapeutic maneuvers, I propose a new treatment strategy for apogeotropic HC-BPPV that is designed to detach both the otoconial debris from the anterior arm of the semicircular canal and the debris that is attached to the utricular side of the cupula using inertia and gravity and based on simulations with a 3D biomechanical model...
August 23, 2016: Audiology Research
Masanori Yatomi, Yasuo Ogawa, Mamoru Suzuki, Koji Otsuka, Taro Inagaki, Ujimoto Konomi, Kiyoaki Tsukahara
CONCLUSIONS: The co-existence of cupulolithiasis and canalolithiasis might be a possible mechanism for the spontaneous inversion of positional nystagmus. OBJECTIVE: To investigate the mechanism of spontaneous inversion of nystagmus direction without a positional change in experimental models of co-existing cupulolithiasis and canalolithiasis. METHODS: Co-existing canalolithiasis and cupulolithiasis models were prepared using the bullfrog posterior semicircular canal (PSC)...
January 2017: Acta Oto-laryngologica
Tomoko Okumura, Takao Imai, Kayoko Higashi-Shingai, Yumi Ohta, Tetsuo Morihana, Takashi Sato, Suzuyo Okazaki, Yoriko Iwamoto, Yukiko Hanada, Yoshiyuki Ozono, Ryusuke Imai, Kazuya Ohata, Hidenori Inohara
INTRODUCTION: A pathological nystagmus is an objective sign that a patient feels vertigo. However, there have been few opportunities to observe and record pathological nystagmus during a paroxysmal vertigo attack. Furthermore, it can be difficult to obtain cooperation in pediatric patients. We present two cases of paroxysmal vertigo in children in whom we successfully recorded and analyzed their pathological nystagmus during a vertigo attack. METHODS: Of a total sample of 4349 patients seen at our hospital for dizziness in the last decade, a retrospective analysis revealed that 68 were children (<15 years old; 1...
September 2016: International Journal of Pediatric Otorhinolaryngology
Takao Imai, Noriaki Takeda, Tetsuo Ikezono, Kohichiro Shigeno, Masatsugu Asai, Yukio Watanabe, Mamoru Suzuki
Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test...
February 2017: Auris, Nasus, Larynx
Jung Eun Shin, Kyung-Hwa Jeong, Sung Hwan Ahn, Chang-Hee Kim
OBJECTIVE: To demonstrate positional nystagmus during a head-roll test in two patients with lateral semicircular canal (LSCC) cupulolithiasis who presented with spontaneous detachment of otoliths from the LSCC cupula, and to confirm that otoliths may adhere to both the utricle and canal sides of the cupula. PATIENTS AND METHODS: Using video nystagmography, positional nystagmus was evaluated in two patients with LSCC cupulolithiasis who showed the change of nystagmus direction during a head-roll test...
April 2017: Auris, Nasus, Larynx
Toru Seo, Ko Shiraishi, Takaaki Kobayashi, Kitano Mutsukazu, Katsumi Doi
CONCLUSION: A short clinical course and frequent recurrence are common features of persistent geotropic direction-changing positional nystagmus with neutral position (positional nystagmus of light cupula: PNLC) and cupulolithiasis of the lateral semicircular canal. It is suggested that PNLC is caused by light debris attached to the cupula of the lateral semicircular canal. OBJECTIVES: PNLC is a sub-type of direction-changing positional nystagmus. It is thought to be caused by anti-gravitational deviation of the cupula of the lateral semicircular canal (light cupula); however, the exact mechanism is yet to be elucidated...
2016: Acta Oto-laryngologica
Eliana Teixeira Maranhão, Péricles Maranhão Filho
Benign paroxysmal positional vertigo (BPPV), the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form...
June 2015: Arquivos de Neuro-psiquiatria
Shiping Sun, Huizhong Wang, Weiguo Wang, Rongjun Man, Xia Zheng
OBJECTIVE: By analysing the video-nystagmography findings of positional tests,to evaluate the therapeutic effect of the patients with horikontal semicircular canal cupulolithiasis (HSC-Cup). METHOD: A retrospective study of 36 patients with HSC-Cup. The induced nystagmus in roll tests was recorded by videonystagmography, whose direction, latency, intensity and time characteristics were analysed. All of the 36 patients were treated with lying position avoiding normal side and oral-taken betahistine mesilate tablets...
January 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Niels West, Søren Hansen, Martin Nue Møller, Sune Land Bloch, Mads Klokker
The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo referred to our clinic within a 10-month period. The BPPV patients were managed with classical manual manoeuvres, the Epley Omniax(®) rotator (EO) or the TRV chair (TRV). In addition, a comprehensive review of the literature was performed...
March 2016: European Archives of Oto-rhino-laryngology
S Yetiser, D Ince
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular problem. However, demographic analysis is few. AIM: The aim of this study was to document the demographic data of patients with BPPV regarding distribution of gender, age, associated problems, most common form, symptom duration, severity of nystagmus and cure rate. SUBJECTS AND METHODS: A total of 263 patients with video-nystagmography confirmed BPPV were enrolled in this retrospective study (2009-2013)...
January 2015: Annals of Medical and Health Sciences Research
Li-Chen Chu, Cheng-Chien Yang, Hsen-Tien Tsai, Hung-Ching Lin
OBJECTIVE: Horizontal benign paroxysmal positional vertigo (H-BPPV) is more difficult to successfully treat than posterior benign paroxysmal positional vertigo (P-BPPV) because of the diverse mechanisms required. We developed a simple, rapid, and effective treatment algorithm for treating all subtypes of H-BPPV in an ear, nose, and throat (ENT) outpatient department. MATERIALS AND METHODS: Four hundred ninety patients with BPPV receiving outpatient treatment at Mackay Memorial Hospital were investigated...
October 2014: Otology & Neurotology
Chao Wen, Taisheng Chen, Feiyun Chen, Qiang Liu, Shanshan Li, Yan Cheng, Peng Lin
OBJECTIVE: To investigate the clinical significances and formation mechanism by analyzing the characteristics of the reverse phase nystagmus parameters from benign paroxysmal positional vertigo (BPPV) positioning test. METHODS: There were 183 cases with BPPV, including 108 cases (59.0%) of posterior semicircular canal canalithiasis, 55 cases (30.1%) of horizontal semicircular canal canalithiasis, and 15 cases (8.2%) of horizontal and posterior semicircular canal cupulolithiasis and 5 cases (2...
May 2014: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Corinna Lechner, Rachael L Taylor, Chris Todd, Hamish Macdougall, Robbie Yavor, G Michael Halmagyi, Miriam S Welgampola
Direction changing horizontal positional nystagmus can be observed in a variety of central and peripheral vestibular disorders. We tested sixty subjects with horizontal positional nystagmus and vertigo on the Epley Omniax(®) rotator. Monocular video recordings were performed with the right or left ear down, in the supine and prone positions. Nystagmus slow-phase velocity (SPV) was plotted as a function of time. Thirty-one subjects diagnosed with horizontal canalolithiasis had paroxysmal horizontal geotropic nystagmus with the affected ear down (onset 0...
May 2014: Journal of Neurology
Toshiaki Yamanaka, Yachiyo Sawai, Takayuki Murai, Hideyuki Okamoto, Nobuya Fujita, Hiroshi Hosoi
This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period...
December 2014: European Archives of Oto-rhino-laryngology
Fei-yun Chen, Tai-sheng Chen, Chao Wen, Shan-shan Li, Peng Lin, Hui Zhao, Qiang Liu
OBJECTIVE: To discuss the objective characteristics and mechanism of nystagmus direction, intensity and time in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) . METHODS: A total of 233 patients with HSC-BPPV, whereas 179 horizontal semicircular canalithasis (HSC-Can) and 54 horizontal semicircular cupulolithiasis (HSC-Cup) were involved respectively. The induced nystagmus in roll tests recorded by video-nystagmograph(VNG) , whose direction, intensity and time characteristics were compared in various BPPV...
August 2013: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Sun K Lee, Su J Kim, Moon S Park, Jae Y Byun
OBJECTIVES/HYPOTHESIS: The clinical features and treatment outcomes of benign paroxysmal positional vertigo (BPPV) are known to be different depending on the type of and involved canal. This difference could be due to differences in the functional change of the otolith organ. STUDY DESIGN: Case series. METHODS: Forty-nine patients were diagnosed to primary BPPV; 18 were categorized as posterior canal canalolithiasis (PC canalolithiasis), and 31 were categorized as horizontal canal (HC) BPPV with canalolithiasis or cupulolithiasis (HC canalolithiasis or HC cupulolithiasis)...
April 2014: Laryngoscope
K Otsuka, Y Ogawa, T Inagaki, S Shimizu, U Konomi, T Kondo, M Suzuki
OBJECTIVE: To examine the clinical features, age and gender distribution of patients, treatment methods, and outcomes of benign paroxysmal positional vertigo. METHODS: This paper reports a review of 357 patients treated for this condition at a single institution over a duration of 5 years. Patients with posterior canal benign paroxysmal positional vertigo were divided into two groups: one group underwent the Epley manoeuvre and the other received medication. The lateral canal canalolithiasis patients were also divided into two groups: one underwent the Lempert manoeuvre and the other received medication...
October 2013: Journal of Laryngology and Otology
L Califano, A Vassallo, M G Melillo, S Mazzone, F Salafia
Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position)...
August 2013: Acta Otorhinolaryngologica Italica
Rachael L Taylor, Luke Chen, Corinna Lechner, Swee T Aw, Miriam S Welgampola
Positional vertigo and nystagmus can be due to canalithiasis, cupulolithiasis and less commonly, an underlying peripheral or central vestibular disorder. We present a patient with vestibular schwannoma who initially sought treatment for positioning vertigo. Video-oculography on the roll-test revealed direction-changing horizontal apogeotropic nystagmus, consistent with horizontal cupulolithiasis. However, further audio-vestibular investigations and imaging confirmed a right vestibulopathy attributable to a schwannoma of the right vestibular nerve...
August 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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