CC BY-NC-ND 4.0 · Annals of Otology and Neurotology 2020; 3(02): 061-071
DOI: 10.1055/s-0040-1715533
Original Article

The Clinical Spectrum of Patients of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo Attending an Otoneurology Center in South Rajasthan, India and Their Response to Appropriate Repositioning Maneuvers at a Short-Term Follow-Up

Ajay Kumar Vats
1   Division of Medicine, Department of Neurology, Chaudhary Hospital and Medical Research Centre Private Limited, Udaipur, Rajasthan, India
› Author Affiliations

Abstract

Introduction This article aims to study the clinical spectrum of 20 consecutive patients diagnosed with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) attending an otoneurology center in Udaipur, Rajasthan, India, over a period of 11 months and their response to appropriate repositioning maneuvers evaluated at short-term follow-up of 1 hour and 24 hours.

Study Design This is a nonrandomized prospective interventional study.

Materials and Methods Twenty patients with unilateral HSC-BPPV were treated with a session of an appropriate repositioning maneuver (Gufoni maneuver or barbecue roll maneuver for the geotropic variant of HSC-BPPV [geo-HSC-BPPV]; Appiani maneuver or barbecue roll maneuver or head-shaking maneuver for the apogeotropic variant of the HSC-BPPV [apo-HSC-BPPV]). Patients were followed up twice (at 1 hour and 24 hours) and audited by a supine roll test with questioning for the absence or presence of concomitant vertigo.

Results At the 1-hour follow-up, 78.57% (11/14) patients of geo-HSC-BPPV treated with Gufoni maneuver recovered, and 66.67% (4/6) patients of apo-HSC-BPPV treated with some form of physical therapy recovered. The recovery was maintained at 24 hours’ follow-up in both groups.

Conclusion To the best of the author’s knowledge, no such study on patients of HSC-BPPV has been reported from India hitherto. Gufoni maneuver is an effective and safe treatment for the geo-HSC-BPPV with a recovery rate of 78.57% (11/14) at a short-term follow-up. The physical therapy for the apo-HSC-BPPV must be tailored according to the purported site of pathology which cannot be precisely predetermined most of the times.



Publication History

Article published online:
23 August 2020

© 2020. Indian Society of Otology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Ewald JR. Physiologische Untersuchungen Ueber das Endorgan de Nervus Octavus. Wiesbaden, Germany: Bergmann JF Publishers; 1892
  • 2 De la Meilleure G, Dehaene I, Depondt M, Damman W, Crevits L, Vanhooren G. BPPV of the horizontal canal. J Neurol Neurosurg Psychiatry 1996; 60 (01) 68-71
  • 3 Honrubia V, Baloh RW, Harris MR, Jacobson KM. Paroxysmal positional vertigo syndrome. Am J Otol 1999; 20 (04) 465-470
  • 4 Macias JD, Lambert KM, Massingale S, Ellensohn A, Fritz JA. Variables affecting treatment in BPPV. Laryngoscope 2000; 110 (11) 1921-1924
  • 5 Korres S, Balatsouras DG, Kaberos A, Economou C, Kandiloros D, Ferekidis E. Occurrence of semicircular canal involvement in BPPV. Otol Neurotol 2002; 23 (06) 926-932
  • 6 Sakaida M, Takeuchi K, Ishinaga H, Adachi M, Majima Y. Long-term outcome of BPPV. Neurology 2003; 60 (09) 1532-1534
  • 7 Imai T, Ito M, Takeda N. et al. Natural course of the remission of vertigo in patients with BPPV. Neurology 2005; 64 (05) 920-921
  • 8 Nakayama M, Epley JM. BPPV and variants: improved treatment results with automated, nystagmus-based repositioning. Otolaryngol Head Neck Surg 2005; 133 (01) 107-112
  • 9 Cakir BO, Ercan I, Cakir ZA, Civelek S, Sayin I, Turgut S. What is the true incidence of horizontal semicircular canal BPPV. Otolaryngol Head Neck Surg 2006; 134 (03) 451-454
  • 10 Moon SY, Kim JS, Kim BK. et al. Clinical characteristics of BPPV in Korea: a multicenter study. J Korean Med Sci 2006; 21 (03) 539-543
  • 11 Jackson LE, Morgan B, Fletcher JC, Krueger WW. Anterior canal BPPV: an underappreciated entity. Otol Neurotol 2007; 28 (02) 218-222
  • 12 Chung KW, Park KN, Ko MH. et al. Incidence of horizontal canal BPPV as a function of the duration of symptoms. Otol Neurotol 2009; 30 (02) 202-205
  • 13 Bruintjes TD, Masius-Olthof S, Kingma H. Benign paroxysmal positional vertigo of the horizontal canal. Clin Otorhinolaryngol 2017; 1: 1-7
  • 14 Pagnini P, Nuti D, Vannucchi P. Benign paroxysmal vertigo of the horizontal canal. ORL J Otorhinolaryngol Relat Spec 1989; 51 (03) 161-170
  • 15 Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003; 169 (07) 681-693
  • 16 Lee SH, Kim JS. Benign paroxysmal positional vertigo. J Clin Neurol 2010; 6 (02) 51-63
  • 17 Ciniglio Appiani G, Catania G, Gagliardi M. A liberatory maneuver for the treatment of horizontal canal paroxysmal positional vertigo. Otol Neurotol 2001; 22 (01) 66-69
  • 18 Ciniglio Appiani G, Catania G, Gagliardi M, Cuiuli G. Repositioning maneuver for the treatment of the apogeotropic variant of horizontal canal benign paroxysmal positional vertigo. Otol Neurotol 2005; 26 (02) 257-260
  • 19 Tusa RJ. Vertigo. Neurol Clin 2001; 19 (01) 23-55
  • 20 Kim JS, Oh SY, Lee SH. et al. Randomized clinical trial for apogeotropic horizontal canal benign paroxysmal positional vertigo. Neurology 2012; 78 (03) 159-166
  • 21 Han BI, Oh HJ, Kim JS. Nystagmus while recumbent in horizontal canal benign paroxysmal positional vertigo. Neurology 2006; 66 (05) 706-710
  • 22 Nuti D, Vannucchi P, Pagnini P. Benign paroxysmal positional vertigo of the horizontal canal: a form of canalolithiasis with variable clinical features. J Vestib Res 1996; 6 (03) 173-184
  • 23 Casani AP, Vannucci G, Fattori B, Berrettini S. The treatment of horizontal canal positional vertigo: our experience in 66 cases. Laryngoscope 2002; 112 (01) 172-178
  • 24 Asprella Libonati G. Diagnostic and treatment strategy of lateral semicircular canal canalolithiasis. Acta Otorhinolaryngol Ital 2005; 25 (05) 277-283
  • 25 Vannucchi P, Asprella Libonati G, Gufoni M. The physical treatment of lateral semicircular canal canalolithiasis. Audiol Med 2005; 3: 52-56
  • 26 von Brevern M, Bertholon P, Brandt T. et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 2015; 25 (3-4) 105-117
  • 27 Mandalà M, Pepponi E, Santoro GP. et al. Double-blind randomized trial on the efficacy of the Gufoni maneuver for treatment of lateral canal BPPV. Laryngoscope 2013; 123 (07) 1782-1786