Tumarkin-like phenomenon as a sign of therapeutic success in benign paroxysmal positional vertigo

ABSTRACT

Objective: To describe an unusual patient reaction to maneuvers used in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV) that we termed the “Tumarkin-like phenomenon”.

Methods: At a private practice, 221 outpatients were diagnosed and treated for PC-BPPV. The treatment consisted of performing the Epley or Semont maneuvers. At the end of these maneuvers, when assuming the sitting position, the patients’ reactions were recorded.

Results: Thirty-three patients showed a Tumarkin-like phenomenon described by a self-reported sensation of suddenly being thrown to the ground. In the follow-up, this group of patients remained without PC-BPPV symptoms up to at least 72 hours after the maneuvers.

Conclusion: The occurrence of a Tumarkin-like phenomenon at the end of Epley and Semont maneuvers for PC-BPPV may be linked with treatment success.

RESUMO

Objetivo: Descrever uma reação incomum dos pacientes às manobras utilizadas no tratamento da vertigem posicional paroxística benigna do canal posterior (VPPB-CP), a qual denominamos de fençmeno Tumarkin-like.

Métodos: Em uma clínica privada, 221 pacientes ambulatoriais foram diagnosticados e tratados para VPPB-CP. O tratamento consistiu em realizar as manobras de Epley ou de Semont. Ao término da manobra, ao serem colocados na posição sentado, as reações dos pacientes foram filmadas.

Resultados: Trinta e três pacientes apresentaram o fençmeno de Tumarkin-like, descrito como uma sensação súbita de ser jogado no chão. O acompanhamento mostrou que todos eles permaneceram sem sintomas de VPPB até pelo menos 72 horas após as manobras.

Conclusão: A ocorrência do fençmeno Tumarkin-like no final das manobras de Epley e Semont para VPPB-CP pode estar associado ao sucesso terapêutico.

Keywords:

benign paroxysmal positional vertigo, posterior semicircular canal - canalithiasis - vestibulolithiasis - treatment

Palavras-chave:

vertigem posicional paroxística benigna - canal semicircular posterior - canalitíase - litíase vestibular - tratamento

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