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Diagnosis of Single- or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus.

Balatsouras DG, Koukoutsis G, Ganelis P, Korres GS, Kaberos A - Int J Otolaryngol (2011)

Bottom Line: Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics.It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test.Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers.

View Article: PubMed Central - PubMed

Affiliation: ENT Department, Tzanio General Hospital of Piraeus, Afentouli 1 and Zanni, 18536 Piraeus, Greece.

ABSTRACT
Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis.

No MeSH data available.


Related in: MedlinePlus

Mechanism of canalolithiasis of bilateral geotropic horizontal canal BPPV (the involved horizontal canal sare colored black). (a) Patient in supine position with debris in the posterior part of both horizontal canals. (b) Supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow. Vectorial summation would result in an intense, symmetric geotropic nystagmus.
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fig7: Mechanism of canalolithiasis of bilateral geotropic horizontal canal BPPV (the involved horizontal canal sare colored black). (a) Patient in supine position with debris in the posterior part of both horizontal canals. (b) Supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow. Vectorial summation would result in an intense, symmetric geotropic nystagmus.

Mentions: In a theoretical case of bilateral horizontal BPPV with geotropic nystagmus, supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow (Figure 7). Vectorial summation would result in an intense, symmetric geotropic nystagmus.


Diagnosis of Single- or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus.

Balatsouras DG, Koukoutsis G, Ganelis P, Korres GS, Kaberos A - Int J Otolaryngol (2011)

Mechanism of canalolithiasis of bilateral geotropic horizontal canal BPPV (the involved horizontal canal sare colored black). (a) Patient in supine position with debris in the posterior part of both horizontal canals. (b) Supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow. Vectorial summation would result in an intense, symmetric geotropic nystagmus.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3139887&req=5

fig7: Mechanism of canalolithiasis of bilateral geotropic horizontal canal BPPV (the involved horizontal canal sare colored black). (a) Patient in supine position with debris in the posterior part of both horizontal canals. (b) Supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow. Vectorial summation would result in an intense, symmetric geotropic nystagmus.
Mentions: In a theoretical case of bilateral horizontal BPPV with geotropic nystagmus, supine roll test on either side would result in excitation of the horizontal canal of the lowermost ear, due to ampullopetal endolymph flow and at the same time inhibition of the horizontal canal of the uppermost ear, due to ampullofugal endolymph flow (Figure 7). Vectorial summation would result in an intense, symmetric geotropic nystagmus.

Bottom Line: Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics.It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test.Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers.

View Article: PubMed Central - PubMed

Affiliation: ENT Department, Tzanio General Hospital of Piraeus, Afentouli 1 and Zanni, 18536 Piraeus, Greece.

ABSTRACT
Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis.

No MeSH data available.


Related in: MedlinePlus