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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

When the patient with horizontal canal BPPV is quickly brought from the sitting to the supine position, a mild horizontal nystagmus may appear, attributed either to ampullofugal movement of otoconia in the horizontal canal (geotropic type), triggering nystagmus toward the unaffected ear, or in cases of cupulolithiasis (apogeotropic type) to ampullopetal deflection of the cupula, resulting in nystagmus directed toward the affected ear.
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fig10: When the patient with horizontal canal BPPV is quickly brought from the sitting to the supine position, a mild horizontal nystagmus may appear, attributed either to ampullofugal movement of otoconia in the horizontal canal (geotropic type), triggering nystagmus toward the unaffected ear, or in cases of cupulolithiasis (apogeotropic type) to ampullopetal deflection of the cupula, resulting in nystagmus directed toward the affected ear.

Mentions: Another method is to examine the appearance of positional nystagmus by performing the head down test [32, 33], quickly bringing the patient from the sitting to the supine position, in the sagittal plane (Figure 10). Frequently, a mild horizontal nystagmus appears, attributed to the movement of debris in the horizontal canal, when canalolithiasis is the underlying pathology. This movement causes the debris to move ampullofugally, resulting in nystagmus towards the unaffected ear. In cases of cupulolithiasis, otoconial debris attached to the cupula causes ampullopetal movement, resulting in nystagmus directed towards the affected ear.


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)

When the patient with horizontal canal BPPV is quickly brought from the sitting to the supine position, a mild horizontal nystagmus may appear, attributed either to ampullofugal movement of otoconia in the horizontal canal (geotropic type), triggering nystagmus toward the unaffected ear, or in cases of cupulolithiasis (apogeotropic type) to ampullopetal deflection of the cupula, resulting in nystagmus directed toward the affected ear.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3139887&req=5

fig10: When the patient with horizontal canal BPPV is quickly brought from the sitting to the supine position, a mild horizontal nystagmus may appear, attributed either to ampullofugal movement of otoconia in the horizontal canal (geotropic type), triggering nystagmus toward the unaffected ear, or in cases of cupulolithiasis (apogeotropic type) to ampullopetal deflection of the cupula, resulting in nystagmus directed toward the affected ear.
Mentions: Another method is to examine the appearance of positional nystagmus by performing the head down test [32, 33], quickly bringing the patient from the sitting to the supine position, in the sagittal plane (Figure 10). Frequently, a mild horizontal nystagmus appears, attributed to the movement of debris in the horizontal canal, when canalolithiasis is the underlying pathology. This movement causes the debris to move ampullofugally, resulting in nystagmus towards the unaffected ear. In cases of cupulolithiasis, otoconial debris attached to the cupula causes ampullopetal movement, resulting in nystagmus directed towards the affected ear.

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