Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

• Published in: Arquivos de neuro-psiquiatria Vol. 73; no. 6; pp. 487 - 492
• Main Authors: Maranhao, Eliana Teixeira, Maranhao Filho, Pericles
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01.06.2015; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Adult; Aged; Aged, 80 and over; Benign Paroxysmal Positional Vertigo - diagnosis; Benign Paroxysmal Positional Vertigo - physiopathology; Benign Paroxysmal Positional Vertigo - therapy; canal horizontal; Exercise Therapy - methods; Female; Head Movements - physiology; Humans; Male; manobras de reposição canalicular; Middle Aged; NEUROSCIENCES; nistagmo; Nystagmus, Pathologic - physiopathology; Nystagmus, Pathologic - therapy; Patient Positioning - methods; PSYCHIATRY; Semicircular Canals - physiopathology; Supine Position - physiology; Time Factors; tonteira; Treatment Outcome; vertigem posicional paroxística; dizziness; canalith-repositioning maneuvers; canal horizontal; benign paroxysmal positional vertigo; nystagmus; horizontal canal; tonteira; nistagmo; manobras de reposição canalicular; vertigem posicional paroxística
• ISSN: 0004-282X; 1678-4227; 1678-4227; 0004-282X
• DOI: 10.1590/0004-282X20150040

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. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%), the barbecue 360° maneuver in twelve patients (32.4%), both manoeuvers in four patients (10.8%), both manoeuvers plus head shaking in one patient (2.7%), and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0%) on the initial visit.