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Sitting Up Vertigo. Proposed Variant of Posterior Canal Benign Paroxysmal Positional Vertigo.

Identifieur interne : 000051 ( Main/Corpus ); précédent : 000050; suivant : 000052

Sitting Up Vertigo. Proposed Variant of Posterior Canal Benign Paroxysmal Positional Vertigo.

Auteurs : Darío H. Scocco ; Iván E. García ; María A. Barreiro

Source :

RBID : pubmed:30870365

English descriptors

Abstract

OBJECTIVE

To describe a variant of posterior canal benign paroxysmal positional vertigo (BPPV).

STUDY DESIGN

Retrospective case review.

SETTING

Tertiary referral center.

PATIENTS

Fifteen patients with symptoms of BPPV and oculomotor evidence of activation of posterior semicircular canal (P-SCC) cupula that arises when sitting up from Dix-Hallpike maneuver (DH).

INTERVENTION

All patients were examined with videonystagmography and underwent brain magnetic resonance imaging (MRI).

RESULTS

All patients showed up-beating nystagmus with ipsilateral torsional component when coming up from right or left side DH. Most patients described vertiginous symptoms when sitting up from bed and many described severe non-positional disequilibrium. Eight patients had been treated with Epley canalith repositioning maneuver (CRM) at our clinic for posterior canal BPPV. Four of them were re-tested within an hour for CRM effectiveness and the rest, a week later. Three patients had been diagnosed with BPPV and were being treated with CRM in other institutions. Four patients showed these findings but they had not previously undergone CRM. All patients were treated with CRM without success, but they resolved their positional vertigo by means of Brandt Daroff exercises. No patient showed evidence of central vestibular disorder.

CONCLUSION

We propose a P-SCC canalolithiasis limited to the periampullar portion by means of an anatomical restriction of distal movement of the otoconial debris. This syndrome seems to be more frequent early after CRM of classical P-SCC canalolithiasis. Close attention to ocular movement on sitting up after DH on patients is warranted.


DOI: 10.1097/MAO.0000000000002157
PubMed: 30870365

Links to Exploration step

pubmed:30870365

Le document en format XML

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<title xml:lang="en">Sitting Up Vertigo. Proposed Variant of Posterior Canal Benign Paroxysmal Positional Vertigo.</title>
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<name sortKey="Scocco, Dario H" sort="Scocco, Dario H" uniqKey="Scocco D" first="Darío H" last="Scocco">Darío H. Scocco</name>
<affiliation>
<nlm:affiliation>Institute of Neuroscience, Favaloro Foundation University Hospital, Buenos Aires, Argentina.</nlm:affiliation>
</affiliation>
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<author>
<name sortKey="Garcia, Ivan E" sort="Garcia, Ivan E" uniqKey="Garcia I" first="Iván E" last="García">Iván E. García</name>
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<name sortKey="Barreiro, Maria A" sort="Barreiro, Maria A" uniqKey="Barreiro M" first="María A" last="Barreiro">María A. Barreiro</name>
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<term>Adult (MeSH)</term>
<term>Benign Paroxysmal Positional Vertigo (physiopathology)</term>
<term>Benign Paroxysmal Positional Vertigo (therapy)</term>
<term>Eye Movements (physiology)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Nystagmus, Pathologic (diagnosis)</term>
<term>Nystagmus, Pathologic (physiopathology)</term>
<term>Otolithic Membrane (pathology)</term>
<term>Physical Examination (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Semicircular Canals (pathology)</term>
<term>Sitting Position (MeSH)</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Nystagmus, Pathologic</term>
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<term>Otolithic Membrane</term>
<term>Semicircular Canals</term>
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<term>Eye Movements</term>
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<term>Benign Paroxysmal Positional Vertigo</term>
<term>Nystagmus, Pathologic</term>
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<term>Benign Paroxysmal Positional Vertigo</term>
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<term>Adult</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Physical Examination</term>
<term>Retrospective Studies</term>
<term>Sitting Position</term>
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<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>To describe a variant of posterior canal benign paroxysmal positional vertigo (BPPV).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>STUDY DESIGN</b>
</p>
<p>Retrospective case review.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SETTING</b>
</p>
<p>Tertiary referral center.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PATIENTS</b>
</p>
<p>Fifteen patients with symptoms of BPPV and oculomotor evidence of activation of posterior semicircular canal (P-SCC) cupula that arises when sitting up from Dix-Hallpike maneuver (DH).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>INTERVENTION</b>
</p>
<p>All patients were examined with videonystagmography and underwent brain magnetic resonance imaging (MRI).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>All patients showed up-beating nystagmus with ipsilateral torsional component when coming up from right or left side DH. Most patients described vertiginous symptoms when sitting up from bed and many described severe non-positional disequilibrium. Eight patients had been treated with Epley canalith repositioning maneuver (CRM) at our clinic for posterior canal BPPV. Four of them were re-tested within an hour for CRM effectiveness and the rest, a week later. Three patients had been diagnosed with BPPV and were being treated with CRM in other institutions. Four patients showed these findings but they had not previously undergone CRM. All patients were treated with CRM without success, but they resolved their positional vertigo by means of Brandt Daroff exercises. No patient showed evidence of central vestibular disorder.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>We propose a P-SCC canalolithiasis limited to the periampullar portion by means of an anatomical restriction of distal movement of the otoconial debris. This syndrome seems to be more frequent early after CRM of classical P-SCC canalolithiasis. Close attention to ocular movement on sitting up after DH on patients is warranted.</p>
</div>
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<AbstractText Label="STUDY DESIGN">Retrospective case review.</AbstractText>
<AbstractText Label="SETTING">Tertiary referral center.</AbstractText>
<AbstractText Label="PATIENTS">Fifteen patients with symptoms of BPPV and oculomotor evidence of activation of posterior semicircular canal (P-SCC) cupula that arises when sitting up from Dix-Hallpike maneuver (DH).</AbstractText>
<AbstractText Label="INTERVENTION">All patients were examined with videonystagmography and underwent brain magnetic resonance imaging (MRI).</AbstractText>
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<AbstractText Label="CONCLUSION">We propose a P-SCC canalolithiasis limited to the periampullar portion by means of an anatomical restriction of distal movement of the otoconial debris. This syndrome seems to be more frequent early after CRM of classical P-SCC canalolithiasis. Close attention to ocular movement on sitting up after DH on patients is warranted.</AbstractText>
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