[Management of bilateral benign paroxysmal positional vertigo with Dix-Hallpike test].
Identifieur interne : 000168 ( Main/Corpus ); précédent : 000167; suivant : 000169[Management of bilateral benign paroxysmal positional vertigo with Dix-Hallpike test].
Auteurs : Fei Zhao ; Jianhua Zhuang ; Xuewei Xie ; Zhe Jin ; Ying Chen ; Zhongxin ZhaoSource :
- Zhonghua nei ke za zhi [ 0578-1426 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
Abstract
OBJECTIVE
To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral positive Dix-Hallpike test.
METHODS
This is a retrospective study based on the clinical data of BPPV patients diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012. Totally 490 patients with vertigo and nystagmus provoked by Dix-Hallpike maneuver were included in the present analysis.
RESULTS
Among all the patients, 55 (11.2%) of them presented with bilateral nystagmus by the provocative test. According to the type of nystagmus provoked by Dix-Hallpike maneuver, the 55 patients can be divided into the following four categories. (1) Bilateral geotropic (n = 16) and apogeotropic nystagmus (n = 5): all these patients were diagnosed with horizontal canal BPPV and free of vertigo after head side-shaking exercise in supine position and Barbecue maneuver. (2) Bilateral predominant down-beating nystagmus (n = 2): patients in this group were diagnosed with anterior canal BPPV, and got recovered after Kim maneuver. (3) Bilateral torsional up-beating geotropic nystagmus (n = 20): after a lying-down test, 6 of the patients manifested as vertical up-beating nystagmus and 14 patients remained torsional up-beating nystagmus. The former were diagnosed with bilateral posterior canal BPPV, and were cured after bilateral PRM therapy, and the latter were diagnosed with horizontal canal BPPV, who were cured after Barbecue maneuver. (4) Torsional up-beating geotropic nystagmus on one side and down-beating nystagmus on the other side (n = 12). The down-beating nystagmus on the other side disappeared when the patients was firstly seated up with head down in 30 degrees for half an hour before second Dix-Hallpike maneuver. These patients were diagnosed with unilateral posterior canal BPPV and cured by PRM therapy.
CONCLUSIONS
It is common for vertigo patients with bilateral nystagmus induced by Dix-Hallpike test. The diagnoses should be made by the types of nystagmus provoked step by step before maneuver therapy.
PubMed: 25567145
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<author><name sortKey="Zhao, Fei" sort="Zhao, Fei" uniqKey="Zhao F" first="Fei" last="Zhao">Fei Zhao</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zhuang, Jianhua" sort="Zhuang, Jianhua" uniqKey="Zhuang J" first="Jianhua" last="Zhuang">Jianhua Zhuang</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China. Email: jianhuazh11@126.com.</nlm:affiliation>
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<author><name sortKey="Xie, Xuewei" sort="Xie, Xuewei" uniqKey="Xie X" first="Xuewei" last="Xie">Xuewei Xie</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Jin, Zhe" sort="Jin, Zhe" uniqKey="Jin Z" first="Zhe" last="Jin">Zhe Jin</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Chen, Ying" sort="Chen, Ying" uniqKey="Chen Y" first="Ying" last="Chen">Ying Chen</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Zhao, Zhongxin" sort="Zhao, Zhongxin" uniqKey="Zhao Z" first="Zhongxin" last="Zhao">Zhongxin Zhao</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">[Management of bilateral benign paroxysmal positional vertigo with Dix-Hallpike test].</title>
<author><name sortKey="Zhao, Fei" sort="Zhao, Fei" uniqKey="Zhao F" first="Fei" last="Zhao">Fei Zhao</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Zhuang, Jianhua" sort="Zhuang, Jianhua" uniqKey="Zhuang J" first="Jianhua" last="Zhuang">Jianhua Zhuang</name>
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<author><name sortKey="Xie, Xuewei" sort="Xie, Xuewei" uniqKey="Xie X" first="Xuewei" last="Xie">Xuewei Xie</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Jin, Zhe" sort="Jin, Zhe" uniqKey="Jin Z" first="Zhe" last="Jin">Zhe Jin</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Chen, Ying" sort="Chen, Ying" uniqKey="Chen Y" first="Ying" last="Chen">Ying Chen</name>
<affiliation><nlm:affiliation>Department of Neurology, Changzheng Hospital, Second Military Medical University; Dizziness Diagnosis and Treatment Centre, Second Military Medical University, Shanghai 200003, China.</nlm:affiliation>
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<author><name sortKey="Zhao, Zhongxin" sort="Zhao, Zhongxin" uniqKey="Zhao Z" first="Zhongxin" last="Zhao">Zhongxin Zhao</name>
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<series><title level="j">Zhonghua nei ke za zhi</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo (diagnosis)</term>
<term>Exercise (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Physical Examination (MeSH)</term>
<term>Posture (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Semicircular Canals (MeSH)</term>
<term>Vertigo (MeSH)</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Exercise</term>
<term>Humans</term>
<term>Physical Examination</term>
<term>Posture</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral positive Dix-Hallpike test.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>This is a retrospective study based on the clinical data of BPPV patients diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012. Totally 490 patients with vertigo and nystagmus provoked by Dix-Hallpike maneuver were included in the present analysis.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Among all the patients, 55 (11.2%) of them presented with bilateral nystagmus by the provocative test. According to the type of nystagmus provoked by Dix-Hallpike maneuver, the 55 patients can be divided into the following four categories. (1) Bilateral geotropic (n = 16) and apogeotropic nystagmus (n = 5): all these patients were diagnosed with horizontal canal BPPV and free of vertigo after head side-shaking exercise in supine position and Barbecue maneuver. (2) Bilateral predominant down-beating nystagmus (n = 2): patients in this group were diagnosed with anterior canal BPPV, and got recovered after Kim maneuver. (3) Bilateral torsional up-beating geotropic nystagmus (n = 20): after a lying-down test, 6 of the patients manifested as vertical up-beating nystagmus and 14 patients remained torsional up-beating nystagmus. The former were diagnosed with bilateral posterior canal BPPV, and were cured after bilateral PRM therapy, and the latter were diagnosed with horizontal canal BPPV, who were cured after Barbecue maneuver. (4) Torsional up-beating geotropic nystagmus on one side and down-beating nystagmus on the other side (n = 12). The down-beating nystagmus on the other side disappeared when the patients was firstly seated up with head down in 30 degrees for half an hour before second Dix-Hallpike maneuver. These patients were diagnosed with unilateral posterior canal BPPV and cured by PRM therapy.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>It is common for vertigo patients with bilateral nystagmus induced by Dix-Hallpike test. The diagnoses should be made by the types of nystagmus provoked step by step before maneuver therapy.</p>
</div>
</front>
</TEI>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) with bilateral positive Dix-Hallpike test.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">This is a retrospective study based on the clinical data of BPPV patients diagnosed in the Dizziness Clinic of Changzheng Hospital from January 2012 to December 2012. Totally 490 patients with vertigo and nystagmus provoked by Dix-Hallpike maneuver were included in the present analysis.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Among all the patients, 55 (11.2%) of them presented with bilateral nystagmus by the provocative test. According to the type of nystagmus provoked by Dix-Hallpike maneuver, the 55 patients can be divided into the following four categories. (1) Bilateral geotropic (n = 16) and apogeotropic nystagmus (n = 5): all these patients were diagnosed with horizontal canal BPPV and free of vertigo after head side-shaking exercise in supine position and Barbecue maneuver. (2) Bilateral predominant down-beating nystagmus (n = 2): patients in this group were diagnosed with anterior canal BPPV, and got recovered after Kim maneuver. (3) Bilateral torsional up-beating geotropic nystagmus (n = 20): after a lying-down test, 6 of the patients manifested as vertical up-beating nystagmus and 14 patients remained torsional up-beating nystagmus. The former were diagnosed with bilateral posterior canal BPPV, and were cured after bilateral PRM therapy, and the latter were diagnosed with horizontal canal BPPV, who were cured after Barbecue maneuver. (4) Torsional up-beating geotropic nystagmus on one side and down-beating nystagmus on the other side (n = 12). The down-beating nystagmus on the other side disappeared when the patients was firstly seated up with head down in 30 degrees for half an hour before second Dix-Hallpike maneuver. These patients were diagnosed with unilateral posterior canal BPPV and cured by PRM therapy.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">It is common for vertigo patients with bilateral nystagmus induced by Dix-Hallpike test. The diagnoses should be made by the types of nystagmus provoked step by step before maneuver therapy.</AbstractText>
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