The clinical outcome of the patients with horizontal semicircular canal variants of benign paroxysmal positional vertigo

Abstract

Background

Gufoni maneuver is known to be effective for horizontal canal benign positional vertigo (HC-BPPV), but there are some intractable patients that the treatment procedure does not work.

Objective

The clinical outcomes of patients with HC-BPPV were investigated. We also investigated the characteristics of intractable patients which needed long time to the remission.

Methods

Sixty-six patients with HC-BPPV receiving Gufoni maneuver at Tokyo Medical University Hachioji Medical Center were investigated. The patients were classified into geotropic DCPN group and apogeotropic DCPN group. The clinical outcomes in 2 groups were examined.

Results

There were 48 patients with geotropic DCPN and 18 patients with apogeotropic DCPN. There were significant differences between the geotropic HC-BPPV and apogeotropic HC BPPV in the period to remission. There were 7 intractable patients and the average ages of these intractable patients were higher than other patients.

Conclusion

The patients with geotropic DCPN and the patients with the nystagmus conversion from apogeotropic to geotropic DCPN have tendency to easy to resolve, but in patients with apogeotropic type without nystagmus transformation have long time to resolve. The elderly patients whose nystagmus remains apogeotropic without nystagmus conversion have tendencies to become intractable.

Chinese Abstract

背景：已知 Gufoni 手法对水平耳道良性位置性眩晕（HC-BPPV）有效, 但有一些难治性患者, 这种治疗方法不起作用。

目的：调查 HC-BPPV 患者的临床结果。我们还调查了需长时间才能得以缓解的难治性患者的特点。

方法：对在东京医科大学的八王子医疗中心接受 Gufoni 手法的 66 名 HC-BPPV 患者进行了调查。患者被分为向地性 DCPN 组和背地性DCPN组。检查了2组的临床结果。

结果：向地性DCPN患者48例, 背地性DCPN患者18例。在缓解期间, 向地性HC-BPPV和背地性HC-BPPV之间存在显著差异。难治性患者7例, 其平均年龄高于其他患者。

结论：向地性 DCPN 患者以及从背地性至向地性DCPN眼球震颤转换的患者有易于治愈的趋势, 但对于无眼球震颤转化的向地性患者, 需较长时间才能消解。眼球震颤保持背地性而无眼球震颤转变的老年患者趋向于难以治疗。

Keywords:

• Otolith
• semicircular canal
• Gufoni maneuver
• geotropic
• apogeotropic

Acknowledgments

The authors are indebted to the medical editors of the Department of International Medical Communications of Tokyo Medical University for the editorial review of the English manuscript.

Ethical approval

This study was approved by the ethics committee of our facility (T2020-0007)

Disclosure statement

The authors of this article hereby declare not having any conflict of interest.