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Original Article

Differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV)

Diferenciación entre el vértigo postural migrañoso (MPV) y el vértigo postural paroxístico benigno del canal horizontal (HC-BPPV)

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Pages 224-226 | Published online: 26 Aug 2009
 

Abstract

This article presents an approach to differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Such an approach is essential because of the difference in intervention between the two disorders in question. Results from evaluation of the case study presented here revealed a persistent ageotropic positional nystagmus consistent with MPV or a cupulolithiasis variant of HC-BPPV. The patient was treated with liberatory maneuvers to remove possible otoconial debris from the horizontal canal in an attempt, in turn, to provide further diagnostic information. There was no change in symptoms following treatment for HC-BPPV. This case was diagnosed subsequently as MPV, and the patient was referred for medical intervention. Treatment has been successful for 22 months. Incorporation of HC-BPPV treatment, therefore, may provide useful information in the differential diagnosis of MPV and the cupulolithiasis variant of HC-BPPV.

Abbreviations
BPPV=

benign paroxysmal positional vertigo

HC-BPPV=

horizontal canal – benign paroxysmal positional vertigo

MPV=

migrainous positional vertigo

Abbreviations
BPPV=

benign paroxysmal positional vertigo

HC-BPPV=

horizontal canal – benign paroxysmal positional vertigo

MPV=

migrainous positional vertigo

Sumario

Este artículo presenta un enfoque de diferenciación entre el vértigo postural migrañoso (MPV) y el vértigo postural paroxístico benigno del canal horizontal (HC-BPPV). Tal enfoque es esencial debido a las diferencias en la intervención para cada uno de estos trastornos. Los resultados de la evaluación del estudio de caso presentado revelaron un nistagmo postural geotrópico persistente, consistente con un MPV, o una variante de cupulolitiasis del HC-BPPPV. El paciente fue tratado con maniobras de liberación para remover posible restos de otoconias del canal horizontal, en un intento, a su vez, de aportar información diagnóstica adicional. No existió cambio en los síntomas después del tratamiento del HC-BPPV. Este caso fue posteriormente diagnosticado como MPV, y el paciente fue referido para manejo médico. El tratamiento ha tenido éxito durante 22 meses. La incorporación de un tratamiento para el HC-BPPV, por tanto, puede aportar información útil en el diagnóstico diferencial del MPV y de la variante de cupulolitiasis del HC-BPPV.

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