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Original Articles

Benign paroxysmal positional vertigo of the anterior semicircular canal: Atypical clinical findings and possible underlying mechanisms

, , &
Pages 276-282 | Received 05 Jun 2007, Published online: 07 Jul 2009
 

Abstract

Anterior semicircular canal (ASC) lithiasis is uncommon and usually self-treated. In the rare cases when such patients seek medical advice, diagnosis requires careful consideration of the patient's symptoms and the clinical characteristics of the nystagmus triggered by the Dix-Hallpike (D-H) examination. In this study, two atypical cases of ASC benign paroxysmal positional vertigo (BPPV) are presented and the relevant literature is reviewed. Regardless of their unique symptoms, both participants in this study were diagnosed with lithiasis of the left ASC. The clinical manifestations of ASC BPPV may differ significantly from typical symptoms seen in the more common posterior semicircular canal BPPV. The possible mechanisms responsible for this intriguing variance, as well as guidelines for diagnosing the affected side, are discussed.

Abbreviations
ASC=

Anterior semicircular canal

BPPV=

Benign paroxysmal positional vertigo

D-H=

Dix-Hallpike

Abbreviations
ASC=

Anterior semicircular canal

BPPV=

Benign paroxysmal positional vertigo

D-H=

Dix-Hallpike

Sumario

La litiasis del canal semicircular anterior (ASC) es poco común y usualmente autolimitada. En los pocos casos en que los pacientes buscan atención médica, el diagnóstico requiere consideraciones minuciosas sobre los síntomas del paciente y las características del nistagmus desencadenado por la maniobra de Dix-Hallpike (D-H). En este estudio se presentan dos casos atípicos de vértigo postural paroxístico benigno y se revisa la literatura relevante. A pesar de sus síntomas particulares, ambos pacientes en este estudio se diagnosticaron con litiasis del ASC izquierdo. Las manifestaciones clínicas del BPPV del ASC pueden diferir significativamente de los síntomas típicos vistos en el BPPV que es mucho más común. Se discuten los mecanismos posibles responsables de esta curiosa variación, así como las guías diagnósticas para descubrir el lado afectado.

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