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OBJECTIVE To review the clinical features, electronystagmography findings, the possible mechanism, and a possible therapeutic approach to benign paroxysmal positional vertigo (BPPV). METHODS Sixty-three cases of BPPV of the horizontal canal type have been reviewed. It is characterised by horizontal nystagmus and an intense vertigo, provoked by rotation of the head in a supine patient. The horizontal nystagmus beats towards the ground on both sides, becomes more pronounced when lying on the pathological side, and then the nystagmus often changes direction. RESULTS Forty-eight patients underwent electronystagmography. On the pathological side, the first phase nystagmus had a mean latency of three seconds and a mean duration of 31.6 seconds. Nystagmus inversion occurred in 36 patients after a nystagmus free interval. The mean second phase nystagmus duration lasted 33.4 seconds. On the healthy side, the nystagmus had a mean latency of 3.4 seconds and a mean duration of 39.5 seconds. Fatigue was seen in six patients. Simultaneous involvement of the posterior canal was present in 16 patients. A liberatory manoeuvre was successful in six patients. CONCLUSIONS The liberatory manoeuvre should be tried in patients with horizontal canal vertigo. It should not be performed in patients with severe cervical arthrosis, vertebrobasilar insufficiency, or when the patient has neck pain during the manoeuvre.
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G Vanhooren
January 2003,
Revue de laryngologie - otologie - rhinologie,
G De la Meilleure, and
I Dehaene, and
M Depondt, and
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G Vanhooren
January 2005,
Journal of vestibular research : equilibrium & orientation,
G De la Meilleure, and
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G Vanhooren
September 2007,
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris,
G De la Meilleure, and
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December 2006,
Acta otorrinolaringologica espanola,
G De la Meilleure, and
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January 1997,
Journal of vestibular research : equilibrium & orientation,
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January 2003,
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June 2013,
Auris, nasus, larynx,
G De la Meilleure, and
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February 2013,
Auris, nasus, larynx,
G De la Meilleure, and
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G Vanhooren
April 2002,
No to shinkei = Brain and nerve,
G De la Meilleure, and
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G Vanhooren
December 2012,
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery,
