Diagnostic Value of Straight Head Hanging in Posterior Canal Benign Paroxysmal Positional Vertigo
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Purpose To determine the diagnostic value of straight head hanging (SHH) in benign paroxysmal positional vertigo involving the posterior semicircular canal (PC-BPPV). Methods We retrospectively included 62 patients (age=56.2±15.0 years, 47 female) with unilateral PC-BPPV who underwent both the Dix-Hallpike maneuver and SHH before receiving canalith repositioning therapy (CRT) between September 2017 and July 2020 at the Dizziness Center of Seoul National University Bundang Hospital in South Korea (16 patients, 25.8%) or the Neurology Outpatient Clinic of Aerospace Central Hospital in China (46 patients, 74.2%). SHH was performed before (n=29, group A) or after (n=33, group B) the Dix- Hallpike maneuver. Results Torsional upbeat nystagmus typical of PC-BPPV was induced during SHH in 52 (83.9%) patients, and the incidence of this type of positional nystagmus did not differ between the groups A and B (79.3% vs. 87.9%, p=0.569). The maximum slow-phase velocity of the induced upbeat nystagmus was higher during SHH than during the Dix-Hallpike maneuver toward the lesion side [range=2.0–60.0°/s (median=18.5°/s) vs. range=2.7–40.0°/s (median= 13.4°/s), p<0.001]. Reversal of the positional nystagmus was observed upon resuming the sitting position after SHH in 47 (75.8%) patients and after the Dix-Hallpike maneuver in 54 (87.7%) patients, with no significant difference between the groups (p=0.082). Conclusions SHH is effective for diagnosing PC-BPPV. Given its simplicity, SHH may be performed before the Dix-Hallpike maneuver, and CRT may be attempted thereafter when the typical positional nystagmus for unilateral PC-BPPV is induced during SHH.
Abstract
Background and Purpose To determine the diagnostic value of straight head hanging (SHH) in benign paroxysmal positional vertigo involving the posterior semicircular canal (PC-BPPV). Methods We retrospectively included 62 patients (age=56.2±15.0 years, 47 female) with unilateral PC-BPPV who underwent both the Dix-Hallpike maneuver and SHH before receiving canalith repositioning therapy (CRT) between September 2017 and July 2020 at the Dizziness Center of Seoul National University Bundang Hospital in South Korea (16 patients, 25.8%) or the Neurology Outpatient Clinic of Aerospace Central Hospital in China (46 patients, 74.2%). SHH was performed before (n=29, group A) or after (n=33, group B) the Dix- Hallpike maneuver. Results Torsional upbeat nystagmus typical of PC-BPPV was induced during SHH in 52 (83.9%) patients, and the incidence of this type of positional nystagmus did not differ between the groups A and B (79.3% vs. 87.9%, p=0.569). The maximum slow-phase velocity of the induced upbeat nystagmus was higher during SHH than during the Dix-Hallpike maneuver toward the lesion side [range=2.0–60.0°/s (median=18.5°/s) vs. range=2.7–40.0°/s (median= 13.4°/s), p<0.001]. Reversal of the positional nystagmus was observed upon resuming the sitting position after SHH in 47 (75.8%) patients and after the Dix-Hallpike maneuver in 54 (87.7%) patients, with no significant difference between the groups (p=0.082). Conclusions SHH is effective for diagnosing PC-BPPV. Given its simplicity, SHH may be performed before the Dix-Hallpike maneuver, and CRT may be attempted thereafter when the typical positional nystagmus for unilateral PC-BPPV is induced during SHH.
참고문헌 (30)
- Baloh RW, "Benign paroxysmal positional nystagmus", Am J Otolaryngol, 1, pp.1~6 (1979)
- McClure JA, "Horizontal canal BPV", J Otolaryngol, 14, pp.30~35 (1985)
- Gresty MA, "Neurology of otolith function. Peripheral and central disorders", Brain, 115, pp.647~673 (1992)
- Kim JS, "Clinical practice. Benign paroxysmal positional vertigo", N Engl J Med, 370, pp.1138~1147 (2014)
- von Brevern M, "Benign paroxysmal positional vertigo : diagnostic criteria", J Vestib Res, 25, pp.105~117 (2015)
- Bhattacharyya N, "Clinical practice guideline : benign paroxysmal positional vertigo(update)", Otolaryngol Head Neck Surg, 156, pp.S1~ (2017)
- De la Meilleure G, "Benign paroxysmal positional vertigo of the horizontal canal", J Neurol Neurosurg Psychiatry, 60, pp.68~71 (1996)
- Honrubia V, "Paroxysmal positional vertigo syndrome", Am J Otol, 20, pp.465~470 (1999)
- Vannucchi P, "Pathophysiology of lateral semicircular canal paroxysmal positional vertigo", J Vestib Res, 20, pp.433~438 (2010)
- Dix MR, "The pathology symptomatology and diagnosis of certain common disorders of the vestibular system", Proc R Soc Med, 45, pp.341~354 (1952)
- Cohen HS, "Side-lying as an alternative to the Dix-Hallpike test of the posterior canal", Otol Neurotol, 25, pp.130~134 (2004)
- Michael P, "An abbreviated diagnostic maneuver for posterior benign positional paroxysmal vertigo", Front Neurol, 7, pp.115~ (2016)
- Jeon EJ, "The efficacy of a modified Dix-Hallpike test with a pillow under shoulders", J Vestib Res, 29, pp.197~203 (2019)
- Kim HJ, "Update on benign paroxysmal positional vertigo", J Neurol, 268, pp.1995~2000 (2021)
- Yong C, "The use of center head hanging Dix-Hallpike in the diagnosis of benign paroxysmal positional vertigo", Journal of Audiology and Speech Pathology, 6, pp.483~485 (2008)
- Yacovino DA, "New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo", J Neurol, 256, pp.1851~1855 (2009)
- Schuknecht HF, "Positional vertigo : clinical and experimental observations", Trans Am Acad Ophthalmol Otolaryngol, 66, pp.319~332 (1962)
- Schuknecht HF, "Cupulolithiasis", Arch Otolaryngol, 90, pp.765~778 (1969)
- Hall SF, "The mechanics of benign paroxysmal vertigo", J Otolaryngol, 8, pp.151~158 (1979)
- Nylén CO, "Positional nystagmus; a review and future prospects", J Laryngol Otol, 64, pp.295~318 (1950)
- Yetiser S, "Vertical nystagmus during the seated-supine positional(straight head-hanging)test in patients with benign paroxysmal positional vertigo", J Laryngol Otol, 128, pp.674~678 (2014)
- Yang X, "Diagnosis strategy and Yacovino maneuver for anterior canal-benign paroxysmal positional vertigo", J Neurol, 266, pp.1674~1684 (2019)
- Choi JY, "Central paroxysmal positional nystagmus : characteristics and possible mechanisms", Neurology, 84, pp.2238~2246 (2015)
- Bertholon P, "Positional down beating nystagmus in 50 patients : cerebellar disorders and possible anterior semicircular canalithiasis", J Neurol Neurosurg Psychiatry, 72, pp.366~372 (2002)
- Blanks RH, "Planar relationships of the semicircular canals in man", Acta Otolaryngol, 80, pp.185~196 (1975)
- Della Santina CC, "Orientation of human semicircular canals measured by three-dimensional multiplanar CT reconstruction", J Assoc Res Otolaryngol, 6, pp.191~206 (2005)
- Kim DK, "Analysis of the coplanarity of functional pairs of semicircular canals using threedimensional images reconstructed from temporal bone magnetic resonance imaging", J Laryngol Otol, 129, pp.430~434 (2015)
- Valli P, "Simulation of cupulolithiasis and canalolithiasis by an animal model", J Vestib Res, 18, pp.89~96 (2008)
- Lim HJ, "The significance of 180-degree head rotation in supine roll test for horizontal canal benign paroxysmal positional vertigo", Otol Neurotol, 34, pp.736~742 (2013)
- Lin Ping, "Diagnosis and treatment of the short-arm type posterior semicircular canal BPPV", Brazilian Journal of Otorhinolaryngology (2020), Elsevier BV[DOI]