Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals
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Background and Objectives: Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Subjects and Methods: Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. Results: Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. Conclusions: As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV.
Abstract
Background and Objectives: Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Subjects and Methods: Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. Results: Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. Conclusions: As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV.
참고문헌 (15)
- Kim JS., "Clinical practice. Benign paroxysmal positional vertigo", N Engl J Med, 370, pp.1138~1147 (2014)
- Balatsouras DG., "Diagnosis of Single-or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus", Int J Otolaryngol, 2011, pp.483965~ (2011)
- Balatsouras DG., "Benign paroxysmal positional vertigo with multiple canal involvement", Am J Otolaryngol, 33, pp.250~258 (2012)
- Soto-Varela A., "Benign paroxysmal positional vertigo simultaneously affecting several canals : a 46-patient series", Eur Arch Otorhinolaryngol, 270, pp.817~822 (2013)
- Pollak L., "Approach to bilateral benign paroxysmal positioning vertigo", Am J Otolaryngol, 27, pp.91~95 (2006)
- Tomaz A., "Benign paroxysmal positional vertigo : concomitant involvement of different semicircular canals", Ann Otol Rhinol Laryngol, 118, pp.113~117 (2009)
- Lopez-Escamez JA., "Multiple positional nystagmus suggests multiple canal involvement in benign paroxysmal vertigo", Acta Otolaryngol, 125, pp.954~961 (2005)
- Bhattacharyya N., "Clinical practice guideline: benign paroxysmal positional vertigo", Otolaryngol Head Neck Surg, 139(5 Suppl 4), pp.S47~S81 (2008)
- Steddin S., "Unilateral mimicking bilateral benign paroxysmal positioning vertigo", Arch Otolaryngol Head Neck Surg, 120, pp.1339~1341 (1994)
- Kim SH., "A cupulolith repositioning maneuver in the treatment of horizontal canal cupulolithiasis", Auris Nasus Larynx, 39, pp.163~168 (2012)
- Yacovino DA., "New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo", J Neurol, 256, pp.1851~1855 (2009)
- Suarez H., "Clinical characteristics of positional vertigo after mild head trauma", Acta Otolaryngol, 131, pp.377~381 (2011)
- Del Rio M., "Benign positional vertigo : prognostic factors", Otolaryngol Head Neck Surg, 130, pp.426~429 (2004)
- 이승한, "Benign Paroxysmal Positional Vertigo", Journal of Clinical Neurology, 6(2), pp.51~63 (2010), 대한신경과학회
- 김지홍, "양성돌발성두위현훈에서 치료 실패에 연관된 예후인자", 대한이비인후과학회지 두경부외과학, 56(2), pp.74~78 (2013), 대한이비인후과학회[DOI]