Clinical Characteristics of Benign Paroxysmal Positional Vertigo in Korea: A Multicenter Study

Moon, So Young; Kim, Ji Soo; Kim, Byung-Kun; Kim, Jae Il; Lee, Hyung; Son, Sung Il; Kim, Kyu Sung; Rhee, Choong Kyun; Han, Gyu Cheol; Lee, Won Sang

doi:10.3346/jkms.2006.21.3.539

Cited by 109 publications

(96 citation statements)

References 23 publications

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“…* Lateral semicircular canal BPPV may spontaneously remit more quickly than other forms of BPPV. 72,184 There have also been several recent randomized controlled studies on both forms of lateral semicircular canal BPPV. 58,[196][197][198] Casani et al demonstrated the effectiveness of these 2 types of CRPs in treating the geotropic form of lateral semicircular canal BPPV.…”

Section: Lateral (Horizontal) Semicircular Canal Bppv Crp Treatmentsmentioning

confidence: 99%

“…Some authors have commented that lateral canal BPPV may be prone to more rapid spontaneous resolution than posterior canal BPPV. 72,184 One study of untreated patients (n = 34) with posterior canal BPPV determined a mean interval from onset of symptoms to spontaneous resolution to be about twice that of those patients with lateral canal BPPV (39 vs 16 days, respectively). 70 Although repositioning maneuvers have shown success in lateral canal BPPV, the available high-quality comparative data regarding treatment versus observation (eg, RCTs) are limited in this subtype of BPPV.…”

Section: Action Statement Profile For Statement 4cmentioning

confidence: 99%

“…Lateral semicircular canal BPPV is the second-most common type of BPPV. [70][71][72] Several studies have cited an incidence of approximately 5% to 22% in populations referred for evaluation and treatment of BPPV. 10,11,58,[73][74][75][76] The wide range of incidence of lateral semicircular canal BPPV reported in the literature is probably a function of how soon after the onset of vertigo the patient can be seen at each institution.…”

Section: Statement 1b Diagnosis Of Lateral (Hori-mentioning

confidence: 99%

See 2 more Smart Citations

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

585

776

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Objective. This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV.Purpose. The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV.Action Statements. The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate...

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Section: Lateral (Horizontal) Semicircular Canal Bppv Crp Treatmentsmentioning

confidence: 99%

Section: Action Statement Profile For Statement 4cmentioning

confidence: 99%

Section: Statement 1b Diagnosis Of Lateral (Hori-mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Bhattacharyya¹,

Gubbels

Schwartz

et al. 2017

Otolaryngol.--head neck surg.

585

776

View full text Add to dashboard Cite

show abstract

“…The maximum slow-phase velocity among the BLT-responsive patients was higher than that of nonresponsive patients: 36.7 /sec versus 11.7 /sec, respectively, in the canalolithiasis type and 29. 4 /sec versus 8.6 /sec, respectively, in the cupulolithiasis type; these differences were statistically significant (Fig. 6).…”

Section: Comparison Of Remission Rates Between the Blt-responsive Andmentioning

confidence: 73%

“…The most common type of BPPV involves the posterior semicircular canal (PSC), but horizontal semicircular canal (HSC) BPPV accounts for about 6% to 40.5% of all patients presenting with BPPV. [1][2][3][4][5] The incidence of HSC-BPPV significantly decreases according to the duration of symptoms owing to a high spontaneous resolution rate. 5 In contrast to PSC-BPPV, HSC-BPPV nystagmus is induced by a quick turn of the head to the side while the patient is in a supine position and shows little change with repeated positioning.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the “bow and lean test” for the management of horizontal canal benign paroxysmal positional vertigo

et al. 2010

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Objectives/Hypothesis: Horizontal semicircular canal (HSC) benign paroxysmal positional vertigo (BPPV) has been reported to have a poorer prognosis than posterior semicircular canal BPPV. Incorrect determination of the affected ear appears to be one of the causes of poorer outcome. The aim of this study was to assess the efficacy of the ''bow and lean test'' (BLT) for proper determination of the affected ear followed by preferable treatment outcomes of HSC-BPPV.Study Design: A prospective study. Results: The remission rates after two sessions of CRPs in the BLT group and the HRT group were 83.1% and 67.4% (P ¼ .041), respectively, for the canalolithiasis type and 74.7% and 61.1% (P ¼ .250), respectively, for the cupulolithiasis type. In the BLT group, 76.8% had bowing and/or leaning nystagmus; 35.7% of them (45 of 126 cases) benefited from BLT with regard to determining the affected ears because HRT was unable to provide the definitive affected ears (17 cases) or showed different localization between two methods (28 cases).Conclusions: BLT is a useful method to improve the remission rates of HSC-BPPV, giving more corrective information regarding affected ears than the HRT alone.

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The Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo

et al. 2023

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ImportanceQuestions remain concerning treatment efficacy for the common condition of benign paroxysmal positional vertigo (BPPV).ObjectiveTo compare the effectiveness of the Semont-plus maneuver (SM-plus) and the Epley maneuver (EM) for treatment of posterior canal benign paroxysmal positional vertigo (pcBPPV) canalolithiasis.Design, Setting, and ParticipantsThis prospective randomized clinical trial was performed at 3 national referral centers (in Munich, Germany; Siena, Italy; and Bruges, Belgium) over 2 years, with a follow-up to 4 weeks after the initial examination. Recruitment took place from June 1, 2020, until March 10, 2022. Patients were selected randomly during routine outpatient care after being referred to 1 of the 3 centers. Two hundred fifty-three patients were assessed for eligibility. After consideration of the exclusion criteria as well as informed consent, 56 patients were excluded and 2 declined to participate, with 195 participants included in the final analysis. The analysis was prespecified and per-protocol.InterventionsAfter being randomized to the SM-plus or the EM group, patients received 1 initial maneuver from a physician, then subsequently performed self-maneuvers at home 3 times in the morning, 3 times at noon, and 3 times in the evening.Main Outcome and MeasuresPatients had to document whether they could provoke positional vertigo every morning. The primary end point was the number of days until no positional vertigo could be induced on 3 consecutive mornings. The secondary end point was the effect of the single maneuver performed by the physician.ResultsOf the 195 participants included in the analysis, the mean (SD) age was 62.6 (13.9) years, and 125 (64.1%) were women. The mean (SD) time until no positional vertigo attacks could be induced in the SM-plus group was 2.0 (1.6) days (median, 1 [range, 1-8] day; 95% CI, 1.64-2.28 days); in the EM group, 3.3 (3.6) days (median, 2 [range, 1-20] days; 95% CI, 2.62-4.06 days) (P = .01; α = .05, 2-tailed Mann-Whitney test). For the secondary end point (effect of a single maneuver), no significant difference was detected (67 of 98 [68.4%] vs 61 of 97 [62.9%]; P = .42; α = .05). No serious adverse event was detected with both maneuvers. Nineteen patients (19.6%) in the EM group and 24 (24.5%) in the SM-plus group experienced relevant nausea.Conclusions and RelevanceThe SM-plus self-maneuver is superior to the EM self-maneuver in terms of the number of days until recovery in pcBPPV.Trial RegistrationClinicalTrials.gov Identifier: NCT05853328

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Clinical Characteristics of Benign Paroxysmal Positional Vertigo in Korea: A Multicenter Study

Cited by 109 publications

References 23 publications

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)

Efficacy of the “bow and lean test” for the management of horizontal canal benign paroxysmal positional vertigo

The Semont-Plus Maneuver or the Epley Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo

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