Unilateral Mimicking Bilateral Benign Paroxysmal Positioning Vertigo

Steddin, Sven; Brandt, Thomas

doi:10.1001/archotol.1994.01880360037007

Cited by 46 publications

(31 citation statements)

References 14 publications

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“…The difference between vertical and torsional, and torsional BPPN may depend on the size, weight, viscosity and position of the canalolithiasis or on the speed and trajectory of the head movement by the Dix-Hallpike maneuver. So, it is thought that if the positioning test was induced by the lateral head-trunk tilt [4,19], the ratio of torsional BPPN became smaller, because the length of the trajectory of the lateral head-trunk tilt is shorter than that of the Dix-Hallpike maneuver. When the length of trajectory is short, the length of otocania movement is short and otocania stops in the posterior canal far from the common crus, so the influence of common crus to BPPN becomes small.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Eye Rotation Axis Analysis of Benign Paroxysmal Positioning Nystagmus

Imai

Takeda

Uno

et al. 2002

ORL

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We have developed a new technique for analyzing the rotation vector of eye movement with an infrared CCD camera [Imai et al.: Acta Otolaryngol 1999;119:24–28]. We used this technique to analyze the eye rotation axis of benign paroxysmal positioning nystagmus (BPPN) that was induced by the Dix-Hallpike maneuver in 14 patients with benign paroxysmal positioning vertigo (BPPV). Eye rotation axes of BPPN in 8 patients were closely perpendicular to the posterior canal of the undermost ear in the provocative head position. Under the hypothesis that BPPN is due to a mechanical stimulation of the posterior canal by canalolithiasis, this finding suggested that the posterior canal of the undermost ear is the lesion. On the other hand, eye rotation axes of BPPN in the other 6 patients were closely aligned with the naso-occipital axis. It is suggested that canalolithiasis induces endolymphatic flow in both posterior and anterior canals via the common crus and the summation of the eye movements induced by stimulation of both the posterior and anterior canals rotates the eye along the naso-occipital axis.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Eye Rotation Axis Analysis of Benign Paroxysmal Positioning Nystagmus

Imai

Takeda

Uno

et al. 2002

ORL

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“…Note that unilateral benign paroxysmal positional vertigo may mimic bilateral benign paroxysmal positional vertigo of the posterior canal if the positional maneuver is executed without appropriate alignment of the head [68].…”

Section: Commentsmentioning

confidence: 99%

Benign paroxysmal positional vertigo: Diagnostic criteria

Brevern

Bertholon

Brandt

et al. 2015

VES

584

502

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Abstract. This article presents operational diagnostic criteria for benign paroxysmal positional vertigo (BPPV), formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society. The classification reflects current knowledge of clinical aspects and pathomechanisms of BPPV and includes both established and emerging syndromes of BPPV. It is anticipated that growing understanding of the disease will lead to further development of this classification.

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“…9 Post-traumatic cases in particular can be bilateral but it is sometimes difficult to tell bilateral BPPV from unilateral BPPV. 10 In most patients with BPPV, there are no other symptoms and there is no demonstrable abnormality of vestibular or auditory function. In a few, it follows acute vestibular neuritis or occurs during the course of a progressive inner ear disease (for example, Menière's disease, Cogan's syndrome).…”

Section: Benign Paroxysmal Positioning Vertigo (Bppv)mentioning

confidence: 99%

Diagnosis and management of vertigo

Halmagyi

2005

Clinical Medicine

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-Vertigo is an illusion of rotation due to a disorder of the vestibular system, almost always peripheral. In the history it must be distinguished from pre-syncope, seizures and panic attacks. A single attack of acute, isolated spontaneous vertigo lasting a day or more is due either to vestibular neuritis or cerebellar infarction; distinguishing between the two requires mastery of the head impulse test. Recurrent vertigo is mostly due to benign paroxysmal positioning vertigo (BPPV), Menière's disease or migraine. With a good history, a positional test, an audiogram and a caloric test, it is usually possible to distinguish between these. BPPV is the single most common cause of recurrent vertigo and can usually be cured immediately with a particle repositioning manoeuvre. Posterior circulation ischaemia very rarely causes isolated vertigo attacks and when it does the attacks are brief and frequent and the history is short. KEY WORDS What vertigo is and is notVertigo is an illusion of rotation caused by asymmetry of neural activity between the left and right vestibular nuclei. This can be induced in anyone• by simply spinning them at constant speed for about 20 seconds and then suddenly stopping them• by heating or cooling one labyrinth, as happens in the caloric test• by otoconial particles (calcium-containing debris: literally 'earstones') moving along semicircular canal duct, as happens in benign paroxysmal positional vertigo (BPPV). It can also be produced by sudden unilateral destruction of a normal vestibular end-organ, nerve or nucleus or vestibulo-cerebellum, a structure that normally inhibits the ipsilateral vestibular nucleus. (Bilateral simultaneous vestibular destruction does not produce vertigo -in fact, a patient with bilateral vestibular loss will never again experience vertigo from unilateral or asymmetrical vestibular stimulation.)Vertigo is always temporary. Even after the vestibular nerve on one side has been surgically severed, the resulting vertigo (and nystagmus) will abate within a few days. This is not because the vestibular nerve has re-anastomosed but because profound neurochemical changes occuring in the brainstem during the process of vestibular compensation restore symmetrical vestibular nucleus activity. Vertigo is always made worse by head movement; thus patients who are 'dizzy all the time' and are happy to move around whilst dizzy do not have vertigo.Patients with aural vertigo should not lose consciousness but some patients cannot give confident and convincing answers to such simple questions as 'Did it feel as if you were losing balance or as if you were losing consciousness? Did you feel as if you were going to pass out or fall over?' Patients with vertigo might lose consciousness if they have been vomiting a lot, or if they incurred a head injury when they fell.Witness descriptions are not much help in identifying vertigo, but can be helpful in identifying other paroxysmal disorders such as seizure and syncope. Whereas panic attacks, especially with hyperventilation, co...

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Unilateral Mimicking Bilateral Benign Paroxysmal Positioning Vertigo

Cited by 46 publications

References 14 publications

Three-Dimensional Eye Rotation Axis Analysis of Benign Paroxysmal Positioning Nystagmus

Three-Dimensional Eye Rotation Axis Analysis of Benign Paroxysmal Positioning Nystagmus

Benign paroxysmal positional vertigo: Diagnostic criteria

Diagnosis and management of vertigo

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