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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 Jan;60(1):68–71. doi: 10.1136/jnnp.60.1.68

Benign paroxysmal positional vertigo of the horizontal canal.

G De la Meilleure 1, I Dehaene 1, M Depondt 1, W Damman 1, L Crevits 1, G Vanhooren 1
PMCID: PMC486192  PMID: 8558155

Abstract

OBJECTIVES--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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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baloh R. W., Honrubia V., Jacobson K. Benign positional vertigo: clinical and oculographic features in 240 cases. Neurology. 1987 Mar;37(3):371–378. doi: 10.1212/wnl.37.3.371. [DOI] [PubMed] [Google Scholar]
  2. Baloh R. W., Jacobson K., Honrubia V. Horizontal semicircular canal variant of benign positional vertigo. Neurology. 1993 Dec;43(12):2542–2549. doi: 10.1212/wnl.43.12.2542. [DOI] [PubMed] [Google Scholar]
  3. Bourgeois P. M., Dehaene I. Benign paroxysmal positional vertigo (BPPV). Clinical features in 34 cases and review of literature. Acta Neurol Belg. 1988 Mar-Apr;88(2):65–74. [PubMed] [Google Scholar]
  4. Brandt T., Steddin S., Daroff R. B. Therapy for benign paroxysmal positioning vertigo, revisited. Neurology. 1994 May;44(5):796–800. doi: 10.1212/wnl.44.5.796. [DOI] [PubMed] [Google Scholar]
  5. Cohen B., Tokumasu K., Goto K. Semicircular canal nerve eye and head movements. The effect of changes in initial eye and head position on the plane of the induced movement. Arch Ophthalmol. 1966 Oct;76(4):523–531. doi: 10.1001/archopht.1966.03850010525010. [DOI] [PubMed] [Google Scholar]
  6. DIX M. R., HALLPIKE C. S. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol. 1952 Dec;61(4):987–1016. doi: 10.1177/000348945206100403. [DOI] [PubMed] [Google Scholar]
  7. Gacek R. R. Further observations on posterior ampullary nerve transection for positional vertigo. Ann Otol Rhinol Laryngol. 1978 May-Jun;87(3 Pt 1):300–305. doi: 10.1177/000348947808700301. [DOI] [PubMed] [Google Scholar]
  8. Hall S. F., Ruby R. R., McClure J. A. The mechanics of benign paroxysmal vertigo. J Otolaryngol. 1979 Apr;8(2):151–158. [PubMed] [Google Scholar]
  9. Katsarkas A. Nystagmus of paroxysmal positional vertigo: some new insights. Ann Otol Rhinol Laryngol. 1987 May-Jun;96(3 Pt 1):305–308. doi: 10.1177/000348948709600313. [DOI] [PubMed] [Google Scholar]
  10. Lempert T. Horizontal benign positional vertigo. Neurology. 1994 Nov;44(11):2213–2214. doi: 10.1212/wnl.44.11.2213-a. [DOI] [PubMed] [Google Scholar]
  11. McClure J. A. Horizontal canal BPV. J Otolaryngol. 1985 Feb;14(1):30–35. [PubMed] [Google Scholar]
  12. Pagnini P., Nuti D., Vannucchi P. Benign paroxysmal vertigo of the horizontal canal. ORL J Otorhinolaryngol Relat Spec. 1989;51(3):161–170. doi: 10.1159/000276052. [DOI] [PubMed] [Google Scholar]
  13. Schuknecht H. F. Cupulolithiasis. Arch Otolaryngol. 1969 Dec;90(6):765–778. doi: 10.1001/archotol.1969.00770030767020. [DOI] [PubMed] [Google Scholar]
  14. Schuknecht H. F., Ruby R. R. Cupulolithiasis. Adv Otorhinolaryngol. 1973;20:434–443. doi: 10.1159/000393114. [DOI] [PubMed] [Google Scholar]
  15. Semont A., Freyss G., Vitte E. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol. 1988;42:290–293. doi: 10.1159/000416126. [DOI] [PubMed] [Google Scholar]

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