Bedside therapeutic experiences with horizontal canal benign paroxysmal positional vertigo (cupulolithiasis)

María Soledad Boleas-Aguirre, Nicolás Pérez, Angel Batuecas-Caletrío
Acta Oto-laryngologica 2009, 129 (11): 1217-21

CONCLUSIONS: After forced prolonged position type one (FPP-one) and the appropriate repositioning maneuvers, or FPP-two, 95.45% of patients with cupulolithiasis of the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV).were symptom-free.

OBJECTIVES: To treat patients with cupulolithiasis of the HSC-BPPV.

SUBJECTS AND METHODS: This was a prospective study including 22 subjects with HSC-BPPV (cupulolithiasis) based on apogeotropic direction-changing positional nystagmus (apo-DCPN). Patients adopted FPP-one, which means lying down on the side of the weaker nystagmus during nightly rest for 2 weeks. If apo-DCPN persisted, subjects adopted type two FPP (FPP-two), which means lying on the strongest nystagmus side during nightly rest for 2 weeks.

RESULTS: No vertigo or nystagmus was observed in 15 subjects after FPP-one. One subject experienced geotropic DCPN (geo-DCPN), two subjects had posterior BPPV, and another had superior BPPV. Three subjects had persistent apo-DCPN and they were subjected to FPP-two. After that, no vertigo or nystagmus was detected in two subjects. Apo-DCPN persisted in the other remaining subject after FPP-two.

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