Diagnosis and treatment of anterior canal benign paroxysmal positional vertigo

Xia Ling, Kang-Zhi Li, Bo Shen, Li-Hong Si, Yuan Hong, Xu Yang
International Journal of Audiology 2018, 57 (9): 673-680

OBJECTIVE: To investigate the diagnosis and treatment of anterior canal benign paroxysmal positional vertigo (AC-BPPV).

DESIGN: Retrospective analysis of clinical data regarding the diagnosis and treatment of patients with AC-BPPV.

STUDY SAMPLE: Six patients with AC-BPPV.

RESULTS: All patients underwent the Dix-Hallpike test and/or the straight head-hanging test to induce vertigo and down-beating nystagmus with or without torsional components. Down-beating nystagmus in patients 1, 3 and 6 lasted <1 min and was successfully treated with the Yacovino manoeuvre. Down-beating nystagmus in patients 2, 4 and 5 lasted >1 min. The Yacovino manoeuvre was not effective in patient 4, whereas it was effective in patient 2 but with frequently recurring symptoms. Patients 3, 4 and 6 also had other types of typical BPPV. Canal conversion appeared in patients 4 and 5 during the follow-up period.

CONCLUSION: Typical BPPV, canal conversion, a therapeutic diagnosis after applying the Yacovino manoeuvre, and the follow-up outcome contribute to AC-BPPV diagnosis in patients with dizziness and vertigo presenting with down-beating positional nystagmus. Yacovino manoeuvre was more effective in AC-BPPV patients with down-beating positional nystagmus lasted <1 min than in those in whom it lasted >1 min.

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