“Sitting-up vertigo as an expression of posterior semicircular canal heavy cupula and posterior semicircular canal short arm canalolithiasis”

IF 1.4 Q2 OTORHINOLARYNGOLOGY
Darío H. Scocco, María A. Barreiro, Iván E. García
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引用次数: 7

Abstract

Background

Vestibular symptoms on sitting-up are frequent on patients seen by vestibular specialists. Recently, a benign paroxysmal positional vertigo (BPPV) variant which elicits vestibular symptoms with oculomotor evidence of posterior semicircular canal (P-SCC) cupula stimulation on sitting-up was described and named sitting-up vertigo BPPV. A periampullar restricted P-SCC canalolithiasis was proposed as a causal mechanism.

Objective

To describe new mechanisms of action for the sitting-up vertigo BPPV variant.

Methods

Eighteen patients with sitting-up vertigo BPPV were examined with a pre-established set of positional maneuvers and follow-up until they resolved their symptoms and clinical findings.

Results

All patients showed up-beating torsional nystagmus (UBTN) and vestibular symptoms on coming up from either Dix-Hallpike (DHM) or straight head-hanging maneuver. Sixteen out of 18 patients presented a sustained UBTN with an ipsitorsional component to the tested side on half-Hallpike maneuver (HH). A slower persistent contratorsional down-beating nystagmus was found in eleven out 18 patients tested on nose down position (ND).

Conclusions

Persistent direction changing positional nystagmus on HH and ND positions indicative of P-SCC heavy cupula was found in 11 patients. A sustained UBTN on HH with the absence of findings on ND, which is suggestive of the presence of P-SCC short arm canalolithiasis, was found on 5 patients. All patients were treated with canalith repositioning maneuvers without success, but they resolved their findings by means of Brandt-Daroff exercises. We propose P-SCC heavy cupula and P-SCC short arm canalolithiasis as two new putative mechanisms for the sitting-up vertigo BPPV variant.

Abstract Image

Abstract Image

Abstract Image

后半规管重丘和后半规管短臂管结石的仰卧起坐表现
背景:前庭专家经常看到病人因仰卧起坐而出现前庭症状。最近,一种良性阵发性体位性眩晕(BPPV)变异被描述为引起前庭症状,并伴有仰卧起坐时后半规管(P-SCC)丘刺激的眼部运动证据,并命名为仰卧起坐性眩晕BPPV。壶腹周围限制性P-SCC管结石被认为是其病因机制。目的探讨BPPV变异对仰卧起坐性眩晕的新作用机制。方法对18例仰卧起坐性BPPV患者进行体位手法检查和随访,直至症状和临床表现得到缓解。结果所有患者均出现上跳性扭转性眼球震颤(UBTN)及前庭症状。18例患者中有16例在半hallpike手法(HH)中出现持续的UBTN,并向测试侧倾斜。18例鼻下位(ND)患者中有11例出现较慢的持续性收缩性下跳动性眼球震颤。结论11例患者在HH和ND位置出现持续性方向改变的体位性眼球震颤,提示P-SCC重丘。5例患者在HH上发现了持续的UBTN,但没有ND的发现,这提示存在P-SCC短臂管结石。所有的患者都接受了导管复位术,但没有成功,但他们通过Brandt-Daroff练习解决了他们的发现。我们提出P-SCC重丘和P-SCC短臂管结石是BPPV变体的两种新的推测机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Otology
Journal of Otology Medicine-Otorhinolaryngology
CiteScore
2.70
自引率
0.00%
发文量
461
审稿时长
18 days
期刊介绍: Journal of Otology is an open access, peer-reviewed journal that publishes research findings from disciplines related to both clinical and basic science aspects of auditory and vestibular system and diseases of the ear. This journal welcomes submissions describing original experimental research that may improve our understanding of the mechanisms underlying problems of basic or clinical significance and treatment of patients with disorders of the auditory and vestibular systems. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines. Journal of Otology welcomes contributions from scholars in all countries and regions across the world.
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