The clinical study of benign paroxysmal positional vertigo of horizontal semicircular canal origin

J Korean Neurol Assoc > Volume 15(2); 1997 > Article

Journal of the Korean Neurological Association 1997;15(2): 340-348.

수평 반고리관 기원의 양성 발작성 체위성 현훈의 임상적 고찰

유영수, 김지언, 임정근, 이상도, 박영춘, 박성파

계명대학교 의대 신경과, 경북대학교 의대 신경과

The clinical study of benign paroxysmal positional vertigo of horizontal semicircular canal origin

Young Soo Yoo, M.D., Ji Eun Kim, M.D., Jeong Geun Lim, M.D., Sang Do Yi, M.D., Young Choon Park, M.D., Sung Pa Park, M.D.

Department of Neurology, Keimyung University School of Medicine, Department of Neurology, School of Medicine, Kyungpook National University

Abstract

Background and Objectives : It was well known that benign paroxysmal positional vertigo(BPPV) was caused by the involvement of the posterior semicircular canal, but there were a few reports about horizontal canal variant of BPPV. We studied the clinical features electronystagmographic (ENG) findings and the possible mechanism of BPPV of the horizontal canal(HBPPV). Methods : We examined 10 cases of HBPPV with episodic vertigo and intense horizontal geotropic nystagmus provoked by rotation of the head in a supine position. Six patients underwent ENG and we recorded four patients' nystagmus, provoked by rotating head from extreme lateral, mid and nose-up position to extreme contralateral direction in supine position. Results ; All observed horizontal nystagmus beated towards the ground on both sides and were more pronounced when head was rotated to pathological side. In rotating to pathological side, nystagmus had mean latency of 2.6±1.8 seconds, peak velocity of slow phase of 66,8±19.7 degree/second and mean duration of 24.7±3.4 seconds. In rotating to healthy side the nystagmus had 3. 7± 2.9, 38.0±11.5 and 22.5±4. Secondary phase nystagmus occurred in 2 patients and fatigue was observed in 4 patients. The slow phase velocity of nystagmus was relative to the distance of head rotation. The duration of attack is 3 to 17 days(6.9±5.2days). Liberatory manuever had relatively a good effect. Conclusion : HBPPV represents the origin of horizontal semicircular canal and has a good prognosis Above findings support that mechanism of horizontal BPPV is canalolithiasis.