A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV

Introduction: In patients with benign paroxysmal positional vertigo, BPPV; a torsional-vertical down beating positioning nystagmus can be elicited in the supine straight head-hanging position test or in the Dix-Hallpike test to either side. This type of nystagmus can be explained by either an anteri...

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Autores: Garaycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16d, Perez-Fernandez, N. (Nicolás)|||/items/f35b1b73-f2d0-4c4c-9a3f-c496e4dff4d4, Manrique-Huarte, R. (Raquel)|||/items/4e0d942c-9492-4896-8995-2d876c7cc3ff
Formato: artículo
Fecha de publicación:2022
País:España
Recursos:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/65290
Acesso em linha:https://hdl.handle.net/10171/65290
Access Level:acceso abierto
Palavra-chave:Anterior semicircular canal
Apogeotropic posterior canal BPPV
Benign paroxysmal positional vertigo
Down beating nystagmus
Maneuver
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spelling A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPVGaraycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16dPerez-Fernandez, N. (Nicolás)|||/items/f35b1b73-f2d0-4c4c-9a3f-c496e4dff4d4Manrique-Huarte, R. (Raquel)|||/items/4e0d942c-9492-4896-8995-2d876c7cc3ffAnterior semicircular canalApogeotropic posterior canal BPPVBenign paroxysmal positional vertigoDown beating nystagmusManeuverIntroduction: In patients with benign paroxysmal positional vertigo, BPPV; a torsional-vertical down beating positioning nystagmus can be elicited in the supine straight head-hanging position test or in the Dix-Hallpike test to either side. This type of nystagmus can be explained by either an anterior canal BPPV or by an apogeotropic variant of the contralateral posterior canal BPPV Until now all the therapeutic maneuvers that have been proposed address only one possibility, and without first performing a clear differential diagnosis between them. Objective: To propose a new maneuver for torsional-vertical down beating positioning nystagmus with a clear lateralization that takes into account both possible diagnoses (anterior canal-BPPV and posterior canal-BPPV). Methods: A prospective cohort study was conducted on 157 consecutive patients with BPPV. The new maneuver was performed only in those with torsional-vertical down beating positioning nystagmus with clear lateralization. Results: Twenty patients (12.7%) were diagnosed with a torsional-vertical down beating positioning nystagmus. The maneuver was performed in 10 (6.35%) patients, in whom the affected side was clearly determined. Seven (4.45%) patients were diagnosed with an anterior canal-BPPV and successfully treated. Two (1.25%) patients were diagnosed with a posterior canal-BPPV and successfully treated with an Epley maneuver after its conversion into a geotropic posterior BPPV. Conclusion: This new maneuver was found to be effective in resolving all the cases of torsional-vertical down beating positioning nystagmus-BPPV caused by an anterior canal-BPPV, and in shifting in a controlled way the posterior canal-BPPV cases of the contralateral side into a geotropic-posterior-BPPV successfully treated during the followup visit. Moreover, this new maneuver helped in the differential diagnosis between anterior canal-BPPV and a contralateral posterior canal-BPPV.Dadun. Depósito Académico Digital Universidad de Navarra20232023-02-0720222022-01-0120222022-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/65290reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/652902026-06-21T12:47:57Z
dc.title.none.fl_str_mv A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
title A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
spellingShingle A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
Garaycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16d
Anterior semicircular canal
Apogeotropic posterior canal BPPV
Benign paroxysmal positional vertigo
Down beating nystagmus
Maneuver
title_short A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
title_full A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
title_fullStr A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
title_full_unstemmed A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
title_sort A novel maneuver for diagnosis and treatment of torsional-vertical down beating positioning nystagmus: anterior canal and apogeotropic posterior canal BPPV
dc.creator.none.fl_str_mv Garaycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16d
Perez-Fernandez, N. (Nicolás)|||/items/f35b1b73-f2d0-4c4c-9a3f-c496e4dff4d4
Manrique-Huarte, R. (Raquel)|||/items/4e0d942c-9492-4896-8995-2d876c7cc3ff
author Garaycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16d
author_facet Garaycochea-Mendoza-del-Solar, O. (Octavio)|||/items/8d46df1e-ef72-43c2-8256-b63c640ed16d
Perez-Fernandez, N. (Nicolás)|||/items/f35b1b73-f2d0-4c4c-9a3f-c496e4dff4d4
Manrique-Huarte, R. (Raquel)|||/items/4e0d942c-9492-4896-8995-2d876c7cc3ff
author_role author
author2 Perez-Fernandez, N. (Nicolás)|||/items/f35b1b73-f2d0-4c4c-9a3f-c496e4dff4d4
Manrique-Huarte, R. (Raquel)|||/items/4e0d942c-9492-4896-8995-2d876c7cc3ff
author2_role author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Anterior semicircular canal
Apogeotropic posterior canal BPPV
Benign paroxysmal positional vertigo
Down beating nystagmus
Maneuver
topic Anterior semicircular canal
Apogeotropic posterior canal BPPV
Benign paroxysmal positional vertigo
Down beating nystagmus
Maneuver
description Introduction: In patients with benign paroxysmal positional vertigo, BPPV; a torsional-vertical down beating positioning nystagmus can be elicited in the supine straight head-hanging position test or in the Dix-Hallpike test to either side. This type of nystagmus can be explained by either an anterior canal BPPV or by an apogeotropic variant of the contralateral posterior canal BPPV Until now all the therapeutic maneuvers that have been proposed address only one possibility, and without first performing a clear differential diagnosis between them. Objective: To propose a new maneuver for torsional-vertical down beating positioning nystagmus with a clear lateralization that takes into account both possible diagnoses (anterior canal-BPPV and posterior canal-BPPV). Methods: A prospective cohort study was conducted on 157 consecutive patients with BPPV. The new maneuver was performed only in those with torsional-vertical down beating positioning nystagmus with clear lateralization. Results: Twenty patients (12.7%) were diagnosed with a torsional-vertical down beating positioning nystagmus. The maneuver was performed in 10 (6.35%) patients, in whom the affected side was clearly determined. Seven (4.45%) patients were diagnosed with an anterior canal-BPPV and successfully treated. Two (1.25%) patients were diagnosed with a posterior canal-BPPV and successfully treated with an Epley maneuver after its conversion into a geotropic posterior BPPV. Conclusion: This new maneuver was found to be effective in resolving all the cases of torsional-vertical down beating positioning nystagmus-BPPV caused by an anterior canal-BPPV, and in shifting in a controlled way the posterior canal-BPPV cases of the contralateral side into a geotropic-posterior-BPPV successfully treated during the followup visit. Moreover, this new maneuver helped in the differential diagnosis between anterior canal-BPPV and a contralateral posterior canal-BPPV.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01
2022
2022-01-01
2023
2023-02-07
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/65290
url https://hdl.handle.net/10171/65290
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra
instname:Universidad de Navarra
instname_str Universidad de Navarra
reponame_str Dadun. Depósito Académico Digital de la Universidad de Navarra
collection Dadun. Depósito Académico Digital de la Universidad de Navarra
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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