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Clinical Characteristics of Horizontal Canal Benign Paroxysmal Positional
Vertigo with Persistent Geotropic Direction Changing Positional
Nystagmus
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Kyung Min Ko, Mee Hyun Song, Jin Woo Park, Joon Hee Lee, Yong Gook Shin, Dae Bo Shim
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Res Vestib Sci. 2015;14(4):117-122.
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 Abstract
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- Objective: The purpose of this study was to identify the clinical characteristics of
horizontal canal benign paroxysmal positional vertigo (h-BPPV) with persistent geotropic
direction changing positional nystagmus (DCPN).
Methods
One hundred thirty two patients diagnosed as the geotropic subtype of
h-BPPV were analyzed retrospectively. Patients were classified into two groups:
persistent h-BPPV (ph-BPPV) group which means h-BPPV showing persistent (＞1
minute) geotropic DCPN and short duration h-BPPV (sh-BPPV) group that means
h-BPPV with short duration (≤1 minute) geotropic DCPN. We compared the clinical
characteristics and treatment outcomes between the two groups.
Results
The study included 34 patients with ph-BPPV and 98 patients with sh-BPPV.
There were no differences between the two groups in age, distribution of sex and the
affected side. The ph-BPPV group had higher secondary BPPV preponderance and
dizziness handicap index (DHI) score compared to the sh-BPPV group. The ph-BPPV
group required higher number of canalith repositioning procedures (CRPs) until
resolution and higher multiple/single CRP ratio than the sh-BPPV group. In addition,
the ph-BPPV group showed longer duration until the remission of subjective symptoms
(vertigo, dizziness) compared to the sh-BPPV group.
Conclusion
ph-BPPV was more frequently associated with secondary causes of BPPV
and demonstrated higher DHI score, total number of CRP, and longer remission
duration of subjective symptoms compared to sh-BPPV. This information may be
helpful for clinicians in counseling and managing the patients with persistent geotropic
DCPN h-BPPV.
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