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Research in Vestibular Science > Volume 9(3); 2010 > Article
Research in Vestibular Science 2010;9(3): 108-113.
수평반고리관 양성돌발성두위현훈의 치료 효과 예측: Gufoni 수기를 이용한 예비연구
문정수, 신종욱, 김현정, 백인철, 오응석, 오지은, 이경재, 이지희, 김재문, 정성해
충남대학교 의학전문대학원 신경과학교실
Prediction of Successful Repositioning of Horizontal Canal Benign Positional Vertigo in Gufoni’s Maneuver: A Preliminary Study
Jeong Soo Moon, Jong Wook Shin, Hyun Jung Kim, In Chul Baek, Eung Seok Oh, Ji Eun Oh, Kyung Jae Lee, Ji Hee Lee, Jae Moon Kim, Seong Hae Jeong
Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea. mseaj@hanmail.net
Background and Objectives:   Although several methods of repositioning maneuver have been introduced for the benign paroxysmal positional vertigo involving horizontal canal (HC-BPPV), no study has investigated the nystagmus pattern during the repositioning maneuver and its correlation with the repositioning results. Therefore, we evaluated the predictive value of the nystagmus for successful repositioning by studying the nystagmus pattern during the position of the Gufoni’s maneuver.
Materials and Methods:  
Seventeen consecutive patients (age range=36~76 years, median age=64), with a diagnosis of HC-BPPV were recruited between July and August 2010. The Gufoni's maneuver for apogeotropic and geotropic nystagmus was performed. After 30 minutes, the treatment outcome was evaluated according to the nystagmus pattern at the individual stage of Gufoni’s maneuver. Successful treatment was defined by the resolution of positional vertigo in geotropic HC-BPPV and nystagmus shifted from apogeotropic to geotropic in apogeotropic HC-BPPV.
In the successfully treated patients, 4 of 6 patients had the contralesional nystagmus between 1st and 2nd position of Gufoni’s maneuver. Ipsilesional nystagmus in 1st position of Gufoni’s maneuver was observed in 1 patient with apogeotropic nystagmus. And the other 1 patient with Geotropic HC-BPPV showed no nystagmus in 2nd position after contralesional nystagmus in 1st position of Gufoni’s maneuver. Unsuccessfully treated 11 patients had a conversion of nystagmus direction in 2nd position after 1st step.
During the 2nd position of the Gufoni’s maneuver, a nystagmus toward unaffected side predicts a successful repositioning, whereas reversed nystagmus is suggestive of poor response to repositioning.
Keywords: Positional vertigo; Nystagmus; Treatment
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