Clinical Characteristics of Benign Positional Vertigo in Korea: Retrospective Multicenter Study

J Korean Bal Soc > Volume 2(2); 2003 > Article

Practical Review

Journal of the Korean Balance Society 2003;2(2): 269-276.

국내 양성체위성어지럼증의 임상양상 : 후향적 다기관 공동연구

문소영, 김지수, 김규성,1 김병건,2 김재일,3 이원상,4 이 형,5 한규철6

서울대학교 의과대학 신경과학교실, 분당서울대학교병원 신경과, 인하대학교 의과대학 이비인후과학교실1, 을지대학교 의과대학 신경과학교실2, 단국대학교 의과대학 신경과학교실3, 연세대학교 의과대학 이비인후과학교실4, 계명대학교 의과대학 신경과학교실5, 가천의과대?

Clinical Characteristics of Benign Positional Vertigo in Korea: Retrospective Multicenter Study

So Young Moon, MD, Ji Soo Kim, MD, Kyu-Sung Kim, MD1, Byung-Kun Kim, MD2, Jae Il Kim, MD3, Won-Sang Lee, MD4, Hyung Lee, MD5, Gyu-Cheol Han, MD6

Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, Department of Otolaryngology, College of Medicine, Inha University1, Department of Neurology, Eulji University School of Medicine, Eulji H

ABSTRACT

Background: Benign positional vertigo (BPV) is characterized by episodic vertigo and nystagmus provoked by head motion. There have been major advances in the understanding of this common condition. We evaluated clinical features of large group of BPV patients in a multicenter study.
Method:   We analyzed clinical features of 1474 patients who had been diagnosed as having BPV in seven dizziness clinics in Korea. The diagnosis of BPV was based on the typical nystagmus concurrent with vertigo elicited by positioning maneuvers. According to the semicircular canal involved, we classified BPV into posterior, horizontal, and anterior canal types. The horizontal BPV was subdivided into geotropic and apogeotropic types according to the nystagmus elicited by head turning while lying down.
Results:   The patients included 1002 women and 472 men. Mean age of the patients was 55.2 with no difference between women and men. Posterior (61.5%) and horizontal (32.0%) semicircular canals were most commonly involved. The Horizontal BPV was subdivided into 61.5% of geotropic and 31.5% of apogeotropic types. Most patients were idiopathic. Most of the patients (89.9%) were successfully treated with canalith repositioning procedure (CRP).
Conclusions:   BPV may involve each of the three semicircular canals. The involved canal can be identified by careful observation of the nystagmus induced by Hallpike maneuver or head turning in supine position. The horizontal canal is more commonly involved than previously known. High success rate of CRP is expected only when different method of CRP is applied to each patient depending on the canal involved.