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Outcome of Canalith Repositioning Procedure in Patients with Persistent and Transient Geotropic Direction-Changing Positional Nystagmus: Short-term Follow-up Evaluation
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Seung Sik Jeon, Sung Won Li, Sung Kyun Kim, Yong Bok Kim, Il-Seok Park, Seok Min Hong
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Res Vestib Sci. 2018;17(3):109-115. Published online September 18, 2018
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DOI: https://doi.org/10.21790/rvs.2018.17.3.109
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 Abstract
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- Objectives
Patients, who showed persistent geotropic-direction changing positional nystagmus (p-DCPN) tend to have different clinical manifestations from those who showed transient geotropic DCPN (t-DCPN). We investigated the clinical characteristics between p-DCPN and t-DCPN patients, and its recovery rate after canalith repositioning procedure (CRP).
Methods
Based on the duration of nystagmus, 117 geotropic DCPN patients were classified to 2 groups, p-DCPN and t-DCPN. Barbeque maneuver had been introduced towards the opposite direction of null plane for the p-DCPN patients, and to the opposite direction of stronger nystagmus for the t-DCPN patients.
Results
Seventy-four patients showed t-DCPN and 43 patients were classified to the p-DCPN cases. No p-DCPN patient showed prompt improvement after the 1st canalolith reposition therapy. Among the t-DCPN patients, 18 canal switch cases were found , but, there was no canal switch cases found among the p-DCPN The CRP has showed less effective for the p-DCPN patients than the t-DCPN patients (after the 1st CRP, 37 in 74 improved, p＜0.001).
Conclusions
Due to its distinguishing clinical manifestation, p-DCPN may have different pathogenesis and clinical mechanisms from t-DCPN. And for the p-DCPN patients, the CRP seems not an efficient treatment compared to the t-DCPN patients. Further study with larger number of enrolled subjects is necessary.
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Outcome of canalith repositioning procedure in patients with persistent and transient geotropic direction-changing positional nystagmus : Short term follow-up evaluation
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Seung Sik Jeon, Seok Min Hong, Yong Bok Kim, Sung Kyun Kim, Il-Seok Park
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Received July 19, 2018 Accepted August 31, 2018 Published online August 31, 2018
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[Accepted]
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Abstract
- Objectives
Patients, who showed persistent geotropic-direction changing positional nystagmus(p-DCPN) tend to have different clinical manifestations from those who showed transient persistent geotropic DCPN(t-DCPN). We investigated the clinical characteristics between p-DCPN and t-DCPN patients, and its recovery rate after canalith repositioning procedure(CRP).
Methods
Based on the duration of nystagmus, 117 geotropic DCPN patients were classified to two groups, p-DCPN and t-DCPN. Barbeque maneuver had been introduced towards the direction of null plane for the p-DCPN patients, and to the direction of stronger nystagmus for the t-DCPN patients.
Results
74 patients showed t-DCPN with latency and 43 patients were classified to the p-DCPN cases. The t-DCPN cases showed more dominant female proportion than those of the p-DCPN cases. No p-DCPN patient showed prompt improvement after the 1st canalolith reposition therapy. Among the t-DCPN patients, 18 canal switch cases were found, but, there was no canal switch cases found among the p-DCPN patients. The CRP has showed less effective for the p-DCPN patients and no canal switch patients found in the t-DCPN patients. Null plane direction among p-DCPN patients, didn’t always match the direction of stronger nystagmus during the supine head roll test.
Conclusions
Due to its distinguishing clinical manifestation, p-DCPN may have different pathogenesis and clinical mechanisms from t-DCPN. And the CRP is not an adequate treatment for the p-DCPN patients. Further study with larger number of enrolled subjects is necessary.
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Dizzy and Psychological Scales in Benign Paroxysmal Positional Vertigo: Suspicious Patients without Characteristic Nystagmus
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Seok Min Hong, Sung Kyun Kim, Heejin Kim, Seok Jin Hong, Yong Bok Kim, Il-Seok Park, Dawoon Oh
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Res Vestib Sci. 2017;16(3):80-84. Published online September 15, 2017
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DOI: https://doi.org/10.21790/rvs.2017.16.3.80
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Abstract
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- Objectives
Patients, who have had a history of benign paroxysmal positional vertigo (BPPV)-like symptoms, but no characteristic nystagmus, were often present. They are diagnosed as having a resolved state from BPPV or normal, and tend to be overlooked. We investigated the dizzy and psychological scales in BPPV-suspicious patients. Methods: Thirty-nine patients, which they had vertigo of a short duration at the specific head position, and clinically suspicious BPPV, but no nystagmus in positional tests, were enrolled. We compared dizzy and psychological scales of suspicious BPPV patients with 138 BPPV patients, using dizziness handicap inventory (DHI), the beck depression inventory (BDI), and the Spielberger state-trait anxiety inventory. Additionally, among the BPPV-suspicious group, patients with a BPPV history were compared with those with no previous BPPV. Results: No differences in the all scales were found between the two groups. However, DHI scores of patients with a previous BPPV attack were significantly higher than those of patients with no BPPV-like symptoms; in particular, there was a significant difference in emotional scores. Conclusion: Although the patients had no characteristic nystagmus, if they have a BPPV-like history and symptoms, emotional support and periodic follow up are needed. In particular, careful observation should be performed in patients with previous BPPV attack.
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Dizzy and psychological scales in BPPV-suspicious patients without characteristic nystagmus
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Seok Min Hong, Sung Kyun Kim, Heejin Kim, Seok Jin Hong, Yong Bok Kim, Il-seok Park, Dawoon Oh
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Received July 29, 2017 Accepted August 19, 2017 Published online August 19, 2017
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[Accepted]
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Abstract
- Objectives
Patients, who have had a history of BPPV-like symptoms, but no characteristic nystagmus, were often present. They are diagnosed as having a resolved state from BPPV or normal, and tend to be overlooked. We investigated the dizzy and psychological scales in BPPV-suspicious patients.
Study Design : prospective study
Methods
Thirty-nine patients, which they had vertigo of a short duration at the specific head position, and clinically suspicious BPPV, but no nystagmus in positional tests, were enrolled. We compared dizzy and psychological scales of suspicious BPPV patients with 138 BPPV patients, using DHI, BDI and STAI. Additionally, among the BPPV-suspicious group, patients with a BPPV history were compared with those with no previous BPPV.
Results
No differences in the all scales were found between the two groups. However, DHI scores of patients with a previous BPPV attack were significantly higher than those of patients with no BPPV-like symptoms; in particular, there was a significant difference in emotional scores.
Conclusion
Although the patients had no characteristic nystagmus, if they have a BPPV-like history and symptoms, emotional support and periodic follow up are needed. In particular, careful observation should be performed in patients with previous BPPV attack.
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