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Clinical Study of Benign Paroxysmal Positional Vertigo
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Chang Hee Bae, In Hyo Lee, Dong Yook Park, Jung Eun Kim, Hyuk Soon Chang, Dong Wook Kim
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Res Vestib Sci. 2010;9(3):93-99.
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 Abstract
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- Background and Objectives: Benign paroxysmal positional vertigo (BPPV) was the most frequent peripheral type vertigo. It has been well controlled with canalith repositioning procedure. Canalith repositioning procedure provides rapid and long-lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after canalith repositioning procedure, even after the disappearance of nystagmus and vertigo. The purpose of this study is to assess type distribution of BPPV and relationship between recurrence and subjective residual dizziness after canalith repositioning procedure in patients.
Materials and Methods: Ninety-five BPPV patients of 501 patients with dizziness who visited Dizziness Clinic in the Department of Otolaryngology at Soonchunhyang University Hospital from July 2005 to June 2008 were included in this study. These patients were retrospectively reviewed based on clinical charts. In the case of BPPV, repositioning procedure was performed. We analyzed the recurrence, the relationship between recurrence and subjective residual dizziness after canalith repositioning procedure.
Results: Overall recurrence rate was 13.6%. Lateral canal origin was more common than posterior canal origin. All cases except 1 were recovered by canalith repositioning procedure. There was no correlation between recurrence and origin, type, subjective residual dizziness of patients.
Conclusion: Patients showed various origin, type and recurrence. After the successful canalith repositioning procedure, residual subjective symptoms of patients were presented sometimes, but was no relation to recurrence. Thus, additional follow up and emotional management may be needed.
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Tilt Suppression of the Post-rotatory Nystagmus in Cerebellar Nodular Lesions
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Sun Young Oh, Kwang Dong Choi, Jung Eun Kim, Ja Won Koo, Ji Soo Kim
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J Korean Bal Soc. 2007;6(2):161-166.
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Abstract
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- Background and Objectives: Head tilt at the end of step rotation about a vertical axis decreases the time constant (TC) of the post-rotatory nystagmus, which is known as tilt-suppression of the vestibulo-ocular reflex (VOR). Tilt suppression of the VOR is mediated by the cerebellar nodulus and ventral uvula and is eliminated after surgical ablation of those structures. However, studies on the tilt suppression of the VOR have been sparse in humans with cerebellar lesions.
Materials and Methods: Five patients with circumscribed cerebellar lesions involving the nodulusor ventral uvula underwent recording of spontaneous and positional nystagmus, and the VOR. To evaluate tilt suppression of the VOR, the participants pitched their head forward at the end of step rotation about a vertical axis both in the clockwise and counter-clockwise directions.
Results: The VOR gain was increased in a patient with infarction in the territory of the medial posterior inferior cerebellar artery while the gain of visually enhanced VOR was normal in all the patients. The time constants of perand post-rotatory nystagmus was increased in a patient with increased VOR gain and the tilt suppression of the post-rotatory nystagmus was impaired in two patients, either uni- or bilaterally. Spontaneous downbeat and central positional nystagmus were frequently accompanied.
Conclusions: Nodular lesion may impair tilt suppression of the VOR. Measurement of tilt suppressive effect of the VOR may provide a valuable tool for evaluating the nodular dysfunction.
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