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Benign Paroxysmal Positional Vertigo of Childhood
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Seong Jun Choi, Dong Hyun Kim, You Ree Shin, Hun Yi Park, Tae Yun Kim, Yun Hoon Choung
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J Korean Bal Soc. 2006;5(2):269-273.
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 Abstract
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- Background
and Objectives: Episodic vertigo and/or dizziness in children are not frequent symptoms. Causes of benign episodic vertigo in pediatric age include bengin paroxysmal vertigo of childhood(BPV) and bengin paroxysmal positional vertigo(BPPV). While BPPV has been frequently observed in adult, less frequently observed in children. The aim is to review the clinical manifestations in children with BPPV.
Materials and Method: 154 children with dizziness or vertigo, who visited the Dizziness Clinic in the Department of Otolaryngology, Ajou University Hospital, Suwon, Korea between January 2001 and November 2006 were selected for this study. From all the patients, a comprehensive history was obtained, followed by clinical examination of the ears, nose, and throat and a complete audiologic and neurotologic examination including electronystagmography. All patients were treated with an appropriate canalith repositioning maneuver(CRP), depending on the type of BPPV.
Results
Seven (4.5%) of 154 children with dizziness or vertigo showed typical BPPV. The mean age was 11.8 years old (9-15 years). The horizontal and anterior semicircular canals were involved in 6 (85.8%) whereas the multiple semicircular canals were involved in 1 (14.2%) patients. Vertigo symptom subsided immediately in 6 (85.7%) patients after one or two trials of CRP, but 1(28.6%) patient showed recurred vertigo, that was treated with retrial of CRP.
Conclusion
The incidence of BPPV in children were much lower than that of adult BPPV, but it was higher than we expected before. We recommend that clinical tests such as Dix-Hallpike maneuver and head rolling test should be performed on all children with dizziness to establish the diagnosis of BPPV.
Key Words : Positional vertigo, Child
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Bilateral Multiple Benign Paroxysmal Positional Vertigo Combined with Vestibular Neuritis
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Seong Jun Choi, You Lee Shin, Yun Tae Kim, Nam Soo Han, Yun Hoon Choung
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J Korean Bal Soc. 2006;5(1):81-85.
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Abstract
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- Although classical benign paroxysmal positional vertigo (BPPV) has generally been resolvable by routine manual repositioning maneuvers, nevertheless resistant cases and variant remain a significant problem. Recently, we experienced a case of posterior semicircular canal BPPV combined with changes to various types of BPPV during manual reposition maneuver and vestibular neuritis. We examined her brain MRI due to low response of routine manual reposition maneuvers and frequently recurrence of BPPV. In brain MRI, we found 1.3cm sized mass in hypoglossal canal. It seemed to be neuroma on hypoglossal nerve. A refractory BPPV poses problems of pathophysiogenetic interpretation, differential diagnosis with a CNS lesion and therapeutic strategy. We thought that refractory BPPV should be treated with more frequently examination and manual repositional maneuver and distinguished from CNS lesion.
Key Words : Canalolithiasis, Cupulolithiasis, Vestibular neuritis
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The New Method to Determine the Causing Site of Horizontal Canal Benign Paroxysmal Positional Vertigo: “Bowing and Leaning Nystagmus”
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You Ree Shin, Hison Khang, Jung Sub Park, Seong Jun Choi, Keehyun Park, Yun Hoon Choung
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J Korean Bal Soc. 2006;5(1):55-60.
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Abstract
PDF
- Background
and Objectives: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald’s second law. The purpose of this study is to develop the new “Bow and Lean Test (BLT)” to determine easily the affected ear of HSC-BPPV and evaluate its efficiency.
Materials and Method: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald's second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both “bowing nystagmus” and “leaning nystagmus” at head’s bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis.
Results
In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT.
Conclusion
“Bow and Lean Test” (also called “Choung’s test”) is a new method which can easily determine the affected ear of HC-BPPV.
Key Words : Vertigo, Benign paroxysmal positional vertigo, Horizontal semicircular canal, iagnosis, Nystagmus
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