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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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