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Original Article
Clinical Significance of Spontaneous Nystagmus in Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo
Jun Lee, Sehun Chang, Ho Yun Lee
Res Vestib Sci. 2018;17(1):18-22.   Published online March 15, 2018
DOI: https://doi.org/10.21790/rvs.2018.17.1.18
  • 9,482 View
  • 130 Download
AbstractAbstract PDF
Objectives
We aimed to assess the clinical significance of spontaneous nystagmus (SN) in horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV).
Methods
Twenty-four patients who were diagnosed with HC-BPPV in Eulji University Hospital from January 2015 to December 2016 were recruited. Various bed-side examinations including SN in both sitting and supine position, head roll test, and bithermal caloric test were evaluated. The number of canalith repositioning maneuvers were counted in all patients.
Results
SN was observed in 18.2% of geotropic HC-BPPV and 38.5% of apogeotropic HC-BPPV, respectively. There was no significant difference between presence of SN and the direction of initial nystagmus (p=0.386, 2-tailed Fisher exact test). The mean number of otolith repositioning maneuvers in patients with SN was 3.29±1.799 and this was significantly higher than in patients without SN (1.76±0.831) (p=0.009). Although the mean number of repositioning maneuver in patients in apogeotropic HC-BPPV and SN (3.80±1.924) tended to be higher than those who were diagnosed with apogeotropic HC-BPPV without SN (1.88±1.991) (p=0.035), the post hoc analysis with Bonferroni correction revealed that it was not significant because it was higher than the adjusted p-value (p=0.017). The initial direction of nystagmus was changed into the opposite direction in 29.17% of patient. However, this change was not different according to presence of SN (p=0.374, 2-tailed Fisher exact test).
Conclusions
The presence of SN in HC-BPPV may be associated with lower treatment response. In particular, cautions are needed in patients with apogeotropic HC-BPPV.
1
Clinical Significance of Spontaneous Nystagmus in Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo
Jun Lee, Sehun Chang, Ho Yun Lee
Received February 26, 2018  Accepted March 7, 2018  Published online March 7, 2018  
   [Accepted]
  • 1,833 View
  • 3 Download
AbstractAbstract
Objectives
We aimed to assess the clinical significance of spontaneous nystagmus (SN) in horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV).
Methods
Twenty-four patients who were diagnosed with HC-BPPV in our hospital from January 2015 to December 2016 were recruited. Various bed-side examinations including SN in both sitting and supine position, head roll test and bithermal caloric test was evaluated. The number of canalith repositioning maneuvers were counted in all patients.
Results
18.2% of geotropic HC-BPPV and 38.5% of apogeotropic HC-BPPV showed SN. There was no significant difference between presence of SN and the direction of initial nystagmus (p=0.386, two-tailed Fisher's exact test). The mean number of otolith repositioning maneuvers in patients with SN was 3.29±1.799 and this was significantly higher than in patients without SN (1.76±0.831) (p=0.009). Although the mean number of repositioning maneuver in patients in apogeotropic HC-BPPV and SN (3.80±1.924) tended to be higher than those who were diagnosed with apogeotropic HC-BPPV without SN (1.88±1.991) (p=0.035), the post-hoc analysis with Bonferroni correction revealed that it was not significant because it was higher than the adjusted p value (p=0.017). the initial direction of nystagmus was changed into the opposite direction in 29.17% of patient. However, this change was not different according to presence of SN (p=0.374, two-tailed faisher's exact test).
Conclusions
The presence of SN in HC-BPPV may be associated with lower treatment response. In particular, cautions are needed in patients with apogeotropic HC-BPPV.
Original Article
Effects of Medical Treatment on Meniere's disease
Won Ho Chung, Hyeok Jun Lee, Byung soo Hong, Hyun Jong Lee, Sung Hwa Hong, Yang Sun Cho
J Korean Bal Soc. 2003;2(1):113-120.
  • 1,793 View
  • 9 Download
AbstractAbstract PDF
Objectives
In Meniere's disease, medical treatment using diuretics has been the mainstream of management. But the effects of medical treatment are very difficult to evaluate because of many variables. Authors tried to investigate the effects of diuretics on Meniere's disease through the change of symptoms. Materials and Method: From January, 1995 to December, 2000, the twenty patients with definite Meniere's disease who has been followed up over 24 months were retrospectively reviewed. They had no history of previous medication, and were managed with diuretics for the first time. The change of frequency of vertigo, the threshold of pure tone audiometry, type of audiogram were analyzed at each period during 6 month before treatment, during 6 month at 1, 2 and 4 years after treatment.
Results
The ratio of sex was 1:1(male 10, female 10), the average age of diagnosis was 53.9 year old, and the average follow up duration was 39.3 month. By medical treatment, vertigo symptom was significantly controlled in 56.2% at 2 year after treatment. Among 20 patients, 5 patients failed to medical treatment and underwent the sac decompression (N=1) and intratympanic gentamicin injection (N=4). The change of pure tone audiometry was from 34.5 dB before treatment to 38 dB at 24 months and 44.2 dB at 48 months after treatment. The most type of audiometry was flat type and flat type was increased with time.
Conclusion
In Meniere's disease, the medical treatment controlled significantly the vertigo frequency in 50~60%. But the hearing threshold was aggravated with time after treatment despite of medical treatment.

Res Vestib Sci : Research in Vestibular Science
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