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1 Outcome of canalith repositioning procedure in patients with persistent and transient geotropic direction-changing positional nystagmus : Short term follow-up evaluation
Seung Sik Jeon, Seok Min Hong, Yong Bok Kim, Sung Kyun Kim, Il-Seok Park

DOI: [Accepted]
Published online: August 31, 2018
Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Gyounggi-do, Korea
Corresponding author:  Seok Min Hong, Tel: 03180862670, Fax: 03180862681, 
Received: 19 July 2018   • Accepted: 31 August 2018
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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).
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.
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.
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.

Res Vestib Sci : Research in Vestibular Science