Benign Paroxysmal Positional Vertigo due to a Simultaneous Involvement of both Horizontal and Posterior Semicircular Canals

Vol. 11, No. 3, 2006

Free Abstract Article (Fulltext) Article (PDF 294 KB)

Original Paper

Benign Paroxysmal Positional Vertigo due to a Simultaneous Involvement of both Horizontal and Posterior Semicircular Canals
Takao Imai^{a, b}, Noriaki Takeda^d, Mahito Ito^a, Koji Nakamae^c, Hideki Sakae^c, Hiromu Fujioka^e, Takashi Matsunaga^f, Takeshi Kubo^b

^aDepartment of Otolaryngology, Kansai-Rosai Hospital, Hyogo,
^bDepartment of Otolaryngology, Osaka University Medical School and
^cDepartment of Information Systems Engineering, Osaka University Graduate School of Engineering, Osaka,
^dDepartment of Otolaryngology, University of Tokushima School of Medicine, Tokushima,
^eDepartment of Management and Information Sciences, Fukui University of Technology, Fukui, and
^fDepartment of Otolaryngology, Nara Medical University, Nara, Japan

Address of Corresponding Author

Audiol Neurotol 2006;11:198-205 (DOI: 10.1159/000091892)

Key Words

Canalolithiasis
Cupulolithiasis
Nystagmus, positional
Rotation vector

Abstract

From April 2001 to November 2003, we investigated 8 patients with benign paroxysmal positional vertigo (BPPV) that was suspected to simultaneously affect both the horizontal and posterior semicircular canals (HSCC and PSCC). These cases showed typical vertical-torsional nystagmus induced by the Dix-Hallpike maneuver, followed by a horizontal nystagmus. They also showed a direction-changing geotropic or apogeotropic positional nystagmus triggered by lateral head rotations in the supine position. Using the three-dimensional analysis of the positional nystagmus, the rotation axis of the positional nystagmus had a component perpendicular to the plane of PSCC and another component perpendicular to the plane of HSCC. All these findings suggest that BPPV in these patients was a combination of posterior and horizontal canal BPPV. The observation of a vertical-torsional positional nystagmus should prompt the specialist to perform not only the canalith repositioning procedure, but also to execute lateral head turns in the supine position.

Author Contacts

Takao Imai, MD, PhD
Department of Otolaryngology, Kansai-Rosai Hospital
3-1-69 Inabasou
Amagasaki, Hyogo 660-8511 (Japan)
Tel. +81 6 6416 1221, Fax +81 6 6419 1870, E-Mail imaitakao@hotmail.com

Article Information

Received: March 11, 2005
Accepted after revision: January 4, 2006
Published online: March 7, 2006
Number of Print Pages : 8
Number of Figures : 5, Number of Tables : 1, Number of References : 24

Medline Abstract (ID 16534183)

Download Citation

Special offer for
members of the ARO

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.