Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

Chonbuk National University157 enrolled

Overview

The purpose of this study was to compare the immediate efficacies of each treatment maneuvers in treatment of apogeotropic horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

A randomized prospective study of patients with HC-BPPV. Patients with apogeotropic type of HC-BPPV were randomized to one of each three treatment groups at their first clinic visit. These groups included the Gufoni maneuver, head-shaking maneuver, and sham group in apogeotropic HC-BPPV. Responsiveness of treatment maneuver was determined by positioning maneuver immediately after each treatment method based on resolves of vertigo and positional nystagmus.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

157

Conditions

HC-BPPV

Interventions

Gufoni maneuverPROCEDURE

For Gufoni maneuver,16,18 the patient was quickly brought down to the side-lying position on the affected ear from the sitting position. After one minute in this position, the head of the patient was quickly turned 45O upward, so that the nose directed upward. Approximately 2 minutes later, the patient was returned to the upright position (Figure 2A).

Head-shaking maneuverPROCEDURE

For head-shaking maneuver,15 patients were brought into a sitting position. After pitching the head forward by approximately 30O, we moved the head sideways in a sinusoidal fashion at an approximate rate of 3 Hz for 15 seconds.

sham maneuverPROCEDURE

For the sham maneuver, patients quickly lied on the unaffected side, and returned to the sitting position after one minute.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * a history of brief episodes of positional vertigo, * direction-changing horizontal nystagmus beating toward the uppermost (apogeotropic nystagmus) or undermost (geotropic nystagmus) ear in both the lateral head turning positions, * no spontaneous nystagmus during upright sitting position, and * absence of identifiable central nervous system disorders that could explain the positional vertigo and nystagmus. Exclusion Criteria: * central positional nystagmus with identifiable CNS lesions that could explain the positional nystagmus

Locations (2)

Chonbuk National University Hospital

Jeonju, Cholabuk-do, South Korea

Seoul National University Bundang Hospital

Seongnam, Kyoungki-do, South Korea

Outcomes

Primary Outcomes

Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial

The immediate treatment response was determined by participating neurologists in each clinic without knowing the maneuver applied to each patient from 30 minutes to one hour after initial maneuver. The absence of both vertigo and nystagmus was required to determine a resolution.

Time frame: one hour

Data from ClinicalTrials.gov

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