Classification, diagnostic criteria and management of benign paroxysmal positional vertigo

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• 作者：Takao Imai^a ; ^{timai@ent.med.osaka-u.ac.jp} ; Noriaki Takeda^b ; Tetsuo Ikezono^c ; Kohichiro Shigeno^d ; Masatsugu Asai^e ; Yukio Watanabe^f ; Mamoru Suzuki^g ; on behalf of Committee for Standards in Diagnosis of Japan Society for Equilibrium Research
• 关键词：Benign paroxysmal positional vertigo ; Canalolithiasis ; Cupulolithiasis ; Canalith repositioning procedure
• 刊名：Auris Nasus Larynx
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：44
• 期：1
• 页码：1-6
• 全文大小：937 K
• 卷排序：44

文摘

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix–Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research.