Combined horizontal and posterior canal benign paroxysmal positional vertigo in three patients with head trauma
Autor: | Stéphane Tringali, Larbi Chelikh, Andrei P. Timoshenko, Christian Martin, Pierre Bertholon |
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Rok vydání: | 2005 |
Předmět: |
Adult
Male medicine.medical_specialty Supine position Benign paroxysmal positional vertigo medicine.medical_treatment Poison control Epley maneuver Positional Nystagmus Head trauma 03 medical and health sciences 0302 clinical medicine Vertigo Head Injuries Closed otorhinolaryngologic diseases medicine Humans 030223 otorhinolaryngology medicine.diagnostic_test biology business.industry Magnetic resonance imaging General Medicine Middle Aged biology.organism_classification medicine.disease Surgery Otorhinolaryngology 030220 oncology & carcinogenesis Female sense organs business |
Zdroj: | The Annals of otology, rhinology, and laryngology. 114(2) |
ISSN: | 0003-4894 |
Popis: | We report 3 patients who complained of positional vertigo shortly after head trauma. Positional maneuvers performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position with the head raised 30°) revealed a complex positional nystagmus that could only be interpreted as the result of combined PC and HC benign paroxysmal positional vertigo (BPPV). Two patients had a right PC BPPV and an ageotropic HC BPPV, and 1 patient had a bilateral PC BPPV and a left geotropic HC BPPV. All 3 patients were rapidly free of vertigo after the PC BPPV was cured by the Epley maneuver and the geotropic HC BPPV was cured by the Vannucchi method. The ageotropic HC BPPV resolved spontaneously. Neuroimaging (brain computed tomography and/or magnetic resonance imaging scans) findings were normal in all 3 patients. From a physiopathological viewpoint, it is easy to conceive that head trauma could throw otoconial debris into different canals of each labyrinth and be responsible for these combined forms of BPPV. Consequently, in trauma patients with vertigo, it is mandatory to perform the Dix-Hallpike maneuver, as well as supine lateral head turns, in order to diagnose PC BPPV, HC BPPV, or the association of both. Early diagnosis and treatment of BPPV may help to reduce the postconcussion syndrome. |
Databáze: | OpenAIRE |
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