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Bilateral simultaneous presentation of posterior canal benign paroxysmal positional vertigo

Published online by Cambridge University Press:  23 June 2023

Sertac Yetiser*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Anadolu Medical Center, Kocaeli, Turkey
Dilay Ince
Affiliation:
Vestibular Laboratory, Department of Otorhinolaryngology and Head and Neck Surgery, Anadolu Medical Center, Kocaeli, Turkey
*
Corresponding author: Sertac Yetiser; Email: syetiser@yahoo.com

Abstract

Objective

To outline the clinical picture of bilateral posterior canal benign paroxysmal positional vertigo.

Methods

A total of 573 patients with posterior canal benign paroxysmal positional vertigo were classified as having unilateral, or true or pseudo bilateral, posterior canal benign paroxysmal positional vertigo, and were treated with the Epley manoeuvre. Statistical significance was set at p < 0.05.

Results

Of the patients, 483 had unilateral and 90 (15.7 per cent) had bilateral presentation. Of the latter, 72 patients had pseudo bilateral posterior canal benign paroxysmal positional vertigo. Comparisons of site of involvement, male to female ratio and the incidence of associated problems in unilateral, and true and pseudo bilateral posterior canal benign paroxysmal positional vertigo did not reveal any statistically significant differences (p = 0.828, p = 0.200, p = 0.142). Comparisons of the number of manoeuvres required to provide symptom relief and the rate of recurrence were significant (p < 0.05).

Conclusion

Identification of true and pseudo bilateral posterior canal benign paroxysmal positional vertigo is important given the differences in aetiology and treatment outcome. Treatment of patients with true bilateral posterior canal benign paroxysmal positional vertigo requires several therapeutic manoeuvre attempts, and patients should be warned about recurrence.

Type
Main Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Sertac Yetiser takes responsibility for the integrity of the content of the paper

References

Balatsouras, DG, Koukoutsis, G, Ganelis, P, Korres, GS, Kaberos, A. Diagnosis of single or multiple canal benign paroxysmal positional vertigo according to the type of nystagmus. Int J Otolaryngol 2011;2011:483965CrossRefGoogle ScholarPubMed
Steddin, S, Brandt, T. Unilateral mimicking bilateral benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 1994;120:1339–41CrossRefGoogle Scholar
Hotta, S, Imai, T, Higashi-Shingai, K, Okazaki, S, Okumura, T, Uno, A et al. Unilateral posterior canal-plugging surgery for intractable bilateral posterior canal-type benign paroxysmal positional vertigo. Auris Nasus Larynx 2017;44:540–7CrossRefGoogle ScholarPubMed
Imai, T, Takeda, N, Sato, G, Sekine, K, Itao, M, Nakaeme, K et al. Differential diagnosis of true and pseudo-bilateral benign positional nystagmus. Acta Otolaryngol 2008;128:151–8CrossRefGoogle ScholarPubMed
Pollak, L, Stryjer, R, Kushnir, M, Flechter, S. Approach to bilateral benign paroxysmal positioning vertigo. Am J Otolaryngol 2006;27:91–5CrossRefGoogle ScholarPubMed
Beyea, JA, Parnes, LS. Purely vertical upbeat nystagmus in bilateral posterior canal benign paroxysmal positional vertigo: a case report. Laryngoscope 2010;120:208–9CrossRefGoogle ScholarPubMed
Ichimura, A, Itani, S. Persistent upbeat positional nystagmus in a patient with bilateral posterior canal benign paroxysmal positional vertigo. Case Rep Otolaryngol 2019;2019:4281641Google Scholar
Yetiser, S, Ince, D. Vertical nystagmus during the seated-supine positional (straight head-hanging) test in patients with benign paroxysmal positional vertigo. J Laryngol Otol 2014;128:674–8CrossRefGoogle ScholarPubMed
Kaplan, DM, Nash, M, Niv, A, Kraus, M. Management of bilateral benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2005;133:769–73CrossRefGoogle ScholarPubMed
Balatsouras, DG. Benign paroxysmal positional vertigo with multiple canal involvement. Am J Otolaryngol 2012;33:250–8CrossRefGoogle ScholarPubMed
Pollak, L, Michael, T. Bilateral posterior canal benign paroxysmal positional vertigo tends to reoccur. Otol Neurotol 2019;40:946–50CrossRefGoogle ScholarPubMed
Longridge, NS, Barber, HO. Bilateral paroxysmal positional nystagmus. J Otolaryngol 1978;5:395–9Google Scholar
Katsarkas, A. Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic? Acta Otolaryngol 1999;119:745–9CrossRefGoogle ScholarPubMed
Vibert, D, Kompis, M, Hausler, R. Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia. Ann Otol Rhinol Laryngol 2003;112:885–9CrossRefGoogle ScholarPubMed
Carr, SD, Rutka, JA. Vestibular outcomes in bilateral posterior semicircular canal occlusion for refractory benign positional vertigo. Otol Neurotol 2018;39:1031–6CrossRefGoogle ScholarPubMed
Kisilevsky, V, Bailie, NA, Dutt, SN, Rutka, JA. Lessons learned from the surgical management of benign paroxysmal positional vertigo: the University Health Network experience with posterior semicircular canal occlusion surgery (1988-2006). J Otolaryngol Head Neck Surg 2009;38:212–21Google ScholarPubMed