Clinical Characteristics of Benign Positional Vertigo

Moon, So Young; Choi, Kwang Dong; Park, Seong Ho; Kim, Ji Soo

Abstract

BACKGROUND
Benign positional vertigo (BPV) is characterized by episodic vertigo and nystagmus provoked by head motion. Though BPV is the most common cause of vertigo, systemic analysis of clinical features has been sparse. METHODS: We analyzed clinical features of 194 patients who had been diagnosed as having BPV in a dizziness clinic from September 2000 to December 2002. The diagnosis of BPV was based on the typical nystagmus concurrent with vertigo elicited by positioning maneuvers. The nystagmus was observed by using Frenzel glasses, or recorded with video- or electro-oculography. According to the semicircular canal involved, we classified BPV into posterior, horizontal, and anterior canal types. The horizontal canal type was subdivided into geotropic or apogeotropic. RESULTS: The patients included 149 women and 45 men. Mean age of the patients was 60.9 +/- 12.7 with no difference between women and men. Posterior (46.4%) and horizontal (40.7%) semicircular canals were most commonly involved. Most patients were idiopathic. Most patients (97.9%) were successfully treated with canalith repositioning procedure (CRP). CONCLUSIONS: BPV may involve each of the three semicircular canals. The involved canal can be identified by careful observation of the nystagmus induced by Hallpike maneuver or head turning in supine position. The horizontal canal is more commonly involved in BPV than previously known. High success rate of CRP is expected only when different method of CRP is applied to each patient depending on the canal involved.