1/4. Clinical effect of canal plugging on paroxysmal positional vertigo.A 63-year-old woman had disabling positional vertigo for four months. She showed intense direction-changing apogeotropic nystagmus. Conservative treatment failed to resolve her vertigo. From the findings of the nystagmus, cupulolithiasis of the right lateral canal was suspected. Plugging of this canal successfully eliminated the nystagmus and positional vertigo. Positional vertigo can sometimes be disabling and unresponsive to conservative therapy. Careful analysis of the nystagmus may allow selection of the most appropriate treatment.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/4. Continuous vertigo and spontaneous nystagmus due to canalolithiasis of the horizontal canal.The authors present a patient with benign paroxysmal positional vertigo of the right horizontal semicircular canal who developed persistent vertigo with spontaneous horizontal nystagmus to the left and caloric hypoexcitability on the right after a head shaking maneuver. Both spontaneous nystagmus and canal paresis resolved after repeated shaking of the head. The most probable mechanism of this type of vertigo is plugging of the horizontal canal by otoconial particles with a negative endolymph pressure between plug and cupula.- - - - - - - - - - ranking = 1.8333333333333keywords = canal (Clic here for more details about this article) |
3/4. A newly recognised cause of vertigo: horizontal canal variant of benign positional vertigo.AIMS: To describe the presentation, causes, treatment, and outcomes of patients presenting with the newly recognised horizontal canal variant of benign positional vertigo (BPV); and to emphasise the importance of performing a positional test on all patients being assessed for vertigo. methods: The records on 400 patients presenting with BPV were analysed. Two detailed patient histories from 2004 are included. RESULTS: Forty-nine patients (12%) had horizontal canal BPV. The median presentation age was 59 years. In 17 patients, it presented de novo during repositioning treatment for 'classical' posterior canal BPV. Repositioning is in the horizontal plane, with the direction depending on whether the mechanism is canalithiasis or cupulolithiasis. CONCLUSIONS: Horizontal canal BPV explains nearly all variations on 'classical' (posterior canal) BPV. It accounts for at least 10% of BPV and has been frequently misdiagnosed. Repositioning is usually curative if the symptomatic ear is correctly identified.- - - - - - - - - - ranking = 1.6666666666667keywords = canal (Clic here for more details about this article) |
4/4. Canalolithiasis of the superior semicircular canal: an anomaly in benign paroxysmal vertigo.According to the canalolithiasis theory, benign paroxysmal vertigo (BPPV) is caused by gravity-dependent movements of otoconial debris that collects in the endolymph of the posterior semicircular canal. Other parts of the vestibular organ are rarely affected, and it is mainly the horizontal canal that is affected by this atypical form of BPPV. Canalolithiasis of the superior semicircular canal must be considered an anomaly because the superior semicircular canal is the highest point of the vestibular organ and debris normally cannot collect in this special location. Until now, BPPV of the superior canal has mainly been dealt with theoretically in the literature. The authors present three patients with canalolithiasis of the superior semicircular canal and offer direct proof of the condition using high-resolution 3D MRI.- - - - - - - - - - ranking = 2keywords = canal (Clic here for more details about this article) |