Abstract
Background
The diagnostic characteristics of patients with cupulolithiasis of the posterior semicircular canal are persistent torsional nystagmus in the supine position and persistent torsional nystagmus (opposite direction) in the nose-down position, which are caused by the affected canal becoming gravity sensitive.
Objective
To investigate the clinical features of posterior cupulolithiasis.
Materials and methods
We interviewed 30 consecutive patients with cupulolithiasis of the posterior canal and categorized them by onset time into the following four groups: (1) during sleep; (2) at the time of awakening; (3) morning; and (4) afternoon. We defined disease duration as the period from onset to the day when we detected remission of positional nystagmus.
Results
Time of awakening was the most common onset time. The mean disease duration was 18.2 days, and 90% of patients achieved cure within 1 month.
Conclusions
Physicians should take into account the duration of nystagmus, because cupulolithiasis of posterior canal exists. The etiology of posterior cupulolithiasis is closely related to sleep, because time of awakening is the most common onset time of vertigo. Most patients with posterior cupulolithiasis cure within 1 month.
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References
Dix MR, Hallpike CS (1952) The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 61:987–1016
Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:765–778
Epley JM (1992) The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 107:399–404
Herdman SJ, Tusa RJ, Zee DS et al (1993) Single treatment approaches to benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 119:450–454
Helminski JO, Zee DS, Janssen I et al (2010) Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther 90:663–678
Parnes LS, Price-Jones RG (1993) Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 102:325–331
Weider DJ, Ryder CJ, Stram JR (1994) Benign paroxysmal positional vertigo: analysis of 44 cases treated by the canalith repositioning procedure of Epley. Am J Otol 15:321–326
Imai T, Takeda N, Ito M et al (2009) 3D analysis of benign positional nystagmus due to cupulolithiasis in posterior semicircular canal. Acta Otolaryngol 129:1044–1049
Ichijo H (2013) Cupulolithiasis of the posterior semicircular canal. Am J Otolaryngol 34:458–463
Ikeda T, Hashimoto M, Horiike O et al (2002) Simple eye movement image analysis technique using NIH image. Equilib Res 61:90–96
Shigeno K, Ogita H, Funabiki K (2012) Benign paroxysmal positional vertigo and head position during sleep. J Vestib Res 22:197–203
Otsuka K, Suzuki M, Furuya M (2003) Model experiment of benign paroxysmal positional vertigo mechanism using the whole membranous labyrinth. Acta Otolaryngol 123:515–518
Hiruma K, Numata T (2004) Positional nystagmus showing neutral points. ORL J Otorhinolaryngol Relat Spec 66:46–50
Ichijo H (2012) Persistent direction-changing geotropic positional nystagmus. Eur Arch Otorhinolaryngol 269:747–751
Honda H, Watanabe Y, Irino O et al (1988) Effects of ifenprodil tartrate on vertebral, basilar and internal carotid arteries. Int J Clin Pharmacol Ther Toxicol 26:4–7
Imai T, Takeda N, Ito M et al (2011) Natural course of positional vertigo in patients with apogeotropic variant of horizontal canal benign paroxysmal positional vertigo. Auris Nasus Larynx 38:2–5
Acknowledgements
We thank Dr. Kazunori Futai for preparing the figures.
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All procedures performed in study involving human participants were in accordance with the ethical board of the Hirosaki Medical Association (certificate number is 2015-29) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Ichijo, H. Analysis of 30 patients with cupulolithiasis of the posterior semicircular canal. Eur Arch Otorhinolaryngol 280, 599–603 (2023). https://doi.org/10.1007/s00405-022-07508-2
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DOI: https://doi.org/10.1007/s00405-022-07508-2