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Natural history of horizontal canal benign paroxysmal positional vertigo is truly short

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Abstract

The objective of the study is to characterize the natural course of positional vertigo and nystagmus in patients with horizontal canal benign paroxysmal positional vertigo (h-BPPV) and to analyze the difference in the natural course between the two variants of h-BPPV. We conducted a prospective study in 106 patients with geotropic type h-BPPV [h-BPPV (Geo)] (n = 43) and apogeotropic type h-BPPV [h-BPPV (Apo)] (n = 63) who agreed and signed the written informed consent of no treatment. All patients were asked to answer a detailed interview about the onset time of positional vertigo and to visit the hospital every 1–3 days. At every visit, they were interviewed about cessation time of positional vertigo and positional nystagmus was assessed. The mean period ± SD between the onset and remission of vertigo in the h-BPPV (Geo) was 6.7 ± 6.3 days, whereas that in the h-BPPV (Apo) was 3.7 ± 4.1 days. In addition, the mean period ± SD from the initial diagnosis to the disappearance of positional nystagmus in the h-BPPV (Geo) was 4.7 ± 3.9 days, whereas that in the h-BPPV (Apo) was 4.4 ± 5.0 days. Although the duration until natural remission of positional nystagmus did not differ between the two variants of h-BPPV, the remission of vertigo occurred faster in h-BPPV (Apo) than h-BPPV (Geo) (p < 0.05). The natural course of h-BPPV is much shorter than that indicated in previous reports. The positional vertigo disappeared faster in the h-BPPV (Apo) compared to the h-BPPV (Geo) unlike the positional nystagmus.

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Acknowledgments

The authors thank Dr. Myung-Whan Suh at Seoul National University College of Medicine, for critical review of this manuscript.

Conflicts of interest

None.

Ethical standard

This study was approved by the Institutional Review Board of Myongji Hospital and informed consent was obtained from all patients. The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Myongji Hospital, 697-24 Hwajung-dong, Deokyang-gu, Goyang, Gyeonggi, 412-270, Korea

    Dae Bo Shim, Kyung Min Ko, Joon Hee Lee & Mee Hyun Song

  2. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hong Ju Park

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  1. Dae Bo Shim
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  2. Kyung Min Ko
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Correspondence to Mee Hyun Song.

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Shim, D.B., Ko, K.M., Lee, J.H. et al. Natural history of horizontal canal benign paroxysmal positional vertigo is truly short. J Neurol 262, 74–80 (2015). https://doi.org/10.1007/s00415-014-7519-0

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  • DOI: https://doi.org/10.1007/s00415-014-7519-0

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