Advances in Positional Vertigo

A special issue of Audiology Research (ISSN 2039-4349).

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 31758

Special Issue Editor


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Guest Editor
UOSD “Vestibologia E Otorinolaringoiatria” Presidio Ospedaliero “Giovanni Paolo II”, Policoro, Italy
Interests: tumors; neurotology; ear; otology; human balance; hearing
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Special Issue Information

Dear Colleagues,

It is my pleasure to invite you and members of your research group to submit an article for a Special Issue on “Positional Vertigo”.

At the beginning of the last century, Robert Bàràny studied positional nystagmus, remarking on its noticeable connection with gravitational forces. In 1950, Carl Olof Nylén classified and defined three main types of positional nystagmus: direction-changing, changing direction in different positions of the head; direction fixed, beating always to the same direction; and irregular, characterized by variations in its behavior. He stated, “The probability is that both the peripheral and central system are capable of giving rise to positional nystagmus”. Two years later, Dix and Hallpike detailed the characteristics of benign paroxysmal positional vertigo (BPPV) and developed the diagnostic maneuver for posterior canal benign paroxysmal positional vertigo. In the last 70 years the literature has been enriched with many works on positional vertigo, especially relating to BPPV. New variants, new diagnostic and therapeutic techniques, and new proposals to prevent recurrent BPPV have been described. However, positional vertigo is not exclusively BPPV. Positional vertigo has been observed in central nervous system disorders that can mimic BPPV, in inner ear disorders such as Meniere’s disease, and in neurological disorders involving the inner ear, such as migraine.

The scope of this Special Issue includes, but is not limited to:

  • BPPV
    • New variants;
    • New approach strategies;
    • Therapeutic approach;
    • Prevention of recurrences, and vitamin D supplementation role;
    • Atypical forms;
    • Patients with poor/no response to the physical therapy;
  • Pathophysiological mechanisms
    • Labyrintholithiasis, cupulolithiasis, and canalolithiasis;
    • Cupulopathy, light/heavy cupula;
  • Central positional vertigo
    • Vascular disorders and neoplasms of the CNS;
    • Neurological disorders;
    • Autoimmune disorders;
  • Recurrent positional vertigo in:
    • Menière;
    • Migraine;
    • New pathophysiological proposals.

Dr. Giacinto Asprella Libonati
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Audiology Research is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • BPPV 
  • positional vertigo 
  • light/heavy cupula 
  • positional nystagmus 
  • benign paroxysmal positional vertigo 
  • central positional vertigo 
  • Menière 
  • vestibular migraine

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Published Papers (5 papers)

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Research

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10 pages, 1181 KiB  
Article
Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo: Zuma e Maia Maneuver versus Appiani Variant of Gufoni
by Marta Alvarez de Linera-Alperi, Octavio Garaycochea, Diego Calavia, David Terrasa, Nicolas Pérez-Fernández and Raquel Manrique-Huarte
Audiol. Res. 2022, 12(3), 337-346; https://doi.org/10.3390/audiolres12030035 - 19 Jun 2022
Cited by 4 | Viewed by 4574
Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that causes dizziness. The incidence of horizontal semicircular canal (HSC) BPPV ranges from 5% to 40.5% of the total number of BPPV cases diagnosed. Several studies have focused on establishing methods [...] Read more.
Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that causes dizziness. The incidence of horizontal semicircular canal (HSC) BPPV ranges from 5% to 40.5% of the total number of BPPV cases diagnosed. Several studies have focused on establishing methods to treat BPPV caused by the apogeotropic variant of the HSC, namely, the Appiani maneuver (App). In 2016, a new maneuver was proposed: the Zuma e Maia maneuver (ZeM), based on inertia and gravity. The aim of this study is to analyze the efficacy of App versus ZeM in the resolution of episodes of BPPV produced by an affectation of the horizontal semicircular canal with apogeotropic nystagmus (Apo-HSC). A retrospective, quasi-experimental study was conducted. Patients attended in office (November 2014–February 2019) at a third-level hospital and underwent a vestibular otoneurology assessment. Those who were diagnosed with Apo-HSC, treated with App or ZeM, were included. To consider the efficacy of the maneuvers, the presence of symptoms and/or nystagmus at the first follow up was studied. Patients classified as “A” were those with no symptoms, no nystagmus; “A/N+”: no symptoms, nystagmus present during supine roll test; “S”: symptoms present. Previous history of BPPV and/or otic pathology and calcium levels were also compiled. From the 54 patients included, 74% were women. The average age was 69. Mean follow-up: 52.51 days. In those patients without previous history of BPPV (n = 35), the probability of being group “A” was 63% and 56% (p = 0.687) when treated with App and ZeM, respectively, while being “A/N+” was 79% and 87% for App and ZeM (p = 0.508). Of the 19 patients who had previous history of BPPV, 13% and 64% were group “A” when treated with App and ZeM (p = 0.043), and 25% and 82% were “A/N+” after App and ZeM, respectively (p = 0.021). In conclusion, for HSC cupulolithiasis, ZeM is more effective than App in those cases in which there is a history of previous episodes of BPPV (“A”: 64% (p = 0.043); “A/N+”: 82% (p = 0.021)). Full article
(This article belongs to the Special Issue Advances in Positional Vertigo)
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8 pages, 247 KiB  
Article
Benign Positional Paroxysmal Vertigo in Children
by Cristiano Balzanelli, Daniele Spataro and Luca Oscar Redaelli de Zinis
Audiol. Res. 2021, 11(1), 47-54; https://doi.org/10.3390/audiolres11010006 - 1 Feb 2021
Cited by 7 | Viewed by 4035
Abstract
The aim of this study was to assess the prevalence and analyze clinical parameters of benign positional paroxysmal vertigo (BPPV) in a pediatric age. A cohort of 423 children under the age of 15 (median age 11. interquartile range 9–13) was submitted to [...] Read more.
The aim of this study was to assess the prevalence and analyze clinical parameters of benign positional paroxysmal vertigo (BPPV) in a pediatric age. A cohort of 423 children under the age of 15 (median age 11. interquartile range 9–13) was submitted to vestibular assessment for balance disorders. Dix-Hallpike and Roll-Supine tests were performed to look for positioning nystagmus using video-infrared goggles. BPPV was found in 43 of 423 children evaluated for balance disorders (10.2%). There were 28 females (65.1%) and 15 (34.9%) males. The posterior canal was involved in 79% of cases and the horizontal canal in 21% of cases. No apogeotropic bilateral or anterior canal form were seen. Thus, BPPV is not an infrequent type of vertigo in children and must be evaluated as soon as possible in order to plan the most appropriate maneuver and restore daily activities as soon as possible, avoiding anxiety and fear. Full article
(This article belongs to the Special Issue Advances in Positional Vertigo)

Review

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10 pages, 798 KiB  
Review
Atypical Positional Vertigo: Definition, Causes, and Mechanisms
by Sergio Carmona, Guillermo Javier Zalazar, Martin Fernández, Gabriela Grinstein and João Lemos
Audiol. Res. 2022, 12(2), 152-161; https://doi.org/10.3390/audiolres12020018 - 14 Mar 2022
Cited by 6 | Viewed by 6213
Abstract
Paroxysmal positional vertigo is a frequent cause for consultation. When approaching these patients, we try to differentiate central from peripheral causes, but sometimes we find manifestations that generate diagnostic doubts. In this review, we address atypical paroxysmal positional vertigo, reviewing the literature on [...] Read more.
Paroxysmal positional vertigo is a frequent cause for consultation. When approaching these patients, we try to differentiate central from peripheral causes, but sometimes we find manifestations that generate diagnostic doubts. In this review, we address atypical paroxysmal positional vertigo, reviewing the literature on the subject and giving a provisional definition of atypical positional vertigo as well as outlining its causes and pathophysiological mechanisms. Full article
(This article belongs to the Special Issue Advances in Positional Vertigo)
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17 pages, 365 KiB  
Review
The Enduring Controversy of Cervicogenic Vertigo, and Its Place among Positional Vertigo Syndromes
by Marcello Cherchi, Frank E. DiLiberto, Darío A. Yacovino and Sunit Das
Audiol. Res. 2021, 11(4), 491-507; https://doi.org/10.3390/audiolres11040045 - 26 Sep 2021
Cited by 5 | Viewed by 7919
Abstract
The idea of cervicogenic vertigo (CV) was proposed nearly a century ago, yet despite considerable scrutiny and research, little progress has been made in clarifying the underlying mechanism of the disease, developing a confirmatory diagnostic test, or devising an appropriately targeted treatment. Given [...] Read more.
The idea of cervicogenic vertigo (CV) was proposed nearly a century ago, yet despite considerable scrutiny and research, little progress has been made in clarifying the underlying mechanism of the disease, developing a confirmatory diagnostic test, or devising an appropriately targeted treatment. Given the history of this idea, we offer a review geared towards understanding why so many attempts at clarifying it have failed, with specific comments regarding how CV fits into the broader landscape of positional vertigo syndromes, what a successful diagnostic test might require, and some practical advice on how to approach this in the absence of a diagnostic test. Full article
(This article belongs to the Special Issue Advances in Positional Vertigo)

Other

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5 pages, 212 KiB  
Brief Report
Benign Paroxysmal Positional Vertigo (BPPV) in COVID-19
by Pasqualina Maria Picciotti, Giulio Cesare Passali, Bruno Sergi and Eugenio De Corso
Audiol. Res. 2021, 11(3), 418-422; https://doi.org/10.3390/audiolres11030039 - 13 Aug 2021
Cited by 15 | Viewed by 7007
Abstract
Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining [...] Read more.
Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining of vertigo. Patients were evaluated at the end of infection with an accurate clinical history, and the investigation of spontaneous, positional and positioning nystagmus. Results: The vestibular findings showed benign paroxysmal positional vertigo (BPPV) in all the patients. Three patients had a mild phenotype of the COVID infection, whereas five subjects were hospitalized for the COVID infection and in three cases intensive care was required. Vestibular evaluation showed an involvement of posterior semicircular canals in five patients and horizontal in three. Three patients were treated with the Epley maneuver, two with Semont, one with Lempert and two with Gufoni maneuvers. Conclusions: We hypothesize that BPPV in COVID-19 infections can be relate to drugs, prolonged bed rest and to direct damage by viral infection on the peripheral vestibular system and in particular on the otolitic membrane due to the cytopathic effect of the virus and to the inflammatory response. Studies on large series of patients are needed to confirm our preliminary observation and to better evaluate the pathophysiological mechanisms underlying BPPV in these patients. Full article
(This article belongs to the Special Issue Advances in Positional Vertigo)
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