KISEP Information Korean J Otolaryngol 2004;47: 양성돌발성체위변환성어지러움 단국대학교의과대학이비인후 - 두경부외과교실 이정구 Benign Paroxysmal Positional Vertigo Chung Ku Rhee,

Size: px

Start display at page:

Download "KISEP Information Korean J Otolaryngol 2004;47: 양성돌발성체위변환성어지러움 단국대학교의과대학이비인후 - 두경부외과교실 이정구 Benign Paroxysmal Positional Vertigo Chung Ku Rhee,"

우재덕 복
5 years ago
Views:

1 KISEP Information Korean J Otolaryngol 2004;47: 단국대학교의과대학이비인후 - 두경부외과교실 이정구 Benign Paroxysmal Positional Vertigo Chung Ku Rhee, MD Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Dankook University, Cheonan, Korea

2 - - Table 1-1. Incidence of BPPV by age Age yrs Katsarkas n171 No of patients % Nunez n168 Table 1-2. Incidence of BPPV by canal % Korea n1455 DKU n Katsarkas1978 n 171 Nunez n168 DKU Dankook university n400 Korea n1455 DKU Marciano Korres Sex FM P SCC canalolithiasis cupulolithiasis L SCC canalolithiasis cupulithiasis S SCC canalolithiasis cupuloithiasis Mixed type PcanalLcanal PcanalLcupul PcanalScanal LcanalScanal LcupulScupul Bilateral 00.5 Korea n1455 Korres n122 Marciano n810 DKU Dankook university Pposterior, Llateral, Ssuperior, SCCsemicircular canal, canalcanalolithiasis, cupulcupulolithiasis 492 Korean J Otolaryngol 2004;47:

3 이정구 - Table 2. The etiologic or associated diseases of BPPV number of patients Etilology Baloh 1987 Blessing 1986 Hughes 1997 Karlberg 2000 O Reilly 2000 Idiopathic Post-TA V.N Cervical-basilar a. insufficiency Meniere s D Post general op Post COM op Ototoxicity Syphillis Labyrithitis 002 COM Bilateral vestibulopathy 0021 SNHL Sudden HL Etc v20 Total TAtraffic accident, VNvestibular neuronitis, COMchronic otitis media, aartery, opoperation, Ddisease, SNHLsensoryneural hearing loss, HLhearing loss, DKUDankook university DKU 2003 Korea

4 Korean J Otolaryngol 2004;47:

5 이정구

6 - 496 Korean J Otolaryngol 2004;47:

7 이정구 - - Table 3. Various diagnostic maneuver of BPPV Posterior canal canalolithiasis Dix-Hallpike maneuver & cupulolithiasis Lateral canal canalolithiasis Lateral head positioning & cupulolithiasis Superior canal canalolithiasis Dix-Hallpike or sidelying & cupulolithiasis maneuver Involvement of more than 2 Dix-Hallpike & lateral head canals positioning Diagnostic criteria of cupulolithiasis Nystagmus Short or no latency, lasting longer Vertigo Less responsive to treatment Vibrator or tapping If cupulolithiasis is converted to canalolithiasis by vibrator or tapping Lateral cupulolithiasis Ageotropic nystagmus Diagnostic criteria of superior canal BPPV Dix-Hallpike test Opposite side canal involvement when down beat nystagmus is seen Rahko maneuver Body moves to lesionside 497

8 498 Fig. 1. Brandt-Daroff habituation exercise. Patient is moved quickly into the position that provokes the vertigo and remains in that position until vertigo clears up and remains in that position for another 30 seconds. The patient is then turned rapidly to the opposite side, and repeats this same exercise several times daily. Fig. 2. Semont maneuver. The patient is moved quickly into the position that provokes the vertigo and remains in that position for 4 minutes. The patient is then turned rapidly to the opposite side ear down, and remains in this second position before slowly siting up. Korean J Otolaryngol 2004;47:

9 이정구 Fig. 3. Modified epley maneuver of right posterior SCC BPPV. The patient is in sitting position. The head is lowed into the right Dix-Hallpike position. The head is moved about 90 into the left Dix-Hallpike position. The head is moved another 90 so that the patient s nose is pointing downward toward the floor. The patient is returned to the upright position. The patient s chin is lowered slightly

10 Korean J Otolaryngol 2004;47:

11 이정구 Fig. 4. Modified rahko maneuver 4 5 Modified from Rahko 2002 The 45 patient lies on healthy side with head turned 45to left side. The head is lowed 45into the left Dix- Hallpike position. The head is raised horizontally upward 45for 30 seconds The head is moved another 45for another 30 seconds. The patient is returned to the upright position and stays up for at least 3 minutes. 501

12 - Table 4. Therapeutic maneuver of BPPV in Korea Epley maneuver, Semont maneuver Epley Brandt-Daroff Vibrator tapping Epley Epley Brandt-Daroff Barbecue Rotation, FPP, Barbecue FPP Head shaking, vibrator, finger tapping Barbecue FPP Brandt-Daroff maneuver Head shaking, vibrator Head shaking, vibrator Barbecue FPP Modified Semont maneuver Casani type FPP vibratorbarbecue Head shaking Brandt-Daroff Dix-Hallpike Barbecue Reversed epley maneuver / Rahko maneuver vibrator Brandt- Daroff maneuver Modified Dix-Hallpike maneuverdix-hallpike maneuver 30. FPPforced prolonged position 502 Korean J Otolaryngol 2004;47:

13 이정구 Probability of No recurrence Follow-up months Fig. 5. Kaplan-Meier estimation of recurrence rate From Nunez The recurrence rate is approximately 15% per year, with approximately 50% recurrence by 40 months. 503

14 504 박현민 전상준 이광선 오승하 한규철 이원상김창우 변성완 박성용 조용범 고의경 정원호 김규철 안성기 우훈영 김리석 장철호 강성호 박현민, 송병호 이승철 REFERENCES 1) Barany R. Diagnose von krankheitserscheinungen im bereiche des otolithenapparates. Acta Otolaryngol (Stockh) 1921;2: ) Dix R, Hallpike CS. The pathology, symptomology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 1952;6: ) Schuknecht HF. Cupulolithiasis. Arch Otolaryngol 1969;90: ) Hall SF, Ruby RR, McClure JA. The mechanics of benign paroxysmal vertigo. J Otolaryngol 1979;8: ) Kveton JF, Kashgarian M. Particulate matter within the membranous labyrinth: Pathologic or normal? Am J Otol 1994;15: ) Epidermiological studies on benign paroxysmal positional vertigo in Japan. Acta Otolaryngol (Stockh) Suppl 1988;447: ) Froehling DA, Bowen JM, Mohr DN, Brey RH, Beatty CW, Wollan PC, et al. Benign positional vertigo: A randomized controlled trial. Mayo Clin Proc 2000;75: ) Baloh RW. Benign positional vertigo. In: Baloh RW, Halmagyi GM, editors. Disorders of the vestibular system. Oxford Uni Press;1996. p Korean J Otolaryngol 2004;47:

15 이정구 9) Epley JM. Human experience with canalith repositioning maneuvers. Ann NY Acad Sci 2001;942: ) Rhee CK. Benign paroxysmal positional vertigo. The 77th congress of Korean society of otolaryngology; 2003 Oct 10-11; ICC Jeju: JungangMoonhwa; ) Moriaty B, Hawke M. The incicence and distribution of cuplae deposits in the labyrinth. Laryngoscope1992;102: ) Naganuma H, Kohut RI, Ryu JH, Tokumasu K, Okamoto M, Fujino A, et al. Basophilic deposits on the cupula: Preliminary findings describing the problems involved in studies regarding the incidence of basophilic deposits on the cupula. Acta Otolaryngol Suppl 1996;524: ) Pulec JL, Patterson MJ. Vestibular nerve pathology in cases of intractable vertigo: An electronmicroscopic study. Am J Otol 1997;18: ) Korres S, Balatsouras DG, Kaberos A, Economou C, Kandiloros D, Ferekidis E. Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurolotol 2002;23: ) Pollak L, Davies RA, Luxon LL. Effectiveness of the particle repositioning maneuver in benign paroxysmal positional vertigo with and without additional vestibular pathology. Otol Neurotol 2002;13: ) O'Reilly RC, Elford B, Slater R. Effectiveness of the Particle Repositioning Maneuver in Subtypes of Benign Paroxysmal Positional Vertigo. Laryngoscope 2000;110: ) Shepard NT, Telian SA. Practical management of the balance disorder patient. San Diego Singular Publishing Group;1996. p ) Modugno GC, Pirodda A, Ferri GG. A relationship between autoimmune thyroiditis and benign paroxysmal positional vertigo? Medical Hypotheses 2000;54: ) Ishiyama A, Jacobson KM, Baloh RW. Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol 2000;109: ) Oghalai JS, Manolidis S, Barth JL, Stewart MG, Jenkins HA. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Surg 2000;122: ) Han GC, Yang SH. Benign paroxysmal positional vertigo and rehabilitation therapy. Korean J Otolaryngol 2003;46: ) Baloh RW, Honrubia V, Jacobson K. Benign positional vertigo: Clinical and oculographic features in 240 cases. Neurogogy 1987; 37: ) Haynes DS, Resser JR, Labadie RF, Girasole CR, Kovach BT, Scheker LE, et al. Treatment of benign positional vertigo using the Semont maneuvre: Efficacy in patients presenting without nystagmus. Laryngoscope 2002;122: ) Bronstein AM. Vestibular reflexes and positional manoeurvres. J Neurol Neurosurg Psychiatry 2003;74: ) McClure JA. Horizontal canal BPPV. J Otolaryngol 1985;14: ) Baloh RW, Jacobson K, Honrubia V. Horizontal semicircular canal variant of benign positional vertigo. Neurology 1993;43: ) Steddin S, Ing D, Brandt T. Horizontal canal benign paroxysmal positioning vertigo: Transition of canalolithiasis to cupulolithiasis. Ann Neurol 1996;40: ) Bisdorff AR, Debatisse D. Localizing signs in positional vertigo due to lateral canal cupulolithiasis. Neurology 2001;57: ) Casani AP, Vannucci G, Fattori B, Berrettini S. The treatment of horizontal canal positional vertigo: Our experience in 66 cases. Laryngoscope 2002;112: ) Jo SW, Chung WK, Han DH, Park JH, Bae JH, Lee WS. Effectiveness of cupulolith repositioning maneuver in the treatment of lateral semicircular canal cupulolithiasis. Korean J Otolaryngol 2000;43: ) Fife TD. Recognition and management of horizontal canal benign paroxismal positional vertigo. Am J Otol 1998;19: ) Rahko T. The test and treatment methods of benign paroxysmal positional vertigo and an addition to the management of veertigo due to the superior vestibular canal (BPPV-SC) Clinical Otolaryngol 2002; 27: ) Brantberg K, Bergenius J. Treatment of anterior benign paroxysmal positional vertigo by canal plugging: A case report. Acta Otolaryngol 2002;122: ) Bertholon P, Bronstein AM, Davis RA, Rudge P, Thilo KV. Positional down beating nystagmus in 50 patients: Cerebellar disorder and possible anterior semicircular canalithiasis. J Neurol Neurosurg Psychiatry 2002;72: ) Katsarkas A, Kirkham TH. Parosysmal positional vertigo-a study of 255 cases. J Otolaryngol 1978;7: ) Mcclure J, Lycett P, Rounthwaite J. Vestibular dysfunction associated with benign paroxysmal vertigo. Laryngoscope 1977;87: ) Iida M, Hitouji K, Takahashi M. Vertical semicircular canal function: A study in patients with benign paroxysmal positional vertigo. Acta Otolaryngol Suppl 2001;545: ) Zucca G, Valli S, Valli P, Perin P, Mira E. Why do benign paroxysmal positional vertigo episodes recover spontaneousely. J Vestib Res 1998;8: ) Gacek RR. Transection of the posterior ampullary nerve for the relief of benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 1974;83: ) Herdman SJ, Tusa RJ, Clendaniel RA. Eye movement signs in vertical canal benign paroxysmal positional vertigo. Contemporary Ocular Motor and Vestibular Research; ) Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otol Rhinol Laryngol 1980;106: ) Semont A, Freyss G, Vitte E. Curing the BPPV with a liberatory maneuver. Adv Otorhinolaryngol 1998;42: ) Epley JM. The canalith repositioning procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107: ) Vannucchi P, Giannoni B, Pagnini P. Treatment of horizontal semicircular canal behign paroxysmal positional vertigo. J Vestib Res 1997; 7: ) Herdman SJ, Tusa RJ, Zee DS, Proctor LR, Mattox DE. Single treatment approaches to benign paroxysmal positional vertigo. Arch Otolaryngol 1993;119: ) Nuti D, Nati C, Passali D. Treatment of benign paroxysmal positional vertigo: No need for postmaneuver restrictions. Otolaryngol Head Neck Surg 2000;122: ) Marciano E, Marcelli V. Postural restrictions in labyrintholithiasis. Eur Arch Otorhinolaryngol 2002;259: ) Nunez RA, Cass SP, Furman JM. Short- and long-term outcomes of canalith repositioning for benign paroxysmal positional vertigo Otolaryngol Head Neck Surg 2000;122: ) Hain TC, Helminski JO, Reis IL, Uddin MK. Vibration does not improve results of the canalith repositioning procedure. Arch Otolaryngol Head Neck Surg 2000;126: ) Jeon HG, Song SH, Han GC, Huh JM. Analysis of factors that affect the result of vestibular rehabilitation in the treatment of benign paroxysmal position vertigo. Korean J Otolaryngol 2001;44: ) Lynn S, Pool A, Rose D, Brey R. Randomized trial of the canalith repositioning procedure. Otolaryngol Head Neck Surg 1995;13: ) Wolf M, Hertanu T, Novikov I, Kronenberg J. Epley s maneuvre for benign paroxysmal positional vertigo: A prospective study. Clin Otolaryngol 1999;24: ) Furman JM, Cass SP. Benign positional vertigo. N Eng J Med 1999;341: ) Tirelli G, D Orlando E, Zarcone O, Giacomarra V. Modified particle repositioning Procedure. Laryngoscope 2000;100: ) Yimtae K, Srirompotong S, Srirompotong S, Sae-seaw P. A randomized trial of the canalith repositioning procedure. Laryngoscope 2003;113: ) Parnes LS, McClure J. Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo. Ann Otol Rhinlo Laryngol 1990;99: ) Nuti D, Agus G, Barbieri MT, Passali D. The management of hori- 505

16 zontal-canal paroxysmal positional vertigo. Acta Otolaryngol 1998; 118: ) Bae MR, Moon IS, Lee JH, Kim HJ, Lee WS. Treatments of lateral semicircular canal BPPV. Korean J Otolaryngol 2003;46: ) Moon SY, Yoon YJ, Kim CH, Lee SH, Kim BK, Lim HS, et al. Pathophysiologic consideration of benign paroxysmal positional vertigo due to the horizontal semicircular canal cupulolithiasis. Korean J Otolaryngol 2002;45: ) Lee JH, Bae MR, Yoo JB, Shin JW, Lee WS. Results of otolith reposition therapy in various types of BPPV. Korean J Otolaryngol 2003; 46: ) Strupp M, Arbusow V. Acute vestibulopathy. Curr Opin Neurol 2001; 14: ) Honrubia V, Baloh RW, Harris MR, Jacobson KM. Paroxysmal positional vertigo syndrome. Am J Otol 1999;20: ) Magnusson M, Karlberg M. Peripheral vestibular disorders with acute onset of vertigo. Current Opinion in Neurology 2002;15: ) Buckingham RA. Anatomical and theoretical observations on otolith repositioning for benign paroxysmal positional vertigo. Laryngscope 1999;109: ) Parnes LS, Price-Jones RG. Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 1993;102: ) Li JC. Mastoid oscillation: A critical factor for success in the canalith repositioning procedure. Otolaryngol Head Neck Surg 1995; 112: ) Radtke A, Neuhauser H, von Brevern M, Lempert T. A modified Epley s procedure for self-treatment of benign paroxysmal positional vertigo. Neurology 1999;3: ) Monobe H, Sugasawa K, Murofushi T. The outcome of the canalith repositioning procedure for benign paroxysmal positional vertigo: Are there any characteristic features of treatment failure cases? Acta Otolaryngol Suppl 2001;545: ) Angeli SI, Hawley R, Gomez O. Systematic approach to benign paroxysmal positional vertigo in the elderly. Otolaryngol Head Neck Surg 2003;128: ) Gross EM, Ress BD, Viirre ES, Nelson JR, Harris JP. Intractable benign paroxysmal positional vertigo in patients with Meniere s disease. Laryngoscope 2000;10: ) Hughes CA, Proctor L. Benign paroxysmal positional vertigo. Laryngoscope 1997;107: ) Kalberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear diseases cause benign paroxysmal positional vertigo? Acta Otolaryngol 2000;120: ) Fujino A, Tohumasu K, Yosio S, Naganuma H, Yoneda S, Nakamara K. Vestibular training for benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 1994;120: ) Nuti D, Vannuchi P, Pagnini P. Benign paroxysmal positional vertigo of the horizontal canal: A form of canalolithiasis with variable clinical features. J Vestib Res 1996;6: Korean J Otolaryngol 2004;47:

KISEP Otology Korean J Otolaryngol 1999;42: 수평반고리관양성발작성두위현기증 김영기 윤용주 김인 Benign Paroxysmal Positional Vertigo of the Horizontal Semicircular Cana

KISEP Otology Korean J Otolaryngol 1999;42:836-42 수평반고리관양성발작성두위현기증 김영기 윤용주 김인 Benign Paroxysmal Positional Vertigo of the Horizontal Semicircular Canal Young Ki Kim, MD, Yong Joo Yoon, MD and In Kim MD