[Diagnosis and treatment of horizontal canal benign paroxysmal positional vertigo].

OBJECTIVE

To explore effective methods for the diagnosis and treatment of horizontal-canal benign paroxysmal positional vertigo (HC-BPPV).

METHODS

Medical records from nine patients with HC-BPPV, treated between July 1996 and March 2000, were retrospectively analyzed. Data of complete history, audiograms, positional tests and neuro-otological examinations were collected. All patients were treated with a particle repositioning maneuver called the "barbecue rotation" which starts with the patient in the supine position and consists of three 90-degree head rotations towards the unaffected ear.

RESULTS

HC-BPPV was characterized by brief attacks of intense vertigo that were induced mainly by rolling over in bed (9/9) and turning the head to either side while upright (5/9). In most cases, rotation to the pathological side from supine position caused a very intense horizontal nystagmus beating towards the undermost ear. Findings such as latency and fatigability, which are common features of posterior-canal BPPV (PC-BPPV), were not present. After the barbecue rotation, all patients had immediate and sustained relief of their attacks during the 4 to 15 months' follow up.

CONCLUSION

HC-BPPV is different from PC-BPPV and other vertiginous diseases in typical presentations and positional testing results. The barbecue rotation is a successful method for curing the disorder.