Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

Study Overview
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Brief Summary
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The purpose of this study was to compare the immediate efficacies of each treatment maneuvers in treatment of apogeotropic horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

Detailed Description
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A randomized prospective study of patients with HC-BPPV. Patients with apogeotropic type of HC-BPPV were randomized to one of each three treatment groups at their first clinic visit. These groups included the Gufoni maneuver, head-shaking maneuver, and sham group in apogeotropic HC-BPPV. Responsiveness of treatment maneuver was determined by positioning maneuver immediately after each treatment method based on resolves of vertigo and positional nystagmus.

Official Title
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Randomized Multicenter Study of Treatment of Horizontal Canal Benign Paroxysmal Positional Vertigo

Conditions
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HC-BPPV

Intervention / Treatment
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* Procedure: Gufoni maneuver
* Procedure: Head-shaking maneuver
* Procedure: sham maneuver


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a history of brief episodes of positional vertigo, direction-changing horizontal nystagmus beating toward the uppermost (apogeotropic nystagmus) or undermost (geotropic nystagmus) ear in both the lateral head turning positions, no spontaneous nystagmus during upright sitting position, and absence of identifiable central nervous system disorders that could explain the positional vertigo and nystagmus. Exclusion Criteria: central positional nystagmus with identifiable CNS lesions that could explain the positional nystagmus

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Gufoni maneuver<br>Gufoni maneuver for apogeotropic HC-BPPV | Procedure: Gufoni maneuver<br>* For Gufoni maneuver,16,18 the patient was quickly brought down to the side-lying position on the affected ear from the sitting position. After one minute in this position, the head of the patient was quickly turned 45O upward, so that the nose directed upward. Approximately 2 minutes later, the patient was returned to the upright position (Figure 2A).<br>|
| Active Comparator: Headshaking maneuver<br>headshaking maneuver for apogeotropic HC BPPV | Procedure: Head-shaking maneuver<br>* For head-shaking maneuver,15 patients were brought into a sitting position. After pitching the head forward by approximately 30O, we moved the head sideways in a sinusoidal fashion at an approximate rate of 3 Hz for 15 seconds.<br>|
| Sham Comparator: sham maneuver<br>sham maneuver for apogeotropic HC BPPV | Procedure: sham maneuver<br>* For the sham maneuver, patients quickly lied on the unaffected side, and returned to the sitting position after one minute.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial | The immediate treatment response was determined by participating neurologists in each clinic without knowing the maneuver applied to each patient from 30 minutes to one hour after initial maneuver. The absence of both vertigo and nystagmus was required to determine a resolution. | one hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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BPPV(benign paroxysmal positional vertigo), HC-BPPV(BPPV involving the horizontal semicircular canal), Nystagmus, Treatment outcome, Horizontal Canal Benign Paroxysmal Positional Vertigo