Clinical trial NCT02046980: Treatment of Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Benign Paroxysmal Positional Vertigo
Lead sponsor: Keimyung University Dongsan Medical Center
Sponsor class: OTHER
First posted: 2014-01-28
Enrollment: 209
Sex: ALL
Minimum age (years): 19
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: To determine the short term therapeutic efficacies of Gufoni maneuver and mastoid oscillation in apogeotropic type of benign paroxysmal positional vertigo (BPPV) involving the horizontal semicircular canal (HC-BPPV), a randomized, prospective, sham-controlled study was conducted.

Detailed description: The apogeotropic type of benign paroxysmal positional vertigo involving the horizontal canal (HC-BPPV) is likely due to otolithic debris in the anterior arm of the canal (canalithiasis) or the debris attached to the cupula (cupulolithiasis). It is important to seek the method to convert treatment-resistant apogeotropic form to the more treatment-responsive geotropic form in HC-BPPV. Recent randomized trials demonstrated that head shaking maneuver was more effective than the modified Semont maneuver and the Gufoni and head shaking maneuvers showed similar efficacy in treating apogeotropic HC-BPPV. Moreover, new repositioning maneuver using mastoid vibration showed good efficacies in patients with apogeotropic HC-BPPV in recent study. So we tried to compare the short term therapeutic efficacies of Gufoni maneuver and mastoid oscillation in apogeotropic HC-BPPV with a randomized, prospective, sham-controlled study.

Eligibility criteria: Inclusion Criteria:

1. history of vertigo associated with changes in head position
2. direction-changing horizontal nystagmus beating toward the uppermost ear (apogeotropic nystagmus) in both turning positions detected with Frenzel glasses or videoculography in the Head turning test
3. vertigo associated with the elicited nystagmus
4. symptom within 2 weeks
5. put one's signature on consent

Exclusion Criteria:

1. patients with identifiable central nervous system disorders that could explain the positional vertigo and nystagmus
2. the patients with apogeotropic form which was transited from geotropic after previous therapeutic maneuvers
3. the patients who transited from apogeotropic from vertical canal BPPV during study
4. patients who had possible cause of secondary BPPV such as Meniere's disease, migraine or recent trauma history
5. patients whose affected ear cannot be identified
6. patients with multiple canal atypical positional nystagmus or who were treated previously with repositioning maneuvers were excluded.
7. patients with cervical or lumbar spine problem

Primary outcomes:
measure: Conversion in Direction of Nystagmus From Apogeotropic to Geotropic or Disappearance of Nystagmus
timeFrame: 2 days
Secondary outcomes:
Other outcomes:
Locations:
city: Daegu
country: Korea, Republic of
facility: Daegu Kyungbook Dizziness society
Study officials:
affiliation: Daegu KyungBook Dizziness society
name: Hyun Ah Kim
role: STUDY_DIRECTOR
affiliation: Keimyung University Dongsan Medical Centerl
name: Hyung Lee
role: STUDY_CHAIR
References:
citation: Kim HA, Park SW, Kim J, Kang BG, Lee J, Han BI, Seok JI, Chung EJ, Kim J, Lee H. Efficacy of mastoid oscillation and the Gufoni maneuver for treating apogeotropic horizontal benign positional vertigo: a randomized controlled study. J Neurol. 2017 May;264(5):848-855. doi: 10.1007/s00415-017-8422-2. Epub 2017 Feb 20.