Diagnosis and management of lateral semicircular canal benign paroxysmal positional vertigo.
OBJECTIVE
Describe the diagnosis, treatment, and outcome of a group of 20 patients with lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV).


METHODS
Retrospective review of 20 patients with LSC-BPPV (10 with geotropic and 10 with apogeotropic nystagmus) presenting to a tertiary balance center. Diagnosis was confirmed with infrared nystagmography in Dix-Hallpike positioning tests and supine positional tests. Patients were treated with one or more particle repositioning maneuvers.


RESULTS
Addition of supine positional nystagmus tests to Dix-Hallpike positioning testing improves sensitivity in the diagnosis of LSC-BPPV. Treatment outcomes in the apogeotropic LSC-BPPV group were poorer than the geotropic LSC-BPPV group.


CONCLUSIONS
Adding supine positional testing to routine vestibular diagnostic testing will increase the identification of LSC-BPPV. Apogeotropic LSC-BPPV is more challenging to treat.
White
Judith A
JA
The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. whitej3@ccf.org
Coale
Kathleen D
KD
Catalano
Peter J
PJ
Oas
John G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002150:Caloric Tests; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012665:Semicircular Canals / Q000503:physiopathology*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014717:Vertigo / Q000175:diagnosis* / Q000628:therapy*