Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus

Béla Büki, László Simon, Sándor Garab, Yunxia W Lundberg, Heinz Jünger, Dominik Straumann

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Presently, the unambiguous diagnosis of benign paroxysmal positioning vertigo (BPPV) requires the detection of positioning or positional nystagmus provoked by DixeHallpike (for vertical semicircular canals) or supine roll (for horizontal semicircular canals) manoeuvres, which indicates canalo- or cupolithiasis of affected semicircular canals. There are patients, however, in whomddespite typical complaints of BPPVdno positional nystagmus can be documented; this is called 'subjective BPPV' (sBPPV). These patients usually complain of short vertigo spells during and after sitting up, sometimes with abnormal retropulsion of the trunk. Aim: In this study, the authors aimed to ascertain whether these patients in fact demonstrate abnormal sitting-up trunk oscillations when measured by posturography. Of 200 unselected patients with vertigo or dizziness, 43% had sBPPV with vertigo spells while sitting up, and 20% classical BPPV. Methods: Posturographic recordings were performed in 20 patients with sBPPV and sitting-up vertigo. Results and discussion: Seven of the 20 patients had trunk oscillations during the act of sitting up and for a short time immediately afterwards. Based on their findings, the authors propose a new type of BPPV, the so-called Type 2 BPPV (typical complaints of BPPV, no nystagmus in DixeHallpike positions but short vertigo spell while sitting up), which may be the result of chronic canalolithiasis within the short arm of a posterior canal. Furthermore, the authors suggest that Type 2 BPPV, which could be identical to sBPPV or constitute a major subgroup of it, occurs frequently among patients with vertigo. For therapy, the authors recommend repetitive sit-ups from the DixeHallpike positions to liberate the short arm of the posterior canal from canaloliths.

Original languageEnglish (US)
Pages (from-to)98-104
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume82
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Physiologic Nystagmus
Vertigo
Semicircular Canals
Arm
Dizziness

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus. / Büki, Béla; Simon, László; Garab, Sándor; Lundberg, Yunxia W; Jünger, Heinz; Straumann, Dominik.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 82, No. 1, 01.01.2011, p. 98-104.

Research output: Contribution to journalArticle

Büki, Béla ; Simon, László ; Garab, Sándor ; Lundberg, Yunxia W ; Jünger, Heinz ; Straumann, Dominik. / Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus. In: Journal of Neurology, Neurosurgery and Psychiatry. 2011 ; Vol. 82, No. 1. pp. 98-104.
@article{b8c811e848324767b49515c139f1e288,
title = "Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus",
abstract = "Background: Presently, the unambiguous diagnosis of benign paroxysmal positioning vertigo (BPPV) requires the detection of positioning or positional nystagmus provoked by DixeHallpike (for vertical semicircular canals) or supine roll (for horizontal semicircular canals) manoeuvres, which indicates canalo- or cupolithiasis of affected semicircular canals. There are patients, however, in whomddespite typical complaints of BPPVdno positional nystagmus can be documented; this is called 'subjective BPPV' (sBPPV). These patients usually complain of short vertigo spells during and after sitting up, sometimes with abnormal retropulsion of the trunk. Aim: In this study, the authors aimed to ascertain whether these patients in fact demonstrate abnormal sitting-up trunk oscillations when measured by posturography. Of 200 unselected patients with vertigo or dizziness, 43{\%} had sBPPV with vertigo spells while sitting up, and 20{\%} classical BPPV. Methods: Posturographic recordings were performed in 20 patients with sBPPV and sitting-up vertigo. Results and discussion: Seven of the 20 patients had trunk oscillations during the act of sitting up and for a short time immediately afterwards. Based on their findings, the authors propose a new type of BPPV, the so-called Type 2 BPPV (typical complaints of BPPV, no nystagmus in DixeHallpike positions but short vertigo spell while sitting up), which may be the result of chronic canalolithiasis within the short arm of a posterior canal. Furthermore, the authors suggest that Type 2 BPPV, which could be identical to sBPPV or constitute a major subgroup of it, occurs frequently among patients with vertigo. For therapy, the authors recommend repetitive sit-ups from the DixeHallpike positions to liberate the short arm of the posterior canal from canaloliths.",
author = "B{\'e}la B{\"u}ki and L{\'a}szl{\'o} Simon and S{\'a}ndor Garab and Lundberg, {Yunxia W} and Heinz J{\"u}nger and Dominik Straumann",
year = "2011",
month = "1",
day = "1",
doi = "10.1136/jnnp.2009.199208",
language = "English (US)",
volume = "82",
pages = "98--104",
journal = "Journal of Neurology, Neurosurgery and Psychiatry",
issn = "0022-3050",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Sitting-up vertigo and trunk retropulsion in patients with benign positional vertigo but without positional nystagmus

AU - Büki, Béla

AU - Simon, László

AU - Garab, Sándor

AU - Lundberg, Yunxia W

AU - Jünger, Heinz

AU - Straumann, Dominik

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: Presently, the unambiguous diagnosis of benign paroxysmal positioning vertigo (BPPV) requires the detection of positioning or positional nystagmus provoked by DixeHallpike (for vertical semicircular canals) or supine roll (for horizontal semicircular canals) manoeuvres, which indicates canalo- or cupolithiasis of affected semicircular canals. There are patients, however, in whomddespite typical complaints of BPPVdno positional nystagmus can be documented; this is called 'subjective BPPV' (sBPPV). These patients usually complain of short vertigo spells during and after sitting up, sometimes with abnormal retropulsion of the trunk. Aim: In this study, the authors aimed to ascertain whether these patients in fact demonstrate abnormal sitting-up trunk oscillations when measured by posturography. Of 200 unselected patients with vertigo or dizziness, 43% had sBPPV with vertigo spells while sitting up, and 20% classical BPPV. Methods: Posturographic recordings were performed in 20 patients with sBPPV and sitting-up vertigo. Results and discussion: Seven of the 20 patients had trunk oscillations during the act of sitting up and for a short time immediately afterwards. Based on their findings, the authors propose a new type of BPPV, the so-called Type 2 BPPV (typical complaints of BPPV, no nystagmus in DixeHallpike positions but short vertigo spell while sitting up), which may be the result of chronic canalolithiasis within the short arm of a posterior canal. Furthermore, the authors suggest that Type 2 BPPV, which could be identical to sBPPV or constitute a major subgroup of it, occurs frequently among patients with vertigo. For therapy, the authors recommend repetitive sit-ups from the DixeHallpike positions to liberate the short arm of the posterior canal from canaloliths.

AB - Background: Presently, the unambiguous diagnosis of benign paroxysmal positioning vertigo (BPPV) requires the detection of positioning or positional nystagmus provoked by DixeHallpike (for vertical semicircular canals) or supine roll (for horizontal semicircular canals) manoeuvres, which indicates canalo- or cupolithiasis of affected semicircular canals. There are patients, however, in whomddespite typical complaints of BPPVdno positional nystagmus can be documented; this is called 'subjective BPPV' (sBPPV). These patients usually complain of short vertigo spells during and after sitting up, sometimes with abnormal retropulsion of the trunk. Aim: In this study, the authors aimed to ascertain whether these patients in fact demonstrate abnormal sitting-up trunk oscillations when measured by posturography. Of 200 unselected patients with vertigo or dizziness, 43% had sBPPV with vertigo spells while sitting up, and 20% classical BPPV. Methods: Posturographic recordings were performed in 20 patients with sBPPV and sitting-up vertigo. Results and discussion: Seven of the 20 patients had trunk oscillations during the act of sitting up and for a short time immediately afterwards. Based on their findings, the authors propose a new type of BPPV, the so-called Type 2 BPPV (typical complaints of BPPV, no nystagmus in DixeHallpike positions but short vertigo spell while sitting up), which may be the result of chronic canalolithiasis within the short arm of a posterior canal. Furthermore, the authors suggest that Type 2 BPPV, which could be identical to sBPPV or constitute a major subgroup of it, occurs frequently among patients with vertigo. For therapy, the authors recommend repetitive sit-ups from the DixeHallpike positions to liberate the short arm of the posterior canal from canaloliths.

UR - http://www.scopus.com/inward/record.url?scp=78650467577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650467577&partnerID=8YFLogxK

U2 - 10.1136/jnnp.2009.199208

DO - 10.1136/jnnp.2009.199208

M3 - Article

C2 - 20660923

AN - SCOPUS:78650467577

VL - 82

SP - 98

EP - 104

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

IS - 1

ER -