Square wave manoeuvre for apogeotropic variant of horizontal canal benign paroxysmal positional vertigo in neck restricted patients
Dario A.Yacovino1
Estefania Zanotti2
Karen Roman2
Timothy C.Hain3
1.Department of Neurology, Dr. Cesar Milstein Hospital, Buenos Aires, Argentina;Memory and Balance Clinic, Buenos Aires, Argentina2.Department of Neurology, Dr. Cesar Milstein Hospital, Buenos Aires, Argentina3.Northwestern University, Chicago, IL, USA
摘要：Objective: We aimed to describe the clinical features of the apogeotropic variant of horizontal canal benign paroxysmal positional vertigo (HC BPPV-AG) in a cluster of patients with restrictive neck movement disorders and a new therapeutic manoeuvre for its management.Methods: In a retrospective review of cases from an ambulatory tertiary referral center, patients with HC BPPV-AG in combination with neck movement restriction that prevented any classical manual reposi-tioning procedure or who were refractory to canalith repositioning manoeuvres, were treated with a new manoeuvre comprised of sequential square-wave pattern of head and body supine rotations while nystagmus was being monitored, until either an apogeotropic to geotropic conversion or resolution of the nystagmus was observed. Results: Fifteen patients were studied. All but one [14/15 cases] showed a positive therapeutic response to the repositioning procedure in a single session. In two cases, a direct relief of vertigo and elimination of nystagmus was observed without an intermediate geotropic phase. Although in three patients the affected ear was not initially identified, it was ultimately identified and successfully treated by the square wave manoeuvre in all of them. Conclusions: The square-wave manoeuvre is an alternative for HC BPPV-AG treatment in either cases with neck restriction, where the affected side is not well identified at the bedside or when other ma-noeuvres fail to resolve the HC BPPV-AG.
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论文发表日期：2021-06-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 65-70 )
英文信息