The clinical outcome of the patients with horizontal semicircular canal variants of benign paroxysmal positional vertigo.

Background: Gufoni maneuver is known to be effective for horizontal canal benign positional vertigo (HC-BPPV), but there are some intractable patients that the treatment procedure does not work.

Objective: The clinical outcomes of patients with HC-BPPV were investigated. We also investigated the characteristics of intractable patients which needed long time to the remission.

Methods: Sixty-six patients with HC-BPPV receiving Gufoni maneuver at Tokyo Medical University Hachioji Medical Center were investigated. The patients were classified into geotropic DCPN group and apogeotropic DCPN group. The clinical outcomes in 2 groups were examined.

Results: There were 48 patients with geotropic DCPN and 18 patients with apogeotropic DCPN. There were significant differences between the geotropic HC-BPPV and apogeotropic HC BPPV in the period to remission. There were 7 intractable patients and the average ages of these intractable patients were higher than other patients.

Conclusion: The patients with geotropic DCPN and the patients with the nystagmus conversion from apogeotropic to geotropic DCPN have tendency to easy to resolve, but in patients with apogeotropic type without nystagmus transformation have long time to resolve. The elderly patients whose nystagmus remains apogeotropic without nystagmus conversion have tendencies to become intractable.