A case of apogeotropic horizontal canal benign paroxysmal positional vertigo that transformed to the geotropic variant during treatment with Appiani maneuver, followed by successful treatment with Gufoni maneuver.

A case of apogeotropic horizontal canal benign paroxysmal positional vertigo that transformed to the geotropic variant during treatment with Appiani maneuver, followed by successful treatment with Gufoni maneuver. Physiother Theory Pract. 2020 Aug 12;:1-9 Authors: Vats AK Abstract Lesions at three possible sites can masquerade as apogeotropic horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV), namely: 1) short anterior (ampullary) arm canalolithiasis; and 2) culpulolithiasis, which may be either canal (Cup-C) or utricle-sided (Cup-U). There are no clinical methods or investigations to determine the exact pathological site when a patient with a history compatible with HSC-BPPV is found to have apogeotropic positional nystagmus on the supine roll test. Therefore, the treatment of apogeotropic variant of HSC-BPPV not only poses difficulties but the therapeutic options need to be tailored according to the ostensible localization of the pathology. If the apogeotropic HSC-BPPV is transformed into the geotropic variant, it becomes relatively easier to treat, as the treatment options for the latter are very well established. There are reports of cases of the apogeotropic variant of HSC-BPPV being transformed inadvertently during diagnostic positional tests as well as during therapeutic (intention-to-treat) positional maneuvers. I report here a case of an apogeotropic variant of right HSC-BPPV, that transformed into...
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research