98 results match your criteria Canalith-Repositioning Maneuvers


Systematic Review of Bilateral Benign Paroxysmal Positional Vertigo.

Laryngoscope 2021 May 10. Epub 2021 May 10.

Division of Otolaryngology - Head & Neck Surgery, McMaster University, Hamilton, Ontario, Canada.

Objectives: To evaluate the success rates of canalith repositioning maneuvers (CRM) in the treatment of patients diagnosed with bilateral benign paroxysmal positional vertigo (BiBPPV).

Study Design: Systematic review.

Methods: A comprehensive search of only English studies in PubMed, Ovid (1946 to the present), and Embase (1974 to the present) databases was done up until January 1, 2021. Read More

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Posttraumatic Dizziness: Navigating the Maze Towards Accurate Vestibular Diagnosis and Treatment.

Otol Neurotol 2021 06;42(5):e573-e578

Division of Otology/Neurotology-Skull Base Surgery, Department of Otolaryngology/Head and Neck Surgery, Michigan Medicine, The University of Michigan, Ann Arbor, Michigan.

Objective: Highlight the importance of establishing a differential diagnosis to identify and treat multiple origins of dizziness in a patient following traumatic brain injury (TBI).

Patient: 73-year-old man with TBI and temporal bone fracture developed posttraumatic bilateral multiple canal benign paroxysmal positional vertigo (BPPV).

Intervention: Multi-disciplinary diagnostic evaluation and vestibular rehabilitation (VR) treatment focused on canalith repositioning maneuvers (CRMs) and central adaptation. Read More

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Quantitative assessment of self-treated canalith repositioning procedures using inertial measurement unit sensors.

J Vestib Res 2021 Feb 20. Epub 2021 Feb 20.

Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea.

Background: Low success and high recurrence of benign paroxysmal positional vertigo (BPPV) after home-based self-treated Epley and Barbeque (BBQ) roll maneuvers is an important issue.

Objective: To quantify the cause of low success rate of self-treated Epley and BBQ roll maneuvers and provide a clinically acceptable criterion to guide self-treatment head rotations.

Methods: Twenty-five participants without active BPPV wore a custom head-mount rotation monitoring device for objective measurements. Read More

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February 2021

[Intervention strategies for residual dizziness after successful repositioning maneuvers in benign paroxysmal positional vertigo: a single center randomized controlled trial].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Jan;56(1):41-46

Department of Otorhinolaryngology Head and Neck Surgery, Eye & ENT Hospital of Fudan University,Shanghai 230001, China.

To compare the effects of different intervention strategies for the management of residual dizziness following successful canalith repositioning procedure (CRP) in patients with benign paroxysmal positional vertigo (BPPV). A total of 129 BPPV patients with residual dizziness following successful CRP were recruited during January 2019 and July 2019. They were randomly assigned into three groups with 43 cases in each group: the vestibular rehabilitation group received rehabilitation training for four weeks; betahistine group was given orally 12 mg betahistine three times a day for four weeks; and the control group had no specific treatment. Read More

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January 2021

The Clinical Response Time of Epley Maneuvers for Treatment of BPPV: A Hospital Based Study.

Indian J Otolaryngol Head Neck Surg 2020 Dec 11;72(4):503-507. Epub 2020 Aug 11.

Department of ENT, Pt. JNM Medical College, Raipur, India.

The Epley maneuver is one of the most effective canalith repositioning procedures for treatment of posterior canal benign paroxysmal positional vertigo. It was found that response to BPPV varies with various factors such as types, single versus multiple canals BPPV, single or repeated cycles of head maneuvers in each session and duration of follow up of patient. Furthermore, less uniform result exists after treatment of BPPV among studies. Read More

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December 2020

Balance performance when responding to visual stimuli in patients with Benign Paroxysmal Positional Vertigo (BPPV).

J Vestib Res 2020 ;30(4):267-274

Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Background: Patients with Benign Paroxysmal Positional Vertigo (BPPV) often report a sensation of disequilibrium before treatment with the canalith repositioning maneuvers. Apart from vestibular information, visual input also contributes to balance control. How visual stimuli influence balance control in BPPV patients is unclear. Read More

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January 2020

Short CRP for Anterior Canalithiasis: A New Maneuver Based on Simulation With a Biomechanical Model.

Front Neurol 2020 13;11:857. Epub 2020 Aug 13.

Audiology Department Arauz Otorhinolaryngology Institute (IORL Arauz), Buenos Aires, Argentina.

Anterior canalithiasis is an uncommon and challenging diagnosis. This is due in part to the difficulty of defining the affected side, the extreme positioning required to carry out described therapeutic maneuvers, and the infrequent use of specific maneuvers. Our objective is to present a new treatment alternative for anterior canalithiasis which is based on the well-known canalith repositioning procedure (CRP) described by Epley and which is used routinely in the treatment of both posterior and anterior canalithiasis. Read More

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Prevention of benign paroxysmal positional vertigo with vitamin D supplementation: A randomized trial.

Neurology 2020 09 5;95(9):e1117-e1125. Epub 2020 Aug 5.

From the Department of Neurology (S.-H.J.), Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon; Departments of Neurology (J.-S.K.) and Otolaryngology (J.-W.K.), Seoul National University College of Medicine; Dizziness Center (J.-S.K., J.-Y.C., J.-W.K.), Research Administration Team (H.-J.K.), and Medical Research Collaborating Center (S.A., S.K.), Seoul National University Bundang Hospital, Seongnam; Department of Neurology (K.-D.C., S.-Y.C.), Pusan National University Hospital, Pusan National University School of Medicine; Department of Neurology (J.-Y.P.), Ulsan University College of Medicine, Ulsan University Hospital; Department of Neurology (S.-H.L.), Chonnam National University Medical School, Gwangju; Department of Neurology (S.-Y.O., T.-H.Y.), Chonbuk National University School of Medicine, Jeonju; Department of Neurology (J.H.P.), School of Medicine, Catholic University of Daegu, Korea; and Department of Neurology (I.J.), Korea University Ansan Hospital.

Objective: To assess the effect of vitamin D and calcium supplementation in preventing recurrences of benign paroxysmal positional vertigo (BPPV).

Methods: We performed an investigator-initiated, blinded-outcome assessor, parallel, multicenter, randomized controlled trial in 8 hospitals between December 2013 and May 2017. Patients with confirmed BPPV were randomly assigned to the intervention (n = 518) or the observation (n = 532) group after successful treatment with canalith repositioning maneuvers. Read More

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September 2020

Upright positioning-related reverse nystagmus in posterior canal benign paroxysmal positional vertigo and its effect on prognosis.

J Vestib Res 2020 ;30(3):195-201

Baskent University, Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Turkey.

Background: Positional nystagmus elicited by the Dix-Hallpike maneuver often reverses its direction as the patient is re-seated from the provoking head hanging position. The incidence of reverse nystagmus and its association with prognosis in posterior canal benign paroxysmal positional vertigo (pcBPPV) is not clear.

Objective: To determine the incidence of upright positioning-related reverse nystagmus and its association with the success of canalith repositioning (Epley) maneuver (CRM) treatment in pcBPPV. Read More

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January 2020

Increased Otolin-1 in Serum as a Potential Biomarker for Idiopathic Benign Paroxysmal Positional Vertigo Episodes.

Front Neurol 2020 13;11:367. Epub 2020 May 13.

Department of Neurology, Hwa Mei Hospital, University of Chinese Academy of Science, Ningbo, China.

Otolin-1, a main specific otoconia matrix protein, passes through the labyrinth-blood barrier and is detectable in peripheral blood. Serum otolin-1 levels differ between patients with benign paroxysmal positional vertigo (BPPV) and healthy controls and are significantly age-related, increasing in healthy controls with age, suggesting that serum otolin-1 levels reflect otolith status. The aim of this study was to determine whether otolin-1 levels change during vertigo episodes in patients with BPPV and whether any change is specific and sensitive enough for BPPV episodes. Read More

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Association between Dix-Hallpike test parameters and successful repositioning maneuver in posterior semicircular canal benign paroxysmal positional vertigo: a case-control study.

Ann Transl Med 2020 Mar;8(6):286

Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai xxxxx, China.

Background: Nystagmus (i.e., involuntary eye movement) provoked by the Dix-Hallpike test (DHT) is considered the gold standard for diagnosing posterior semicircular canal benign paroxysmal positional vertigo (psc-BPPV). Read More

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An Evaluation of the Effects of Betahistine and Dimenhydrinate on Posterior Canal Benign Paroxysmal Positional Vertigo.

Turk Arch Otorhinolaryngol 2019 Dec 1;57(4):191-196. Epub 2019 Dec 1.

Department of Otorhinolaryngology, Erzincan University School of Medicine, Erzincan, Turkey.

Objective: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular system disease causing dizziness. It occurs more in the 5th decade of life and affects the posterior canal in 90% of the patients. The most effective treatment method is canalith repositioning (CRP) maneuver. Read More

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December 2019

Comorbid Cupulolithiasis Is Rare in Patients With Horizontal Semicircular Canal Canalolithiasis.

Otol Neurotol 2020 03;41(3):e357-e362

Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.

Objectives: Considering that otolith particles pass through the canal until attaching to the cupula in the canal-side horizontal semicircular canal (HSCC) cupulolithiasis, comorbidity of HSCC canalolithiasis and cupulolithiasis may occur. We aimed to investigate the incidence of comorbidity of cupulolithiasis in patients with HSCC canalolithiasis and to improve treatment efficacy.

Study Design: Retrospective study. Read More

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Benign Positional Paroxysmal Vertigo Treatment: a Practical Update.

Curr Treat Options Neurol 2019 12 5;21(12):66. Epub 2019 Dec 5.

Otolaryngology Department, University of Siena, Azienda Ospedaliera Universitaria Senese, V.le Bracci, 11, 53100, Siena, Italy.

Purpose Of The Review: To define the best up-to-date practical approach to treat benign paroxysmal positional vertigo (BPPV).

Recent Findings: Both posterior and horizontal canal BPPV canalith repositioning maneuvers (Semont, Epley, and Gufoni's maneuvers) are level 1 evidence treatment for evidence-based medicine. The choice of maneuver (since their efficacy is comparable) is up to the clinician's preferences, failure of the previous maneuver, or movement restrictions of the patient. Read More

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December 2019

Clinical Characteristics and Risk Factors for the Recurrence of Benign Paroxysmal Positional Vertigo.

Front Neurol 2019 13;10:1190. Epub 2019 Nov 13.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Benign paroxysmal positional vertigo (BPPV) manifests itself as a paroxysm of vertigo and nystagmus lasting several seconds, which is self-limiting. The clinical characteristics and risk factors for the recurrence of BPPV in different ages have not yet been investigated. A retrospective observational study was conducted in the Department of Neurology in Beijing Tiantan Hospital from July 2009 to June 2015. Read More

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November 2019

Does cervical range of motion affect the outcomes of canalith repositioning procedures for posterior canal benign positional paroxysmal vertigo?

Am J Otolaryngol 2019 Jul - Aug;40(4):494-498. Epub 2019 Apr 2.

Department of Sense Organs, Sapienza University of Rome, Italy.

Purpose: Canalith repositioning procedure (CRP) for posterior canal benign positional paroxysmal vertigo (BPPV), also known as Epley maneuver, is a common procedure for the treatment of BPPV. This maneuver entails flexion, extension and rotation of the patient's neck. This study aims to investigate the impact of cervical range of motion (C-ROM) on CRP efficacy. Read More

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December 2019

Impaired Calcium Metabolism in Benign Paroxysmal Positional Vertigo: A Topical Review.

J Neurol Phys Ther 2019 04;43 Suppl 2:S37-S41

Department of Neurology (S.-H.J.), Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea; Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul, Korea; Dizziness Center (J.-S.K.), Seoul National University Bundang Hospital, Seongnam, Korea.

Background And Purpose: Although acute attacks of benign paroxysmal positional vertigo (BPPV) may be treated with canalith repositioning maneuvers, there have been no well-designed prospective trials to prevent this highly prevalent and recurrent disorder. This topical review explores the evidence related to the association between deficient calcium metabolism and BPPV. We also describe the development of therapeutic options to prevent recurrences of BPPV and introduce results from a recent randomized controlled trial on the effect of vitamin D and calcium supplementation in preventing BPPV recurrences. Read More

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Diagnosis and treatment choices of suspected benign paroxysmal positional vertigo: current approach of general practitioners, neurologists, and ENT physicians.

Eur Arch Otorhinolaryngol 2019 Apr 29;276(4):985-991. Epub 2019 Jan 29.

Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Purpose: Benign paroxysmal positional vertigo (BPPV) is a frequently underdiagnosed cause of vertigo, potentially due to the underuse of diagnostic and therapeutic canalith repositioning procedures (CRPs). We aimed to investigate self-reported use of the diagnostic and therapeutic approach to BPPV patients by Lithuanian neurologists, ear, nose, and throat (ENT) physicians, and general practitioners (GPs), and to explore potential reasons for the underuse of the maneuvers.

Methods: Neurologists, ENT physicians, and GPs were invited to complete a written questionnaire focused on diagnostic and therapeutic practices related to BPPV. Read More

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Dizziness and the Otolaryngology Point of View.

Med Clin North Am 2018 Nov 20;102(6):1001-1012. Epub 2018 Sep 20.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA. Electronic address:

Dizziness can be due to pathology from multiple physiologic systems, the most common being vestibular. Dizziness may be categorized as vertigo, disequilibrium, lightheadedness, or oscillopsia. Vertigo is an illusion of motion often caused by asymmetrical vestibular input to the brainstem. Read More

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November 2018

Spontaneous Canalith Jam and Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo: Considerations on a Particular Case Mimicking an Acute Vestibular Deficit.

Otol Neurotol 2018 10;39(9):e843-e848

Department of Neurosciences, Institute of Otolaryngology, Padova University, Padova, Italy.

Objective: Canalith jam refers to a condition caused by an otolithic clump blocked inside a semicircular canal, generally provoked by canalith repositioning procedure. We describe the first case of spontaneous canalith jam mimicking an acute vestibular deficit.

Patient: We report the case of an 82-year-old woman who suffered a sudden episode of persistent rotational vertigo with nausea and vomiting, not provoked by head movements. Read More

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October 2018

Comparison of the effectiveness of Brandt-Daroff Vestibular training and Epley Canalith repositioning maneuver in benign Paroxysmal positional vertigo long term result: A randomized prospective clinical trial.

Pak J Med Sci 2018 May-Jun;34(3):558-563

Hakan Coskun, Uludag University Medical School, Department of Otolaryngology, Bursa, Turkey.

Objective: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid change in head position, associated with a characteristic paroxysmal positional nystagmus. Posterior canal benign paroxysmal positional vertigo is the most frequent form of BPPV. Read More

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[Curative effect analysis of the vestibular rehabilitation training on residual dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Jun;31(12):897-900

Department of Otolaryngology Head and Neck Surgery, the First Hospital Shanxi Medical University.

To explore the curative effect and quality life of the vestibular rehabilitation training on residual dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). Residual dizziness after successful canalith repositioning maneuvers in patients with BPPV were enrolled in our study. They were randomized into three groups, the control group A were no disposition which include 32 patients, the intervention group B were guided to self rehabilitation training which include 33 patients, the control group C were guided to Brandt Daroff training which include 33 patients. Read More

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[Relationship between 25-hydroxyvitamin D levels and idiopathic benign paroxysmal positional vertigo in female patients].

Zhonghua Yi Xue Za Zhi 2018 Apr;98(16):1223-1226

Department of Neurology, Ningbo No.2 Hospital, Ningbo 315010, China.

To investigate the relationship between serum 25-hydroxyvitamin D[25(OH) D] levels and idiopathic benign paroxysmal positional vertigo (BPPV) in female patients. A total of 67 women diagnosed with idiopathic BPPV were selected as the study group between January and December 2016 in Ningbo No.2 Hospital, and 95 healthy women without a history of vertigo or dizziness were selected as the control group. Read More

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Treatment of Patients With Benign Paroxysmal Positional Vertigo and Severe Immobility Using the Particle Repositioning Chair: A Retrospective Cohort Study.

Ann Otol Rhinol Laryngol 2018 Jun 7;127(6):390-394. Epub 2018 May 7.

2 Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Novi, Michigan, USA.

Objective: To report treatment of benign paroxysmal positional vertigo (BPPV) in patients unable to undergo traditional canalith repositioning maneuvers (CRMs) using a particle repositioning chair (PRC).

Methods: A retrospective chart review was conducted at a single high-volume otology practice of patients diagnosed with BPPV from 2007 to 2017 with immobility prohibiting use of traditional CRMs. Patients were diagnosed and treated using a PRC, and outcome measures including resolution, recurrence, and number of treatment visits were recorded. Read More

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Peripheral Vestibular Disorders in Children and Adolescents with Concussion.

Otolaryngol Head Neck Surg 2018 08 24;159(2):365-370. Epub 2018 Apr 24.

1 Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA.

Objective To review peripheral vestibular disorders in pediatric patients with dizziness following concussion. Study Design Case series with chart review. Setting Pediatric vestibular clinic and pediatric multidisciplinary concussion clinic at a tertiary level pediatric hospital. Read More

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The aVOR App Increases Medical Students' Competence in Treating Benign Paroxysmal Positional Vertigo (BPPV).

Otol Neurotol 2018 06;39(5):e401-e406

Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany.

Hypothesis: Implementation of the "aVOR app" into teaching courses at medical school enhances students' satisfaction with the course and increases their competence in treating benign paroxysmal positional vertigo (BPPV).

Background: BPPV is often underdiagnosed and left untreated. One problem in teaching the management of BPPV to health care professionals is the lack of simulation-based training tools. Read More

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The impact of diabetes on mobility, balance, and recovery after repositioning maneuvers in individuals with benign paroxysmal positional vertigo.

J Diabetes Complications 2017 Jun 22;31(6):976-982. Epub 2017 Mar 22.

Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160.

Aim: The prevalence of benign paroxysmal positional vertigo (BPPV) is higher in people with type 2 diabetes (DM). The impact of DM on mobility, balance, and management of BPPV is unknown. This prospective study compared symptom severity, mobility and balance before and after the canalith repositioning maneuver (CRM) in people with posterior canal BPPV canalithiasis, with and without DM. Read More

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Benign paroxysmal positional vertigo secondary to laparoscopic surgery.

SAGE Open Med Case Rep 2017 8;5:2050313X17692938. Epub 2017 Feb 8.

Department of Otolaryngology Head and Neck Surgery and Institute of Vertigo, General Hospital of Chinese People's Armed Police Forces, Beijing, China.

Objectives: Benign paroxysmal positional vertigo is a common vestibular disorder and it may be idiopathic or secondary to some conditions such as surgery, but rare following laparoscopic surgery.

Methods: We report two cases of benign paroxysmal positional vertigo secondary to laparoscopic surgery, one after laparoscopic cholecystectomy in a 51-year-old man and another following laparoscopic hysterectomy in a 60-year-old woman.

Results: Both patients were treated successfully with manual or device-assisted canalith repositioning maneuvers, with no recurrence on the follow-up of 6 -18 months. Read More

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February 2017

Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).

Otolaryngol Head Neck Surg 2017 03;156(3_suppl):S1-S47

16 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.

Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV. Purpose The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. Read More

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Central positional nystagmus associated with cerebellar tumors: Clinical and topographical analysis.

J Neurol Sci 2017 Feb 27;373:147-151. Epub 2016 Dec 27.

Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address:

Purpose: Positional nystagmus is usually caused by peripheral vestibular disorder, mostly benign paroxysmal positional vertigo (BPPV). However, positional nystagmus is also encountered in central lesions. We aimed to determine clinical characteristics of the structures responsible for central positional nystagmus (CPN) associated with brain tumors. Read More

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February 2017