Benign Paroxysmal Positional Vertigo: Concomitant Involvement of Different Semicircular Canals

• Published in: Annals of otology, rhinology & laryngology rhinology & laryngology, 2009-02, Vol.118 (2), p.113-117
• Main Authors: Tomaz, Andreza, Ganança, Maurício Malavasi, Ganança, Cristina Freitas, Ganança, Fernando Freitas, Caovilla, Heloisa Helena, Harker, Lee
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Audiometry, Pure-Tone; Biological and medical sciences; Diagnosis, Differential; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Posture - physiology; Retrospective Studies; Semicircular Canals - physiopathology; Tilt-Table Test; Vertigo - diagnosis; Vertigo - physiopathology; Young Adult
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/000348940911800206

Objectives: We evaluated the simultaneous ipsilateral or contralateral involvement of the posterior and lateral, anterior and lateral, or posterior and anterior semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). Methods: The files of 2,345 patients with BPPV were analyzed. Results: Single-canal BPPV occurred in 2,310 cases (98.5%) — Unilaterally in 2,058 (89.1%) and bilaterally in 252 (10.9%). Multiple-canal BPPV occurred in 35 cases (1.5%). Of these 35 cases, there was simultaneous involvement of the posterior and lateral canals on the same side (23) or on opposite sides (9) in 32 cases (91.4%). Simultaneous involvement of the anterior canal on one side and the posterior canal on the opposite side occurred in 2 cases (5.7%), and that of the anterior canal on one side and the lateral canal on the opposite side occurred in 1 case (2.9%). All cases represented canalithiasis. Conclusions: Multiple-canal BPPV was rare, and usually involved canals on the same side; simultaneous involvement of the posterior and lateral canals was much more common than involvement of the anterior and posterior canals or the anterior and lateral canals. Trauma increased the risk for multiple-canal BPPV, but not the risk for bilateral single-canal BPPV. Cupulolithiasis was not a factor in multiple-canal BPPV.