Benign paroxysmal positional vertigo simultaneously affecting several canals: a 46-patient series

Area of Science:

• Neurology
• Otolaryngology
• Vestibular Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
• While typically affecting a single semicircular canal, multi-canal involvement can occur.

Purpose of the Study:

• To investigate potential differences between single-canal BPPV and multi-canal BPPV (unilateral and bilateral).
• To compare aetiology, demographics, treatment response, recurrence, and outcomes across BPPV groups.

Main Methods:

• Prospective study of 583 BPPV patients, categorized into single-canal, unilateral multi-canal, and bilateral multi-canal groups.
• Diagnosis via Dix and Hallpike, supine roll, and cephalic hyperextension tests.
• Treatment using canalith repositioning maneuvers (Semont, Epley, Lempert, Yacovino).

Main Results:

• 46 multi-canal cases (8%) identified: 36 bilateral, 10 unilateral.
• Idiopathic BPPV more frequent in single-canal cases (p < 0.0001).
• Post-traumatic BPPV more common in bilateral multi-canal cases (p = 0.006).
• Prior BPPV history more frequent in unilateral multi-canal cases (p = 0.006).
• No significant differences in treatment response, recurrence, or final status observed between groups.

Conclusions:

• Aetiological factors distinguish single-canal, unilateral multi-canal, and bilateral multi-canal BPPV.
• Therapeutic maneuvers demonstrate high efficacy, with over 90% cure rates across all BPPV presentations.