Objective findings in patients with multi-canal benign paroxysmal positional vertigo

Yanhan Zhu; Xiaoming He; Mei Hu; Chun Mao; Zheng Liu; Xu Yang; Jing Yang; Liying Chang

doi:10.1177/01455613211066679

Objective findings in patients with multi-canal benign paroxysmal positional vertigo

Ear Nose Throat J. 2021 Dec 21:1455613211066679. doi: 10.1177/01455613211066679. Online ahead of print.

Authors

Yanhan Zhu¹, Xiaoming He¹, Mei Hu¹, Chun Mao¹, Zheng Liu¹, Xu Yang², Jing Yang¹, Liying Chang¹

Affiliations

¹ Department of Neurology, Xiangyang Central hospital, 74731Affiliated hospital of Hubei University of Arts and Science, Xiangyang, China.
² Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, P.R. China.

PMID: 34932919
DOI: 10.1177/01455613211066679

Abstract

Objective: The study aimed to investigate the clinical characteristics of patients with multi-canal benign paroxysmal positional vertigo (MC-BPPV).

Methods: We performed a retrospective analysis of 927 patients with BPPV who were admitted to our hospital between January 1, 2016 and December 31, 2019. The clinical data of all patients were collected. The Dix-Hallpike, straight head-hanging, and supine Roll tests were performed in all patients. The nystagmus was recorded using videonystagmography. The clinical characteristics of patients with MC-BPPV and single canal BPPV (SC-BPPV) was analyzed and compared.

Results: Among 927 patients included, 49 (5.29%) patients had MC-BPPV, 878 (94.71%) patients had SC-BPPV. There were significant differences in the male to female ratio (1:3.90 vs 1:1.81, P < .05), mean age (62.47±12.51 vs 59.04±13.72, P < .05), as well as the ratio of cupulolithiasis to canalithiasis (1:1.45 vs 1:4.78, P < .01) between patients with MC-BPPV and SC-BPPV. The frequency of involvement of PC, HC, and AC were involved for 66 (67.35%), 23 (23.47%), and 9 (9.18%) times, respectively, in patients with MC-BPPV, which were involved in 581 (66.17%), 281 (32.0%), and 16 (1.82%) patients, respectively, in patients with SC-BPPV. No significant difference was found in the frequency of involvement of PC and HC between patients with MC-BPPV and SC-BPPV, while there was significant difference in the frequency of AC involvement between 2 groups (P < .01). Ipsilateral PC-HC-BPPV (n = 18) and bilateral PC-BPPV (n=19) were the most common among patients with MC-BPPV. Twenty-six (53.06%) patients had ipsilateral MC-BPPV, 23 (46.94%) had bilateral MC-BPPV. Of the 26 patients with ipsilateral MC-BPPV, 7 patients combined with unilateral peripheral vestibular disorder.

Conclusion: Patients with MC-BPPV had a significantly older mean age at disease onset and a higher proportion of females compared with patients with SC-BPPV. Cupulolithiasis was more common in MC-BPPV. AC involvement was also much more common in MC-BPPV than in SC-BPPV.

Keywords: benign paroxysmal positional vertigo; clinical characteristics; multiple semicircular canals; vestibular disease.