Treatment of Geotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

Overview

The purpose of this study was to compare the immediate efficacies of each treatment maneuvers in treatment of geotorpic horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

Full Title of Study: “Treatment of Geotropic Horizontal Canal Benign Paroxysmal Positional Vertigo; Randomized Controlled Trial of Barbeque Rotation and Gufoni Maneuver”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Participant, Investigator)
  • Study Primary Completion Date: April 2011

Detailed Description

A randomized prospective study of patients with HC-BPPV. Patients with geotropic type of HC-BPPV were randomized to one of each three treatment groups at their first clinic visit. These groups included the barbecue maneuver, Gufoni's maneuver, and sham group in geotropic HC-BPPV. Responsiveness of treatment maneuver was determined by positioning maneuver immediately after each treatment method based on resolves of vertigo and positional nystagmus.

Interventions

  • Procedure: Gufoni
    • For Gufoni maneuver, the patient was quickly brought down on the healthy side from the sitting position, and the head was then turned about 45 degree down, so that the nose was on the bed. After 2 minutes in this position, the patient was returned to the upright position.
  • Procedure: Sham
    • The sham maneuver the opposite of the first step for barbecue rotation; lying down from sitting position for 30 seconds, and head turn 90degree to the affected side for 1 minute, and then sit up.
  • Procedure: Barbecue
    • For barbecue rotation, the head was rotated rapidly 90degree while supine in the direction of the healthy ear, which was immediately followed by a truncal rotation of 90degree in the same direction to lie on the intact side. After 30-60 seconds when the induced nystagmus was dissipated, the patients were subjected to a further 90degree rotation of the head and trunk en block in the same direction to attain the nose-down position. After a further 30-60 seconds, the head was again turned in the same direction so that the affected ear was downward. Finally, after another 30-60s, the patient was brought to sitting position. Only one maneuver was performed per session.

Arms, Groups and Cohorts

  • Active Comparator: Gefoni manenuver
    • Gefoni manenuver for Geotropic HC-BPPV
  • Active Comparator: sham maneuver
    • sham maneuver for geotropic HC-BPPV
  • Active Comparator: barbecue maneuver
    • barbecue maneuver for geotropic HC-BPPV

Clinical Trial Outcome Measures

Primary Measures

  • Immediate therapeutic effects for the treatment of geotropic HC-BPPV
    • Time Frame: one hour
    • The immediate treatment response was determined by participating neurologists in each clinic without knowing the maneuver applied to each patient from 30 minutes to one hour after initial maneuver. The absence of both vertigo and nystagmus was required to determine a resolution. When the patient still showed positioning nystagmus or vertigo, the patient received the previously applied maneuver again.

Participating in This Clinical Trial

Inclusion Criteria

  • a history of brief episodes of positional vertigo, direction-changing horizontal nystagmus beating toward the uppermost (apogeotropic nystagmus) ear in both the lateral head turning positions, – no spontaneous nystagmus during upright sitting position – absence of identifiable central nervous system disorders that could explain the positional vertigo and nystagmus Exclusion Criteria:

  • central positional nystagmus with identifiable CNS lesions that could explain the positional nystagmus

Gender Eligibility: All

Minimum Age: 11 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Chonbuk National University
  • Collaborator
    • Seoul National University Bundang Hospital
  • Provider of Information About this Clinical Study
    • KONOS, Korean neuro-ophthalmology and neuro-otology society

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