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7 16) Buttner U, Helmchen CH, Brandt TH: Diagnostic criteria for central versus peripheral positioning nystagmus and verigo: a review. Acta Otolaryngol (Stockh) 119: 1-5, ) Epley JM: The canalith repositioning procedure: for treament of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 107: , ) Lempert T, Tiel-Wilck K: A positional maneuver for 1) McClure JA: Horizontal canal BPV. J Otolaryngol treatment of horizontal-canal benign positional vertigo. Laryngoscope 106: , : 30-35, ) Baloh RW: Benign positional vertigo. Disorders of the vestibular system. eds by Baloh RW, Halmagyi CM. Oxford university press: pp , ) Thomas Brandt: Benign paroxysmal positioning vertigo. Vertigo: its multisensory syndromes. 2nded. by 21) Hordman SJ, Tusa RJ: Complications of the canalith repositioning procedure. Arch Otolaryngol Head Brandt T. Springer-Verlag: pp , Neck Surg 122: , ) Furman JM, Cass SP: Benign paroxysmal positional 22) Imai T, Takeda N, Morita M, Koizuka I, Kubo T, et vertigo. N Engl J Med 341: , al: Rotation vector analysis of eye movement in three 7) Hall SF, Ruby RRF, MaClure JA: The mechanics of dimensions with an infrared CCD camera. Acta benign paroxysmal vertigo. J Otolaryngol 8: , Otolaryngol 119: 24-28, ) Baloh RW, Honrubia V, Jacobson K: Benign 8) Parnes LS, McClure JA: Free-floating endolymph positional vertigo: Clinical and oculographic features in 240 cases. Neurolory 37: , particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 102: ) Anastasopoulos D, Lempert T, Gianna C, Gresty MA, 992, Bronstein AM: Horizontal otolith-ocular responses 9) Schuknecht HF: Cuplolithiasis. Arch Otolaryngol to lateral translation in benign paroxysmal positional 90: , vertigo. Acta Otolyngol (Stockh) 117: , 1997.

8 30) Mizikoshi K, watanabe Y, Shojaku H, Okuda J, Watanabe I: Epidemiological studies on benign par. oxysmal positional vertigo in Japan. Acta Otolaryngol (Stockh) Suppl 447: 67-72, ) Hughes CA, Proctor L: Benign Paroxysmal Positional Vertigo. Laryngoscope 107: , ) Froeing DA, Silverstein MD, mohr DN, Beatty CW, Offord KP, Ballard DJ: Benign positional vertigo: incidence and prognosis in a population-based study in Olmsted country, Minnesota. Mayo Clin Proc 66: , Clinical Features of Benign Paroxysmal Positional Vertigo Atsuhiko Uno, M.D., Kazuhiro Moriwaki, M.D., Takashi Kato, M.D. Miki Nagai, M.D. and Yoshiharu Sakata, M.D. Department of Otolaryngology, Suita Municipal Hospital, Osaka Our understanding of the pathomechanism of benign paroxysmal positional vertigo (BPPV) has improved dramatically. A type of BPPV featuring mixed torsional and vertical nystagmus induced by the Dix-Hallpike maneuver involves the posterior semicircular canal (P-BPPV). The other type of BPPV featuring horizontal nystagmus induced by spine-to-lateral head positioning involves the horizontal canal BPPV (H-BPPV). In complaints of vertigo or dizziness, 619 patients visited our department last year. Of these, 142 (23%) was had positional nystagmus consistent with a diagnosis of BPPV, 118 (19%) had no nystagmus but were suspected of BPPV due to vertigo episodes. BPPV was the most frequent diagnosis. H-BPPV was not rare, but accounted for 30% of BPPV. Of H-BPPV, 73% featured direction changing geotropic nystagmus, and 27% direction changing apogeotropic nystagmus. H-BPPV resolved faster than P-BPPV. Most cases caused by head trauma were P- BPPV. Transition between P- and H-BPPV was found in 6 cases. Women outnumbered men by about 3 to 2 in both P- and H-BPPV. Peak incidence was found in the those in their 60s and 70s, suggesting that the etiologies of both types of BPPV are essentially the same. Keywords: benign paroxysmal positional vertigo, posterior semicircular canal type, horizontal semicircular canal type J Otolaryngol Jpn 104: 9-16, 2001

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